Answer — What to expect after you send a demand

After you send a written demand to an insurance company in New Mexico, you should expect several clear stages before you receive an initial monetary offer. The exact timing varies with the type of claim (first‑party property, third‑party liability, auto, medical), the insurer’s workload, and how complete your demand packet is. Below is a realistic timeline and what commonly happens in each stage.

Typical timeline (general guide)

• Immediate acknowledgment (within 7–14 days): Most insurers acknowledge receipt of a demand quickly. This may be an automated notice or a claim representative reaching out to confirm they have your demand and will investigate.
• Initial investigation (2–6 weeks): The insurer reviews your demand, orders or reviews records (medical, vehicle repairs, police reports), and may contact witnesses or providers. For complex claims, this period can take longer.
• Follow‑up information requests (2–8 weeks): If the insurer needs more documentation—medical records, wage records, bills, photos—they will request it. Supplying complete, organized documents shortens this stage.
• Decision or offer (commonly 30–90 days after demand): For straightforward claims, you may get an initial offer within 30 days. For claims that require extensive investigation or litigation exposure assessment, an insurer may take 60–90 days or longer before making a first offer.
• Negotiation (days to months): If the initial offer is not acceptable, negotiations can stretch weeks to months. If parties cannot agree, the case may proceed to mediation, appraisal (for property), or litigation.

Why the timeline varies

Factors that make the insurer move faster or slower include:

• Completeness of your demand packet (clear demand letter, documentation of damages, medical records, bills, lost wages).
• Severity and complexity of injuries or damages.
• Whether fault is disputed or obvious.
• Policy limits and the insurer’s exposure (high-value cases often trigger more review).
• Whether you’ve given the insurer permission to obtain records (authorizations speed evidence gathering).
• Workload and staffing at the insurer or their third‑party vendors.

New Mexico consumer protections and oversight

New Mexico regulates insurer conduct and handles consumer complaints. If you believe the insurer unreasonably delays or denies a legitimate claim, you may file a complaint with the New Mexico Office of Superintendent of Insurance (OSI). The OSI provides guidance for filing complaints and tracks insurer practices: New Mexico Office of Superintendent of Insurance — File a Complaint. You can also read New Mexico statutes and insurance law resources via the New Mexico Legislature’s statutes pages: New Mexico Legislature — Statutes.

When delay may be improper

Insurers must investigate claims in a reasonably prompt manner. Unnecessary or abusive delay, refusal to communicate, or failure to explain denials can be unfair claim settlement practices under state law. If you suspect unfair treatment, document communications and consider contacting OSI or an attorney.

Practical, step‑by‑step expectations after you send a demand

1. Send a complete demand: Include a clear demand letter, itemized damages, medical records/bills, invoices, repair estimates, lost wage documentation, photos, and any police reports. A complete packet shortens the process.
2. Send by trackable method: Use certified mail or another trackable delivery so you can prove the insurer received the demand.
3. Record contact details and timelines: Note the date you mailed the demand and all subsequent communications (who you spoke to, date, content).
4. Respond quickly to requests: If the insurer asks for additional records or medical authorizations, provide them promptly.
5. Follow up: If you do not receive an acknowledgment in 10–14 days, call and ask for the claim number and the adjuster handling the file.
6. Expect an initial offer or a reason for delay: If the insurer needs more time, they should explain why and give an approximate date when they will respond.

Hypothetical example timeline (illustrative)

Hypothetical facts: You send a comprehensive demand to the at‑fault driver’s liability insurer for a moderate auto injury claim with medical bills and lost wages.

• Day 1: Demand mailed (certified).
• Day 7: Insurer acknowledges receipt and opens a file.
• Day 14–30: Insurer obtains medical records and reviews bills.
• Day 30–45: Insurer requests additional records (e.g., provider notes). You provide them quickly.
• Day 45–60: Insurer completes evaluation and issues an initial offer or a written denial with reasons.

In this example, a reasonable initial offer often arrives between 30–60 days after a complete demand.

Options if you don’t receive a timely offer or a fair offer

• File a complaint with the New Mexico Office of Superintendent of Insurance: OSI complaint page.
• Send a follow‑up demand or supplemental demand with new evidence.
• Consider mediation, appraisal (for property claims), or other alternative dispute resolution if offered by policy or contract.
• Consult an attorney to evaluate a bad‑faith claim or to prepare litigation if the insurer’s conduct appears unreasonable and your damages justify a lawsuit.

Helpful Hints

• Keep a detailed packet: organized records, chronology, photos, and witness contact info help speed review.
• Use clear, specific language in the demand: spell out the total damages and state your demand number (e.g., “$15,000 for medical bills, lost wages, and pain & suffering”).
• Send authorizations early: signing medical authorizations allows the insurer to gather records without repeated requests.
• Document all communications: note names, dates, times, and summaries of conversations with the insurer.
• Don’t accept the first lowball offer without evaluating it: ask for a written explanation of how the insurer calculated the offer.
• Be patient but persistent: reasonable insurers will communicate timelines; unreasonable delays justify escalation.
• File a complaint with OSI if you suspect unfair practices: see OSI — File a Complaint.
• If damages are substantial, consult an attorney early — an attorney can package demands to shorten the insurer’s evaluation period and protect deadlines.