Insurance Claim Timeline: How Long Will Investigation and Approval Take?

Michael S. Callahan | | Insurance
how long does an insurance company have to investigate a claim

In theory, the insurance claim process should be simple. But in reality, the process can become complicated and it’s normal if you’re left wondering not only how long the insurance claim timeline is, but how to navigate it.

One of the reasons why the insurance claim can become more complex is because insurance adjusters may take advantage of policyholders’ lack of knowledge regarding the insurance claim timeline.

As a policyholder, you have a right to have your claim processed in a timely fashion. But what exactly is the appropriate timeline that your insurance claim should be processed?

Learn more about the investigation timeline and how The Callahan Law Firm can protect your insurance investigation rights.

The Insurance Claim Timeline

There are three mandatory steps that must happen throughout the insurance claim process.

  • Filing the claim
  • Recognizing the claim and starting the investigation process
  • Determining the outcome of the claim.

Each of these steps is required to happen through a specific time period. While it is recommended to file your claim as soon as possible, you have a time period of up to two years from the date of your car accident to file.

Once your claim has been filed, the insurance company must notify you of acknowledgment of your claim and start the investigation process within 15 days. After this time period is up, the insurance company should then progress to the outcome of your claim.

All evidence discovered by the investigation should influence the insurance company’s decision. Whatever the outcome for your car accident claim, the insurance company must inform you about its decision.

All in all, the investigation process should take around 35 days to complete. Here is a step-by-step guideline on what you should expect throughout the process.

Providing Notice of the Claim

The first step of the process begins immediately following your accident. It is up to you to not only file your claim but inform your insurance company about it as soon as possible.

For a Texas car accident, you have a two-year time period from the date of your accident to file your claim. However, it may not be in your best interest to wait that long to file.

A common practice of insurance companies is using a policyholder’s time to file against them. Adjusters may question the validity of your accident or insinuate that you were at fault for your accident. When the details of your accident are still relevant, it is easier to challenge these accusations. So even if another person is at fault, it’s best to inform your insurance company of the claim as soon as possible.

Acknowledgment of Claim and Investigation Process

Once you have submitted your claim, the next step is to receive some acknowledgment of your claim from the insurance company.

Why is this important? The insurance company has two 15-day deadlines to meet:

  • One to acknowledge receipt of your claim
  • One to conduct and complete an investigation after all required information is received.

If either one of these deadlines is missed, the insurance company could be operating in bad faith against you. Your claim could be delayed for longer than expected.

After you’ve received acknowledgment of your claim, the investigation process begins. During this process, the adjusters may send you additional instructions on what to expect throughout the process.

The investigation process may involve the following steps:

  • Following up with you to request additional documents.
  • Asking for witness statements.
  • Assessing the damage done to your car.
  • Determining who is at fault for the accident.
  • Reviewing your at-fault accident insurance.

While the investigation process is happening, you may want to consider speaking with an experienced attorney. Adjusters have a legal obligation to conduct a fair and prompt investigation of your claim.

Unfortunately, that legal obligation is often violated. Instead of conducting a fair investigation, adjusters are looking for ways to avoid paying out as many claims as possible.

Working with a focused attorney can protect you from these predatory practices. Your attorney can ensure that the adjusters are not intentionally delaying your claim.

The Determination Process

After the investigation has been completed, the next step is the determination process. This is when your insurance company uses the findings from the investigation to approve or deny your claim.

You should receive two things during this step: the decision for your claim and the insurance company’s reason why it made that decision. The insurance company should not be requesting additional information from you after you’ve received a decision for your claim. If that happens, you may want to speak with an experienced lawyer from The Callahan Law Firm.

Ideally, you should receive approval or denial of your claim towards the end of the second 15-day deadline.

However, the process can take longer than expected for several reasons:

  • Your claim may be missing important information.
  • Your claim could contain incorrect information.
  • Adjusters may be having issues investigating different aspects of your accident.

Although these issues are frustrating, they are even more frustrating when adjusters fail to communicate these delays to policyholders. If you find yourself experiencing these delays during your claim process, you may want to seek legal counsel.

You still have insurance investigation rights, even while dealing with unforeseen delays. An experienced attorney has experience with negotiating with adjusters. They can interact with the adjusters and ensure that communication remains healthy among all parties.

The Final Payout

Once you’ve received approval for your claim, the last and final step is the payout. The insurance company has 5 days from the date of your claim’s approval to transfer your payment and begin repairs on your car.

Exceptions and Penalties

All in all, the insurance company has approximately 35 days to investigate and approve your claim. The only exception to this timeline is if the company needs additional time to process your claim because it has not received all of the necessary information.

Requests for extensions may arise for several reasons. The insurance company may need additional documentation or is waiting for information from another party involved in the accident.

If the reason for the extension is valid, the timeline to process your claim could be extended for up to 10 days. The extension must be granted by a governing board; if it isn’t, that is when the insurance company accepts liability for operating in bad faith against you.

Insurance companies can face legal consequences for improperly denying or delaying your claim, including:

  • Paying the full amount of the claim
  • Accrued interest at a rate of 18% per year.
  • Attorney fees.

Factors That May Delay Your Claim

When you understand your insurance investigation rights, you begin to understand when the insurance company could be delaying your claim intentionally.

Some of the common tactics that insurance companies will use to delay your claim are:

  • Asking for unnecessary documentation, particularly after the investigation has concluded.
  • Failing to provide an explanation as to why there are delays in the process.
  • Prolonging the investigation process without a valid reason.
  • Underestimating the damage done to your vehicle.
  • Offering a lower settlement than expected.

There are proactive steps that you can take to prevent insurance companies from delaying your claim. You can provide as much documentation as possible when filing your claim.

Double-check to make sure that all information provided by you in your claim is valid and filled out.

Make sure to review your insurance policy in case the insurance company argues that there is not enough coverage for your damages. Document all forms of communication with the adjusters in case you need to pursue legal action.

How An Experienced Personal Injury Lawyer Can Help

Even though there is a mandatory timeline for the insurance company to follow, you truly don’t know what route your process will take. You also can’t trust the insurance company to process your claim in a fair and timely manner.

That is why it would be beneficial to seek legal assistance when filing your claim. An experienced personal injury lawyer knows what to expect with insurance adjusters.

They know how to negotiate with insurance adjusters if they offer a lower settlement to you and can also hold adjusters accountable if they attempt to delay your claim.

Speak With an Experienced Insurance Lawyer Today

At The Callahan Law Firm, we understand how frustrating it can be when your claim is delayed. Let our attorneys help you seek the justice that you deserve after your accident.

Contact The Callahan Law Firm today to schedule a consultation. Our attorneys are here to answer your questions and explore all of your legal options.

FAQ

How long is too long to wait for an insurance claim?

Your insurance claim should be approved or denied within 35 days of filing. If the insurance company needs an extension, the deadline will be extended for 10 days.

If you are still waiting more than 45 days later for an answer from the insurance claim, that is too long. In most cases, anything more than 60 days is excessive.

Do insurance companies have a time limit?

Insurance companies do have a time limit to process your claim. 35 days is how long an insurance company has to approve your claim.

In some cases, the insurance company may request an extension based on valid reasons. Sometimes the other parties involved are dragging their feet. Sometimes there must be additional documentation submitted before making a decision.

In this case, the insurance company will request an extension by a governing board. If the extension is granted, they will have an additional 10 days to process your claim.

How long does it take for insurance to make a decision?

There are three deadlines that the insurance company must meet with the insurance claim process:

  • 15 days to acknowledge receipt of the policyholder’s claim.
  • 15 days to conduct an investigation and make a determination after receiving all of the required information.
  • 5 days to send payment to the policyholder (if the claim is approved).

Around the end of the second 15-day deadline, the insurance company should make a decision regarding your claim. If they fail to make a decision, that is when the insurance company could accept liability for delaying your claim.