Detailed Answer
1. Understand Louisiana’s Liability Framework
Under Louisiana law, a negligent party must compensate any person harmed by their fault. Louisiana Civil Code Article 2315 establishes this duty. To trigger the at-fault driver’s insurer, you must show:
- A legal duty of care (e.g., obeying traffic laws).
- A breach of that duty (e.g., running a red light).
- A causal link between the breach and your injuries.
- Actual damages (medical bills, lost wages, pain and suffering).
Once you prove these elements, the insurer has a statutory obligation to investigate your claim promptly under Louisiana Revised Statutes §22:1973. See Unfair Claims Settlement Practices Act.
2. Gather and Organize Your Medical Evidence
- Obtain complete medical records, billing statements and itemized invoices.
- Request written reports from treating physicians linking your injury to the accident.
- Keep a chronological file of all treatments, medication lists and rehabilitation notes.
3. Submit a Clear Demand Package
Send the insurer a formal demand letter with:
- Copy of the accident report.
- Medical documentation and itemized bills.
- Explanation of how your injuries resulted from the accident.
- A specific request that the insurer accept liability for your medical expenses.
Mail this package via certified mail, return receipt requested, to establish proof of timely delivery.
4. Invoke the Insurer’s Statutory Duty to Act
The Unfair Claims Settlement Practices Act (La. Rev. Stat. §22:1973) requires insurers to acknowledge and act on claims within a reasonable time. If the insurer unreasonably delays or denies coverage without proper justification, you may pursue a bad-faith action.
Link to statute: La. Rev. Stat. §22:1973.
5. Consider Medical Payment (MedPay) Coverage
If the at-fault driver carries MedPay or if you have MedPay on your own policy, you can submit bills directly to MedPay. This may speed up payment while liability is being determined.
6. Prepare for Litigation if Necessary
If the insurer refuses liability or unduly delays payment, you can file a suit for unpaid medical expenses and potential penalties for bad-faith handling. Louisiana law generally prescribes a one-year deadline from the date of injury to file a tort action (La. Civ. Code art. 3492).
Helpful Hints
- Document every communication with adjusters, including dates, times and names.
- Follow up in writing if you call the insurer by phone.
- Keep all original bills—send only copies in your demand package.
- Confirm coverage limits and exclusions in the at-fault driver’s policy.
- Stay within the one-year prescriptive period (La. Civ. Code art. 3492).
Disclaimer
This article is for informational purposes only and does not constitute legal advice. Consult a licensed attorney to discuss your specific situation.