Detailed Answer — what you can do right now

When an insurer’s highest settlement offer does not cover your medical treatment and lost wages, you have several options under Massachusetts law. Which option fits best depends on the type of claim (auto crash, workplace injury, medical malpractice, etc.), the policy limits, and how long it will take you to reach maximum medical improvement. The steps below walk through immediate actions and longer-term remedies.

1. Don’t sign anything right away

Insurers commonly ask claimants to sign releases as a condition of payment. A full release typically prevents you from seeking any more money later, including for future medical bills or wage loss. Before signing, confirm the release’s scope and the dollar amount it covers. If the offer does not fully compensate you, do not accept a full release without legal advice.

2. Verify the insurer’s basis and your policy limits

Ask the insurer in writing how it calculated the offer and request the policy declarations page and limits. If the at-fault party has low liability limits, you may need to pursue other sources: your own uninsured/underinsured motorist coverage, health insurance subrogation issues, or (if the injury was work-related) workers’ compensation benefits under Massachusetts law (M.G.L. c.152).

3. Collect and organize documentation

Insurance companies will often increase offers when you provide clear proof of losses. Prepare:

• All medical records and itemized bills (with provider contact information).
• A current medical prognosis or physician statement estimating future treatment and costs.
• Pay stubs, employer verification, and tax documents showing lost wages and lost earning capacity.
• Receipts for out-of-pocket expenses (transportation, prescriptions, childcare, etc.).

4. Send a clear, written demand

Send a demand letter that summarizes your damages, includes supporting documents, and states the settlement amount you will accept. A precise demand can prompt further negotiation. Keep a copy and use certified mail or another trackable method.

5. Consider mediation or appraisal

If negotiations stall, mediation can be a cost-effective next step. Many insurers participate in mediation to avoid litigation. For disputes about the value of property damage or loss, your policy may include an appraisal or arbitration clause—review the policy or ask an attorney for help invoking those procedures.

6. Evaluate bad-faith or unfair settlement practices

If the insurer has acted unfairly—for example, by refusing reasonable documentation, unreasonably delaying payment, or making deceptive statements—you may have claims under Massachusetts’ consumer protection law, Chapter 93A (M.G.L. c.93A), or you can file a complaint with the Massachusetts Division of Insurance (Division of Insurance). Chapter 93A remedies can include multiple damages and attorney’s fees in appropriate cases. Before filing a 93A suit, check the procedural requirements and consider consulting counsel.

7. File a civil action if negotiation fails

If the insurer won’t pay what you reasonably deserve, you can sue the at-fault party (and sometimes the insurer) in court. For most negligence-based personal injury claims in Massachusetts, you must file within three years from the date of injury (M.G.L. c.260 §2A). Do not let the statute of limitations expire while you try to negotiate.

8. Use small claims court for lower-dollar disputes

If your total claim falls within Massachusetts’ small claims limits, the small claims process is simpler and faster than a full civil trial. See the Mass.gov overview for filing small claims: How to file a small claims case. Note that small claims procedures have limits on recoverable amounts and discovery.

9. If the injury is work-related, consider workers’ compensation

Workplace injuries usually fall under the workers’ compensation system, which covers medical treatment and partial wage replacement without proving fault. Mixed cases (both at-work and a third-party at-fault) require coordination between a workers’ compensation claim and a third-party liability claim. See M.G.L. c.152 for the statutory framework.

10. Talk to a lawyer about contingency representation and liens

Many personal injury lawyers work on contingency (they get paid only if you recover). An attorney can evaluate whether you should accept a low offer now or litigate for more, how future medical costs are calculated, and how medical or health-insurance liens will affect net recovery. If you cannot afford an attorney, ask about a free consultation or legal aid referrals.

11. Consider the long-term financial picture

When assessing any offer, consider future medical care, permanent impairment, and lost earning capacity—not just bills already incurred. A structured settlement, periodic payments, or setting aside funds for future treatment may be appropriate depending on your needs.

12. File a complaint with the Division of Insurance

If you believe the insurer violated regulations or unfairly handled your claim, you can submit a complaint to the Massachusetts Division of Insurance: Division of Insurance. The Division can investigate and sometimes facilitate resolution.

Helpful Hints

• Document everything: save bills, emails, texts, photos, and recordings of settlement conversations (if lawful in your situation).
• Do not sign a full release until you’re certain it covers all future needs or you’ve consulted an attorney.
• Send a demand letter with itemized damages and a deadline for response—this can support a later Chapter 93A claim if applicable (M.G.L. c.93A).
• Act promptly—most personal injury claims have a three-year statute of limitations in Massachusetts (M.G.L. c.260 §2A).
• If the injury happened at work, pursue workers’ compensation quickly to protect wage-replacement rights (M.G.L. c.152).
• Request mediation if negotiations stall—many courts and insurers prefer it as a faster, less expensive path than trial.
• Ask prospective attorneys about contingency fees, who pays costs during litigation, and how medical liens will be handled.
• File a complaint with the Massachusetts Division of Insurance if the insurer’s conduct seems unfair: Division of Insurance.
• Use small claims court only when the amount you seek fits the small claims process; otherwise, consult counsel for larger claims.