Claim Problem
Claim Delayed
Your claim has stalled without a decision. Understand what is causing the hold and how to move forward.
What This Means
A delayed claim means the carrier has not provided a coverage decision, inspection, payment, or response within the expected timeframe. Most states mandate acknowledgment within 15 days and a coverage decision within 30 days.
Why It Happens
- High claim volume: After a major weather event, carriers may have a backlog of claims.
- Incomplete documentation: The carrier may be waiting for documents you have not yet submitted.
- Coverage investigation: Complex claims may require additional review or expert consultation.
- Internal processing issues: The claim may be stuck in an internal queue or reassigned to a new adjuster.
- Intentional delay: In some cases, carriers may delay claims hoping the policyholder will accept a lower amount or give up.
What to Check
- Verify the date the claim was filed and calculate elapsed time.
- Check your state's mandated timelines for acknowledgment and decision.
- Confirm whether the carrier has requested any outstanding documents.
- Document all communication attempts and responses.
What Should Happen Next
Send a Written Follow-Up
Send a dated letter or email referencing the claim number, date of loss, and the specific deadline that has been exceeded. Request a written response within a specified timeframe.
File a Department of Insurance Complaint
If the carrier does not respond or continues to delay, file a formal complaint with your state's Department of Insurance. This creates an official record and may prompt the carrier to act.
See how this looks in action
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