How to challenge an insurer’s final settlement offer after an injury in West Virginia

Quick summary: If you think an insurance company’s final offer after an injury is too low, you have steps you can take in West Virginia: evaluate the offer, document your damages, send a written demand (or reply to theirs), attempt negotiation or alternative dispute resolution, and — if needed — file a lawsuit before the state’s deadline. You may also have a claim for unfair claim handling under West Virginia law in some circumstances. This article explains the common steps and the laws that matter so you can make an informed decision about next steps.

Detailed answer — step-by-step process

1. Don’t sign anything or cash a check until you’re sure

Signing a general release or depositing a settlement check often ends your right to pursue the claim further. Carefully read any release or settlement document. If language is unclear or the amount is small relative to your losses, consider getting legal advice before signing.

2. Compare the offer to your full damages

List and document all components of your claim:

• Medical bills and records (past and expected future care).
• Lost wages and reduced earning capacity (pay stubs, employer statements).
• Pain and suffering and other non-economic harms.
• Property damage and out-of-pocket expenses.

Make a conservative estimate of future medical costs and recovery time. If the offer doesn’t reasonably cover these, it may be inadequate.

3. Ask the insurer to explain how they calculated the offer

Ask the claims adjuster in writing for the basis of the final offer: what damages were considered, what offsets or subrogation were applied, and any reserves or medical opinions on which they relied. A written response helps you spot omissions or miscalculations.

4. Provide or correct documentation and send a demand or counteroffer

If the insurer missed evidence, supply complete medical records, bills, wage documentation, and any expert opinions. Send a clear written demand or counteroffer summarizing losses and the amount you consider fair. Keep copies of everything and use tracked mail or email so you have proof of delivery.

5. Consider alternative dispute resolution (mediation or arbitration)

Mediation is a common, relatively quick way to settle without a trial. Many insurers will agree to mediation if it might avoid litigation. Arbitration is sometimes contractually required (auto insurance or UM/UIM policies may have arbitration clauses); read your policy to see if arbitration is mandatory.

6. File suit before the statute of limitations runs

If negotiation fails, you can file a lawsuit. West Virginia’s time limit for most personal injury suits is two years from the date of injury. See W. Va. Code § 55-2-12. If a suit is necessary, filing preserves your legal right to pursue more compensation.

7. Consider a bad-faith or unfair-claims claim (when applicable)

Insurers must not engage in unfair or deceptive claim handling. West Virginia law prohibits certain unfair methods of competition and unfair or deceptive acts in the business of insurance. See W. Va. Code § 33-11-4. If the insurer acted dishonestly, misrepresented facts, intentionally delayed, or unreasonably refused to pay a proper demand, you may have an additional claim for statutory unfair practices or a tort claim for bad faith. These claims can be legally complex and often require proof of the insurer’s subjective intent or unreasonable conduct.

8. Watch and resolve liens and subrogation claims

If Medicare, Medicaid, or a private health insurer paid bills, they may have a lien or subrogation right against any recovery. Identify potential liens early so you can estimate net recovery and negotiate lien reductions where possible.

9. When to hire an attorney

Consider hiring an attorney if:

• The insurer’s offer is far below your documented losses.
• Your claim involves long-term care, significant future medical costs, or permanent disability.
• There are complicated issues like comparative fault, serious third-party liability, or liens.
• You are considering a bad-faith or statutory claim against the insurer.

An attorney can evaluate liability, value future damages, negotiate, and file suit if needed. Many personal-injury attorneys in West Virginia work on contingency (they collect a percentage only if you recover), but confirm fee structure in writing.

Key West Virginia laws and timelines

• Personal injury statute of limitations (most cases): W. Va. Code § 55-2-12 (typically two years).
• Prohibition on unfair insurance practices: W. Va. Code § 33-11-4.

Practical timeline example (hypothetical)

Jane is injured on March 1. The insurer makes a final offer on June 1. Jane believes the offer is too low. She gathers records, sends a written counteroffer and demand for $50,000 on June 10, supplies updated medical records on June 20, and proposes mediation on July 1. When the insurer refuses, Jane files suit on February 1 of the following year — before the two-year deadline — and proceeds through pretrial settlement discussions. This preserves her rights and forces the insurer to respond in court.

Helpful hints

• Do not cash a settlement check until you have reviewed the release and are sure the amount is fair.
• Keep a single organized file (medical records, bills, correspondence, photos, witness info).
• Use written communications whenever possible and keep copies and delivery receipts.
• Be realistic but thorough: document future medical needs with a treating provider or expert opinion when possible.
• Ask the insurer for a written explanation of how they calculated the final offer; many disputes reflect missing information.
• Check for liens early (Medicare, Medicaid, ERISA plans) to understand your likely net recovery.
• If you think the insurer engaged in unfair practices, document dates, phone calls, and any written denials — this evidence is important for any statutory or bad-faith claim.
• If you hire counsel, get the fee agreement in writing and confirm who handles lien negotiations and upfront costs.

Disclaimer: This article provides general information about West Virginia law and common steps people take to contest an insurer’s offer. It is not legal advice and does not create an attorney-client relationship. For advice specific to your situation, consult a qualified West Virginia attorney who can review your records and deadlines.