How to Handle an Insurance Claim Delay

Most states mandate specific timelines for insurance claim handling:

• 15 days: Acknowledge receipt of claim
• 30 days: Make a coverage decision (approve, deny, or request more information)
• 45 days: Absolute maximum for coverage decision in most states

Note: These timelines vary by state. Check your state Department of Insurance for exact requirements.

1. Confirm claim receipt. Verify the carrier acknowledged your claim within 15 days of filing.
2. Request status update. Contact the adjuster and ask for an expected decision date.
3. Document all communication. Record calls, emails, and correspondence with dates and names.
4. Check for information requests. If the carrier requested documentation, provide it promptly.

1. Send formal written demand. Request a coverage decision in writing within 3 business days, referencing state law timeline.
2. Escalate to claims supervisor. Request management escalation if the adjuster cannot provide a decision date.
3. Reference state law in writing. Cite the specific state requirement (e.g., "State law requires decision within 30 days").
4. Send via certified mail. Document your demand with proof of delivery.

• Claim is complex: Multiple damages, multiple contractors, difficult coverage question.
• Missing documentation: Carrier is waiting for you to submit additional proof or information.
• Dispute over cause of loss: Carrier is investigating to determine if the loss is covered.
• Carrier backlog or negligence: Administrative delays or understaffed claims department.