What to do when an insurer’s top offer won’t cover your medical treatment and lost wages (Indiana)

Short answer: Don’t accept a low offer right away. Document all bills and lost-wage proof, demand a clear explanation and itemized breakdown from the insurer, consider further negotiation or mediation, file a lawsuit before the statute of limitations runs, and consider filing a consumer complaint with the Indiana Department of Insurance. If your damages exceed the insurer’s offer, talk with an attorney about filing suit, resolving medical liens, and preserving future-treatment claims.

Detailed answer — your practical options under Indiana law

If an insurance company’s highest settlement offer does not cover your medical treatment and lost wages, you have multiple paths you can take. Which path makes sense depends on facts such as who is legally responsible, the amount of your damages, the insurer’s stated reasons for the offer, and how soon your medical care or wage losses will continue.

1. Ask for the insurer’s calculation and provide missing documentation

Insurance companies must explain how they calculated the offer. Ask for an itemized settlement worksheet and the legal basis for any deductions (e.g., comparative fault offsets, pre-existing conditions adjustments, or reduction for medical payments). Provide up-to-date medical bills, a physician’s statement about ongoing treatment needs, and wage records (pay stubs, employer statements, tax forms). A clear, documented demand often leads to a higher offer.

2. Make a reasoned counter-demand with proof

Prepare a written demand packet that lists:

• All medical bills and expected future treatment (with physician estimate).
• Paystubs or employer verification of lost wages and computation of lost earnings.
• A chronology of treatments and any functional limitations.
• Photographs, police reports, and any witness statements that support liability.

Deliver the packet and give a firm deadline for response. That creates a record useful later if you sue.

3. Negotiate alternative resolutions

Consider asking the insurer to: (a) increase allocation for future medical expenses, (b) make a structured settlement, (c) coordinate payment directly with health care providers to reduce liens, or (d) release only part of your claim (partial settlement) while reserving the right to pursue future treatment costs. Get any agreement in writing. Be cautious: a full release usually ends your right to sue for the same injury.

4. Use mediation or appraisal (if available)

Some policies or court rules allow mediation or other dispute-resolution processes. Mediation can produce a better result quickly and at lower cost than litigation. If the insurer suggests mediation, confirm that the mediator is neutral and that any settlement will be documented and reviewed by you or your attorney first.

5. File a lawsuit against the at-fault party (and/or their insurer)

If negotiations fail, you can file a personal-injury lawsuit against the responsible party. Lawsuits allow you to take discovery (obtain records), depose witnesses, and ask the court to award damages for medical bills, future treatment, lost wages, and pain and suffering. Under Indiana law, there is a deadline to file suit (the statute of limitations). For most personal injury claims, the time limit is two years from the date of injury. See Indiana Code for limitations on personal actions: Ind. Code § 34-11-2-4. Missing that deadline can cost you the right to sue.

6. Consider small claims court for lower-dollar disputes

If your remaining financial loss is relatively small, small claims court can be faster and cheaper than full civil litigation. Check local court rules and limits before filing. For self-help information about courts and small claims in Indiana, see the Indiana Courts self-service resources: Indiana Courts Self-Service.

7. File a consumer complaint with the Indiana Department of Insurance

If you believe the insurer acted unfairly (for example, they ignored documents, didn’t investigate, or failed to provide a reasoned denial), you can file a complaint with the Indiana Department of Insurance (IDOI). The IDOI can investigate administrative violations and may help resolve consumer disputes: File a Complaint — Indiana Department of Insurance. Filing a complaint does not replace your right to sue.

8. Understand medical liens, subrogation, and releases

If your health providers, ER, or an insurance plan (Medicare/Medicaid/private) paid for care, they may have lien or subrogation rights against any settlement. Before accepting any offer, confirm how those claims will be handled. You may need the insurer or at-fault party to clear liens or negotiate reduced payoffs to make the net recovery cover your needs.

9. Talk with a personal-injury lawyer before you accept anything

A lawyer can review the offer, handle lien negotiations, evaluate whether the offer is reasonable given your future needs, and tell you whether a lawsuit is likely to produce a better result after attorney fees. Many injury lawyers offer free consultations and work on contingency (they only get paid if you recover).

Key timing and legal limits

Do not delay. Preserve evidence, bytes of electronic data, and medical records. The most important timing rule is the statute of limitations for personal injury claims (generally two years in Indiana). See: Ind. Code § 34-11-2-4. If you think the insurer is breaching policy duties, an attorney can tell you whether immediate steps are needed to protect your claim.

Helpful Hints

• Get everything in writing: demand letters, explanations for deductions, and settlement terms.
• Document lost wages with employer statements, paystubs, or tax records.
• Ask your medical providers for cost estimates for anticipated future care.
• Request an itemized statement from the insurer showing how they reached their top offer.
• Don’t sign a full release until you are sure it covers present and reasonably expected future losses.
• Check for medical liens and subrogation claims before settling; negotiate reductions if possible.
• Keep a running total of out-of-pocket expenses and non-economic impacts (e.g., reduced home tasks, caregiving).
• File a complaint with the Indiana Department of Insurance if the insurer won’t explain or appears to act unfairly: IDOI consumer complaint.
• Consult an attorney early if the insurer’s offer leaves you undercompensated — many lawyers offer free case reviews.

Disclaimer: This article is educational and informational only and is not legal advice. It does not create an attorney-client relationship. Laws change, and facts matter. Talk with a licensed Indiana lawyer for advice about your specific situation.