What to do when your insurance claim is taking too long

Start by finding out which deadline applies in your state and whether the insurer has missed it. Then put your questions in writing, and use your state insurance department’s free complaint process if the answers do not come.

How long does an insurer have to respond, decide and pay?

It depends on your state. United Policyholders, a nonprofit, notes that every state has laws and regulations on how insurers are supposed to handle claims. The day counts are not the same from one state to the next. Three examples:

Each rule has exceptions. In Texas, an insurer that cannot decide in time can take up to 45 more days if it tells you why, and the Texas Department of Insurance says it can extend the deadlines by 15 days after a weather catastrophe. Florida’s 60-day rule, which covers residential property claims, does not count delay caused by factors beyond the insurer’s control.

To see the rules where you live, use the claim clock or the state pages.

A long claim is not always a late one. The NAIC, the association of state insurance regulators, says most people find it takes at least 18 to 24 months to repair or rebuild and replace their belongings after a major disaster, and that payments come in stages. The deadlines above are about the insurer’s steps, not the whole rebuild.

Is the clock running yet?

In some states, the deadline to decide starts only when the insurer has what it asked for. The Texas 15 business days run from the date the insurer receives all the items, statements and forms it requested. Florida’s deadlines can be paused when a policyholder does not send information the insurer asked for.

So the first thing to ask, in writing, is whether the insurer is waiting on anything from you. If it is, send it and keep proof of the date.

One delay is not the insurer’s at all. If you have a mortgage, the repair check is made out to you and your lender, and the lender has to release the money. If that is where the claim is stuck, the NAIC suggests contacting the state agency that regulates banks and mortgage lenders, or your state Attorney General’s office.

How do you document contact with the insurer?

Keep one log for the whole claim. If the adjuster changes, or you file a complaint later, this log is your evidence.

• For every call, write the date and time, the person’s name, their company, what was said, and what happens next. The NAIC claims guide includes a log with these fields.
• After each call, send a short email that repeats what was said. United Policyholders advises confirming agreements in writing.
• Write down each person’s job title, phone number and supervisor’s name.
• Keep copies of everything you send and receive. The California Department of Insurance gives the same advice.

How do you ask for a claim status in writing?

Send an email or letter to the adjuster with your claim number in the subject line. Ask four things:

1. What is the current status of my claim?
2. What documents or information are you still waiting for from me?
3. On what date will you accept or deny the claim?
4. If you need more time, what is the reason?

Give a date you would like a reply by. In California, an insurer has 15 calendar days to respond to a claim communication that calls for an answer.

If the adjuster does not reply, send the same message to the claims manager. The California Department of Insurance also suggests writing to the insurer’s headquarters, and says the address is usually on the first or last page of the policy.

How do you file a complaint with your state insurance department?

Filing is free. The NAIC says a state insurance department can investigate unfair claim delays and lack of timely communication.

1. Try to fix the problem with the insurer first, and keep a record of it.
2. Gather your policy number, claim number, log and letters.
3. Write what happened in date order. Stick to facts. Quote your policy where you can.
4. Say what outcome you want, such as a decision by a set date.
5. File online, by mail or by phone, depending on your state.

The department sends your complaint to the insurer, and the insurer has to answer. In Texas, the insurer has 15 days to respond to the department and can ask for 10 more.

Know the limits. The Texas department says it cannot make a company pay unless the failure to pay breaks a law or the policy, and it cannot settle a dispute over facts. The NAIC adds that an insurer cannot discriminate against you later for filing a complaint.

When does outside help make sense?

For a claim that is only slow, the free steps come first: a written status request, then a complaint.

A public adjuster is a licensed professional you hire to handle the claim for you. You pay the fee, which the NAIC says can be a flat fee or a percentage of the settlement, depending on state law. That can be worth it when the claim is large and the paperwork is more than you can keep up with. United Policyholders puts it this way: the smaller the loss, the less sense it makes to hire someone on a percentage. The two-minute quiz and the fee calculator can help you decide.

An attorney is an option when the insurer has stopped responding, has denied the claim, or a deadline to sue is getting close. United Policyholders suggests talking to an attorney at least a month before the one-year anniversary of the loss, because legal time limits can end your right to sue.

For a side-by-side view, see public adjuster vs attorney vs appraisal. If an offer has arrived and it is too small, see what to do when the offer is too low.