Detailed Answer
This answer explains, in plain language, the usual steps to contest a final settlement offer from an insurance company after you were injured in Maine. It assumes a typical third-party personal-injury claim (for example, a car crash or slip-and-fall caused by another person). This is general information only and not legal advice.
1. First things to know: timing and legal deadlines
Do not let time run out. Under Maine law, the usual statute of limitations for personal-injury claims is six years from the date of injury. That deadline is set out in 14 M.R.S. § 752; see the statute for details: 14 M.R.S. § 752. If you file a lawsuit after the statutory deadline, a court will likely dismiss your case even if the insurer acted unfairly.
2. Do not accept a release or sign a full settlement until you are ready
An insurer may send a release or global settlement agreement with a final offer. If you sign a general release you typically give up any future claims related to the injury. Before signing anything, confirm you know the full extent of medical treatment, future care needs, lost earnings, and any liens or subrogation claims that may reduce your net recovery.
3. Read the offer and claim file carefully
Ask the insurer for a complete written explanation of how they calculated the offer and for copies of all claim-file documents they used. Compare the offer to your medical bills, treatment records, lost-wage documentation, and other damages such as pain and suffering. Keep organized copies of all records and correspondence.
4. Send a reasoned written response and a counteroffer
Contest the final offer in writing. A good written response should:
- Identify you, the claim number, and the date of loss.
- State why the insurer’s final offer is insufficient and cite specific documents (medical records, bills, wage statements) that support a higher value.
- Include a concrete counteroffer or demand number based on your documented damages.
- Set a reasonable deadline for an insurer response (commonly 14–30 days).
Keep copies of everything and send the response by a traceable method (certified mail with return receipt, or email with delivery/read receipt if accepted by the insurer).
5. Preserve evidence and your medical record chain
Document every appointment, treatment, and expense. Request and keep copies of all medical records and itemized bills. If you can, obtain statements from witnesses and photos of the scene or injuries. Proper documentation strengthens your position and supports a higher counteroffer.
6. Use formal demand letters, mediator, or appraisal if appropriate
If a written counteroffer does not bring the insurer up, consider these next steps:
- Send a formal demand letter that summarizes injuries, treatment, damages, and a deadline for payment.
- Propose mediation or other alternative dispute resolution. Many insurers will agree to mediation to avoid litigation costs.
- If the dispute involves a policy appraisal or contractual appraisal clause (more common in property claims), follow the contract appraisal procedures strictly.
7. Complain to the Maine Bureau of Insurance
If you believe the insurer handled your claim unfairly, you can file a consumer complaint with the Maine Bureau of Insurance, which can investigate unfair claim-handling practices and explain your options: Maine Bureau of Insurance – Consumer Information and Complaints.
8. Consider filing a lawsuit if negotiations fail
If the insurer will not increase the offer and you want to pursue more compensation, you can file a civil action in court before the statute of limitations expires. Filing opens formal discovery and gives you tools such as depositions and subpoenas to build your case. Keep the six-year limit in mind: see 14 M.R.S. § 752. Courts can be complex; consider consulting an attorney early to avoid procedural mistakes.
9. When to hire a lawyer
Consider hiring an attorney if any of the following apply:
- Your medical bills and future care are substantial or uncertain.
- The insurer says you have preexisting conditions or disputes causation.
- The insurer makes a low final offer that does not cover documented damages.
- You face complex liens, subrogation, or multiple insurance companies.
Most personal-injury attorneys handle cases on contingency, meaning they take a percentage only if you recover money. An attorney can evaluate the case, value damages, draft demand letters, negotiate, and, if necessary, file suit and manage litigation.
10. Typical timeline and realistic expectations
There is no single timeline. Some claims settle within weeks; others require months of negotiation, or years if litigation becomes necessary. Plan for several steps: gathering records, sending demands, negotiation rounds, possible mediation, and—if necessary—litigation. Each step can change the value of a claim, especially when new medical information appears.
Helpful Hints
- Do not give a recorded statement to the insurer without considering legal advice; your words can be used against you.
- Do not sign a full release until you are certain your medical treatment is complete or future care is accounted for.
- Get everything in writing. Verbal promises are hard to enforce.
- Keep a claim file with dates, names, phone calls, and summary notes of any conversations with the insurer.
- If the insurer asserts comparative negligence or preexisting conditions, collect medical evidence and witness statements to rebut those claims.
- Be proactive: send organized, persuasive documentation rather than relying on the insurer to request it.
- If you are unhappy with the insurer’s behavior, file a complaint with the Maine Bureau of Insurance early; they can review unfair claim practices.
- Remember the statute of limitations: do not delay filing suit based purely on hopes of better settlement later.
Disclaimer: This article is for informational purposes and does not constitute legal advice. It does not create an attorney-client relationship. Laws change and every case has unique facts. Consult a licensed Maine attorney to get advice tailored to your situation.