Detailed Answer
When you submit additional medical evidence to support your personal injury claim, timely and organized follow-up helps keep your case on track. Under Massachusetts law, insurers must adhere to specific claim-handling timeframes and fair-practice rules. For instance, Mass. Gen. Laws ch. 175, §113H requires an insurer to acknowledge receipt of claim information within 10 business days and to accept or deny a complete claim within 30 days of receiving all necessary documentation (link).
Follow these steps to engage the insurance company effectively:
- Confirm Receipt in Writing: Send a brief follow-up letter or email referencing the date you sent the medical records and the specific documents included. Use certified mail or request a read receipt by email. If you call, note the date, time, and name of the representative.
- Track Statutory Deadlines: Once you submit complete proof of loss, the insurer has 30 days under Mass. Gen. Laws ch. 175, §113H to make a decision. If the insurer misses this deadline, it may violate unfair claim settlement practices under Mass. Gen. Laws ch. 176D, §3 (link).
- Maintain a Communication Log: Record every call, letter, and email. Note dates, names, and key details. This log demonstrates diligence and supports any future dispute over missed deadlines or unresponsiveness.
- Send a Formal Follow-Up Letter: If you receive no update within 10 business days, send a formal letter. State the date of your previous submission, itemize the records provided, and request a status update by a specified date. Cite Mass. Gen. Laws ch. 175, §113H and ch. 176D, §3 to underscore the insurer’s legal obligations.
- Escalate When Necessary: If your claims adjuster does not respond, ask to speak with a supervisor. Continued delays may warrant a demand letter under Mass. Gen. Laws ch. 93A, §9 (link). A 93A demand gives the insurer 30 days to settle or risk statutory penalties.
- Consider Legal Assistance: If the insurer stalls or denies your claim without valid reason, a Massachusetts-licensed attorney can evaluate bad-faith insurance practices and negotiate on your behalf.
Helpful Hints
- Keep certified mail receipts or email read-receipt confirmations as proof of delivery.
- Summarize your medical evidence in a one-page cover sheet to streamline review by the adjuster.
- Maintain a polite, professional tone in all communications to foster cooperation.
- Always request written confirmation after any phone conversation with claims staff.
- Use calendar reminders for all statutory response deadlines to ensure timely follow-up.
This article is for informational purposes only and does not constitute legal advice. Consult a Massachusetts-licensed attorney for guidance on your specific situation.