Dealing with a claims adjuster can become extremely frustrating. You need the claims adjuster to get in touch with you to let you know what has happened with your claim, what the next steps look like, and how much compensation you can expect for your injuries. If you had a car accident, you may need the claims adjuster to let you know when you can start vehicle repairs or what steps you need to take to get an estimate for those repairs so that you can get your vehicle back sooner.
When the claims adjuster will not call back, you may find yourself wondering what comes next. California puts deadlines on the insurer, and there are two concrete ways to make it answer.
How Long Does an Insurance Adjuster Have to Respond in California?
California puts deadlines on the insurer too. They live in the Fair Claims Settlement Practices Regulations, and most people never hear about them. Four of them matter when an adjuster goes quiet.
15 calendar days to acknowledge your claim. Section 2695.5(e) gives the insurer 15 calendar days from notice of claim to acknowledge it and send you the forms, instructions, and reasonable assistance you need to file.
15 calendar days to answer you. Under section 2695.5(b), when you send the insurer any communication that reasonably suggests you expect a response, it has 15 calendar days to give you a complete answer based on what it knows. That duty stops once you have served a lawsuit.
40 calendar days to accept or deny. Section 2695.7(b) gives the insurer 40 calendar days after proof of claim to accept or deny the claim, in whole or in part. Proof of claim means the documentation showing what you lost, not the day you first called. This deadline does not cover repair bills under your own collision or comprehensive coverage, which matters if you go the route described further down.
Written updates every 30 days after that. If it needs longer, section 2695.7(c) requires written notice before the 40 days run out stating what it still needs and why, then another written update every 30 calendar days until it makes a decision or you serve a lawsuit.
These are deadlines on the company, not promises about your outcome. But they turn “the adjuster is ignoring me” into a specific date you can point at.
The Two Levers That Force a Response
Start putting things in writing. A dated email or letter is what starts the 15-day clock under section 2695.5(b) and leaves a record that a phone call does not.
Then consider a complaint to the California Department of Insurance. This is the step most people do not know about. Under section 2695.5(a), if the Department sends an insurer a written or oral inquiry about a claim, the insurer has 21 calendar days to give the Department a complete written response, including the claim file documents the Department asks for. The Department decides whether to open an inquiry, so this is not automatic, and the response goes to the Department rather than to you.
If you have already sent a demand and heard nothing, there are separate rules on how long an insurer can take to respond to a demand letter.
Why Claims Adjusters Quit Calling
Claims adjusters may stop returning your calls for a variety of reasons, some of them directly related to your claim, and some of them related specifically to how the insurance company works. Actually, claims adjusters may stop calling more frequently than the average person thinks when dealing with a personal injury claim; sometimes because they stay too busy to address every phone call, and sometimes as a tactic that may help push you to accept a low settlement.
1. The insurance adjuster may try to deliberately slow down the claim.
Legally, the insurance company knows that, once it agrees with you, it has a limited time to pay out. Slowing the claim can offer several advantages to the insurance company.
While you wait, you may grow increasingly impatient.
You have medical bills coming in and other expenses that you need to take care of. You may have to rely on the compensation from your personal injury claim to cover many of those costs. As a result, you may grow increasingly impatient as you wait for the insurance adjuster to call you back. You may find yourself more willing to accept a settlement offer that does not reflect your needs as time goes on. The insurance company knows that waiting may increase your overall impatience and make you more likely to accept their offer. As a result, the insurance adjuster may try to wait on purpose.
The insurance company can continue to earn interest on its money while it waits to pay you.
Insurance companies exist to make money. When the insurance company pays out a settlement to you, it will no longer have the funds from that settlement. By dragging out the claim process, the insurance company can increase its overall profits for the year.
2. The insurance adjuster might have nothing new to report.
To make you a settlement offer, or to respond to your attempts at negotiation, the insurance company will need to investigate the accident. That investigation can take considerable time. The insurance company may need to look at all potential causes of the accident, what factors contributed to the accident, and whether you may bear any liability for the accident and your injuries. The insurance company may also want time to look over your medical records or even to investigate you and your activities after the accident, especially if you claim substantial disability.
Sometimes, an overworked insurance adjuster may choose not to call you back because they have nothing new to report. No new information has come out, and the company still needs time to investigate the accident. In the meantime, the insurance adjuster may not have a reason to choose to communicate with you.
3. The insurance company might choose its time to communicate with you carefully.
The insurance company may choose to communicate with you on its timeline. For example, the insurance adjuster might think that you have lied about the extent of your injuries or how they affect you, which means that the insurance company might wait until you feel pressured and become more likely to trip yourself up.
Dealing with delays in insurance processing can make it very difficult to move forward, especially as your bills start to pile up. You may need to take care of your medical expenses quickly. You might feel increasingly frustrated by the losses you have dealt with after the accident. Unfortunately, the insurance company will typically serve its best interests over yours.
4. Overworked insurance adjusters may not have time to respond to every call.
Frequently, insurance companies have too few adjusters working to manage too many claims, especially in the case of sudden jumps in claims or accidents in general. Overworked adjusters may not have time to respond to all the claims on their desks or to deal with all the questions that come their way. Sometimes, they may have to prioritize. Other times, some claims may fall through the cracks. Most adjusters do not mean it as a personal slight, and you should not take it as one. However, you can acknowledge that you need to receive communications more frequently.
What to Do When the Claims Adjuster Will Not Call Back
Some time has passed since the claims adjuster’s last call. You have made calls of your own but still have not received a call back. What should you do next? You may have issues that need to be addressed as soon as possible. What can you do?
Step One: Contact a Lawyer
If you suffered injuries in an accident, you should work with a lawyer to help manage your claim as effectively as possible anyway. A lawyer can tell you what the claim is actually worth, which of the deadlines above the insurer has already missed, and what a fair settlement for your injuries looks like.
A lawyer can also help move the claim process through more smoothly. Sometimes, a lawyer can help put pressure on the insurance company, which may give you a better chance of getting the attention you need. Other times, putting a lawyer on the file changes who the adjuster is dealing with, and in our experience that alone often gets a stalled claim moving.
Working with a lawyer can also help give you a better idea of your options and your rights after a car accident, which may make it easier for you to make decisions about your claim. A lawyer can help review the insurance policy that covers the liable party, discuss your options with you, and give you a better idea of what can make your life easier as you manage your injuries and your claim.
Step Two: Consider Using Your Own Insurance
If you suffered injuries in a car accident, and you need to take care of repairs to your vehicle sooner, you may have the option to use your own auto insurance. Some people balk at the idea of filing through their own insurance companies when the other driver clearly caused the accident. However, if you need to take care of repairs faster, you may find that using your personal insurance company can offer a more effective strategy.
Which carrier is on the other side matters too. Filing against State Farm, Liberty Mutual, Allstate, or USAA each runs through a different portal and phone line.
Collision Coverage
If you carry collision coverage on your vehicle, it will provide compensation that will allow you to cover the cost of repairs regardless of who caused an accident, minus the cost of your deductible. Your insurance company will usually approve repairs to your vehicle within a matter of days. If you have to wait on the other driver’s insurance company, on the other hand, you may find yourself waiting for weeks, or perhaps even longer, to get the go-ahead to begin repairs. Your insurance company may also argue less about the provider you choose to manage your vehicle repairs.
If you do use your collision coverage to cover the cost of repairs to your vehicle, your insurance company will then pursue compensation from the other driver’s insurance company. Once your insurance company receives that check, you will typically receive your deductible back, as well. In the meantime, you will have the use of your vehicle.
MedPay Insurance
California drivers have the option to add MedPay insurance coverage to their auto insurance. MedPay insurance offers coverage or compensation for medical bills you sustain as a result of a car accident. You can use your MedPay coverage regardless of who caused the accident, allowing you to take care of your medical bills, avoid collections, and get the treatment you need for your injuries.
Medical Insurance
If you carry personal medical insurance, it is your main defense against high medical bills, from the cost of emergency transport immediately after the accident, to the cost of surgical care, physical therapy, and your ongoing medical expenses. Medical insurance limits what comes out of your own pocket while the claim is unresolved.
Step Three: Keep Following Your Doctor’s Instructions
Your doctor may have created a care plan that includes a highly specific set of instructions that help increase your odds of making a full recovery. That may mean going through certain treatments, doing exercises that will help you regain strength and mobility, or avoiding certain activities that could worsen your injuries or slow down your recovery.
While you wait to hear back from the claims adjuster, continue to follow the instructions your care provider has laid out. If you ignore those instructions, not only could it slow down your recovery, it gives the insurer an argument that your own choices caused part of the harm.
The insurer can argue that your own choices worsened the injuries, and discount the claim to match.
If you can show that you followed your care plan, on the other hand, it is harder to argue that anything but the crash caused your injuries.
Step Four: Watch Your Social Media Posts
Social media posts, all too often, make difficulties for the victims of serious accidents. Sometimes, you might want to talk about your accident online and share information about what your recovery has looked like. You might want to share your triumphs with all your friends and loved ones or ask for their prayers and support during your recovery.
Those social media posts, however, can allow the insurance company to judge your progress on its own. Social media often reflects a distorted view of what your recovery looks like often by portraying you as further down the road to recovery than you have traveled, since you may want your followers to celebrate with you insurance adjusters may use that information to minimize the compensation they offer.
You may also need to watch the information you post about your other activities during your recovery. Sometimes, you may want to post about the activities you have enjoyed with friends and loved ones after the accident. You may want to continue to share those memories for future you to look back on, or you might want to post some positive moments in the chaos surrounding your accident.
Those posts can undercut the claim. The insurance company may, for example, use those posts to help prove that your injuries do not limit you as much as you claimed. If you can engage in those activities, the insurance company might argue, you can certainly work. The insurance company may not account for the pain you faced because of those activities or the other sacrifices you made to enjoy that single activity.
When managing a personal injury claim, especially when the insurance adjuster will not call you back, stay patient. Personal injury claims can take time, often more than you initially anticipated. If you have questions about your claim, including how to deal with an insurance adjuster, contact an attorney to learn more or to receive help managing your claim.
