Disclaimer: This article is for general informational purposes only and does not constitute legal advice.
Detailed Answer
Under West Virginia law, a motorist’s liability insurer must cover reasonable and necessary medical expenses arising from an accident you did not cause. Insurers must investigate claims promptly and pay covered losses. To maximize the chance they accept liability, follow these key steps.
- Provide Timely Notice of Claim. WV Code §33-6-31 requires insured drivers to notify their carrier promptly after an accident. You, or your health provider, should send written notice to the at-fault party’s insurer within 30 days. Include the date, location and details of the collision.
W. Va. Code §33-6-31 - Submit Complete Medical Documentation. Attach itemized bills, medical records, diagnostic reports and physician statements that link your injuries directly to the crash. Insurers often deny partial claims when documentation lacks clarity. Keep copies of every invoice and report you send.
- Send a Formal Demand Letter. Draft a concise letter stating the at-fault party’s insurer owes payment for your medical expenses. List total charges, attach proof of loss and request a written response within 30 days. Send via certified mail with return receipt to create a record.
- Cooperate Fully with the Insurer. Respond promptly to adjuster requests for additional information. Attend independent medical examinations (IMEs) if scheduled under their policy. Failure to cooperate gives the insurer grounds to delay or deny payment.
- Track Deadlines and Follow Up. West Virginia law does not fix a strict deadline for insurers to accept liability, but unreasonable delay can support a bad-faith claim. If you receive no decision in 60 days, send a written reminder and request an update to avoid waiver of your rights.
- Pursue Remedies for Denial or Delay. If the insurer denies or unreasonably delays payment, you can file a bad-faith claim under West Virginia’s unfair claims practices statute. Bad faith may allow you to recover extra damages, interest and attorney fees.
W. Va. Code §33-11-4
Helpful Hints
- Use certified mail for all correspondence to prove delivery.
- Maintain an organized file of every medical bill, treatment note and communication.
- Get a signed medical authorization form so you can obtain records directly if the insurer stalls.
- Document every phone call: note date, time, person spoken to and summary.
- If the insurer still refuses payment, consult a West Virginia personal injury attorney quickly to protect your legal rights.