What to Do When a Claims Adjuster Is Not Returning Calls and Causing Delays

See common excuses for insurance claim delays, and what you can do when the claims adjuster ignores your calls.

Injuries from an accident are disruptive and expensive. After filing a claim, it’s understandable to expect the insurance adjuster’s full attention.

Whether you’re dealing with the at-fault party’s insurer or your own insurance company, you want prompt service.

While some types of insurance claims settle in a few weeks, personal injury claims can take several months of negotiations. There are often delays before the claimant and adjuster reach a settlement agreement.

Here we discuss how to handle delays, and what to do if the adjuster is not returning your calls.

Why the Adjuster Isn’t Returning Your Phone Calls

One of the ways insurance adjusters exercise control during settlement negotiations is by taking their time when responding to you. Nobody likes to be kept waiting.

Adjusters handle a high volume of injury clams every day. They may be holding off to see how desperate you are to settle your claim, but they are just as likely to be swamped with work.

Common excuses adjusters give for delays:

  • A high caseload with other, more serious claims
  • The time it takes to gather information from witnesses, police reports, and others
  • Review of the claim by insurance company management
  • The time it takes to collect information from you

Promptly send copies of your medical bills and records, lost wage statements, and other proof of expenses to the adjuster. Keep the original documents in your claim file. Keep track of what you sent to the adjuster and the mailing date.

Tactical reasons for adjuster delays:

  • They want accident victims to be financially desperate enough to accept a lower settlement
  • The longer the insurance company holds on to its money, the more interest they collect
  • In most states, insurers don’t have to settle third-party claims promptly

The insurance adjuster might say they can’t process your claim unless you give them a recorded statement. You are not legally obligated to provide a recorded statement to the at-fault party’s insurance company. Giving a statement can help move things along. However, anything you say can be used against you.

You have the right to consult a personal injury lawyer before agreeing to a recorded statement, or at any other time during the negotiation process.

What’s a Reasonable Response Time?

Many states have Claim Settlement Practices laws that require insurance companies to respond to claimants in a reasonable amount of time, but don’t specify what’s a reasonable timeframe.

For example, Texas prohibits insurers from:

“[F]ailing to acknowledge with reasonable promptness pertinent communications relating to a claim arising under the insurer’s policy”

In most cases, it’s probably reasonable to expect a response from the insurance company within two weeks of your communication.

Use our Personal Injury Claim Status Log to keep track of communications and the progress of your injury claim.

How to Handle Insurance Claim Delays

If you go into the negotiation knowing it may stretch over several weeks or months, you’ll not only sleep better, but you’ll probably end up with a higher settlement. By taking your time, you will use more objective reasoning and arguments, and avoid giving in to the anxiety and frustration that leads to bad decisions.

While persistence is important, avoid the temptation to call the insurance adjuster too soon after you’ve made a settlement demand or counteroffer.

Make Effective Follow Up Calls

Negotiating with patience doesn’t mean you can’t call the adjuster if you think it’s been too long since you last spoke. There’s nothing wrong with picking up the phone, so long as you remain professional.

You aren’t trying to be the proverbial squeaky wheel. If you leave a voicemail, let it signal your restraint and determination. Don’t let your frustration show. The adjuster is looking for any weakness they can use as leverage to lower your settlement.

Here’s a good voicemail example:

“Hello John, this is Bill Monroe. My claim number is 23567. We last spoke on May 11th. At that time, I informed you that your offer of $2,400 was unacceptable. On May 13th, I mailed you my counteroffer of $5,100. I have yet to hear from you.

Please get back to me at your earliest convenience so we can settle this matter. My telephone number is 555-345-2741. I look forward to hearing from you.”

The above example conveys restraint and patience, while reminding the adjuster of your intent to resolve your claim. A claims adjuster will respond more quickly to a polite message.

Don’t leave a voicemail like this:

“John, this is Bill. I’m tired of waiting for you to call me back. I sent you a letter with my new demand. Why haven’t you called me yet? I’ve waited long enough. I want to speak to your supervisor. I want my money now!”

Rude or threatening communications will backfire on you. Not only will most adjusters let rude claimants sink to the bottom of their call-back list, this message lets the adjuster know you’re not likely to hold out for more money.

Go Over the Adjuster’s Head

When you have waited for weeks with no response to your follow-up call or email, it’s time to go up the chain of command.

Call the toll-free number for the insurance company’s main office and ask for the name, phone number, and email address of the Claims Manager for injury liability claims. Be prepared to provide the dates of your attempted communications with the adjuster assigned to your claim, and when you last heard from them.

If the manager says the adjuster is out of the office for business reasons or personal leave, ask who will be handling your claim, their contact information, and when you will hear from them.

Lodge a Bad Faith Complaint

Sometimes unnecessary claim delays are bad enough to rise to the level of bad faith insurance practices.

Bad faith delays may include:

  • Taking an unreasonable amount of time to determine insurance policy coverage
  • Repeatedly asking for medical records you’ve already provided
  • Refusing to return calls or email, despite contacting the manager
  • Intentional delays in an attempt to run out the statute of limitations

Most states only allow first-party bad faith lawsuits, meaning the insurance company is not dealing in good faith with their policyholder.

If your claim is against the at-fault party’s insurance company, meaning a third-party claim, seek legal advice from a personal injury attorney to see if you have standing to file a bad-faith lawsuit. If not, you can still lodge a complaint with your state’s insurance commissioner.

Workers’ compensation claim issues can be directed to the state workers’ compensation board by the injured worker or their attorney.

Prepare to Negotiate with Patience

Insurance adjusters are trained negotiators with a variety of negotiation styles and tactics designed to push your buttons and get you to settle for less.

Careful preparation is the best way to keep a firm footing during negotiations. Don’t let the adjuster push you into discussing a settlement before you fully recover from your injuries.

Take the time you need to do your homework so you can prove the at-fault party is responsible and defend the value of your claim.

You can bet the adjuster has an organized claim file in front of them when they sit down to negotiate, and you should too.

Your injury claim file should include:

In a perfect world, the adjuster would thank you for making a fair demand, apologize for the inconvenience you suffered at the hands of their insured, and mail you a check for the full amount. Unfortunately, in the imperfect world of personal injury claims, adjusters don’t apologize to victims, and prompt settlements are the exception, not the rule.

You can negotiate with patience and confidence when you know your case inside out, and have supporting documentation at your fingertips.

Claims adjusters try hard to maintain the upper hand in settlement negotiations, and can sometimes be manipulative and confrontational.

When Negotiations Fail

Most insurance claims settle for a reasonable amount of money after a few weeks or months of back-and-forth negotiations. It’s in the best interest of the insurance company to settle your claim and obtain a release for their insured.

Unfortunately, not all adjusters negotiate in good faith, and some are just plain incompetent.

If your settlement negotiations have stalled, or the adjuster won’t come off a ridiculously low settlement offer, you likely need an attorney to resolve your claim.

Most injury attorneys offer a free consultation to injury victims. There’s no cost to find out what an experienced personal injury law firm can do for you.

Charles R. Gueli, Esq. is a personal injury attorney with over 20 years of legal experience. He’s admitted to the NY State Bar, and been named a Super Lawyer for the NY Metro area, an exclusive honor awarded to the top five percent of attorneys. Charles has worked extensively in the areas of auto accidents,... Read More >>