How to respond when an insurer sends a final settlement offer after an injury — New Mexico
Detailed Answer
If an insurance company sends what it calls a “final” settlement offer after you were injured, you still have options. Under New Mexico practice the word “final” is rarely irreversible. This section walks through the practical steps you can take, the legal paths commonly used in New Mexico, and important deadlines to watch.
1. Take a calm, evidence-based first step
Before you accept or formally reject any offer, collect and review the facts. Make a clear file with: medical records and bills, wage-loss documentation, photos of injuries and accident scene, police reports (if any), repair or property-damage estimates, and all letters, emails, and recorded phone notes with the insurer. Accurate documentation gives you leverage to challenge an inadequate offer.
2. Ask the insurer for a written explanation and breakdown
Request in writing the basis for the settlement amount: how the insurer calculated medical damages, lost wages, future care, and any offsets they applied. Insurers often give a line-item explanation when pressed. Sometimes the offer reflects a miscalculation or missing records that, once corrected, increase value.
3. Prepare and send a demand or counteroffer
Send a clear demand letter or counteroffer that summarizes your documented damages and the legal basis for a larger amount. Include copies (not originals) of key records and a deadline for reply (commonly 10–14 days). A well-supported demand can reopen negotiations even after a “final” offer.
4. Use alternative dispute resolution if available
Many insurance policies and courts encourage mediation or arbitration. Mediation keeps negotiation private and can produce better results than continued direct negotiation. If the policy includes an arbitration clause, arbitration may be the required forum to resolve value disputes without a jury trial.
5. Consider filing a lawsuit — and watch the clock
If negotiations fail, you may file a lawsuit in New Mexico civil court for your personal injury claim. Filing suit preserves your right to pursue full damages and starts the formal litigation process (discovery, depositions, court motions, etc.). New Mexico generally requires injured claimants to bring personal injury actions within the state statute of limitations (commonly three years for most personal injury claims). Missing the applicable deadline can bar your case, so act before the limitation period expires.
6. Evaluate whether an insurer’s conduct supports an insurance-practices complaint or a bad-faith claim
New Mexico law prohibits unfair or deceptive insurance claim practices. If the insurer refuses to reasonably investigate, unreasonably delays, misrepresents policy language, or denies your claim without a legitimate basis, you may have administrative remedies (a complaint to the New Mexico Office of Superintendent of Insurance) and, in some situations, a civil claim for improper claims handling. File consumer complaints with the state regulator to report practices and to trigger a regulator review.
7. Hire an attorney when the offer is below full value or legal issues are complex
An attorney experienced in New Mexico personal injury and insurance practice can: analyze offers, demand appropriate damages (including future care), handle negotiations, prepare for mediation or arbitration, and, if needed, file suit before deadlines. Contingency-fee arrangements are common — the lawyer is paid from any settlement or judgment. Ask potential attorneys about likely costs, recovery expectations, and whether they will advance litigation expenses.
8. Protect your medical lien and coordination-of-benefits issues
If you receive medical treatment paid by Medicaid, Medicare, or a medical provider who placed a lien, you must address lien resolution before finalizing settlement. Resolving liens and subrogation claims can reduce your net recovery; your lawyer or the hospital’s billing office can help clarify amounts owed.
9. Keep records of all communications and get settlement agreements reviewed
Record dates, times, names, and summaries of phone calls and retain written communications. Before signing any release, have an attorney review it — releases are often broad and permanent. A carefully drafted release should close only the intended claims and preserve any unrelated rights you need to keep.
Key New Mexico resources and where to file complaints
- New Mexico Office of Superintendent of Insurance (consumer complaints and guidance): https://www.osi.state.nm.us/
- New Mexico Courts: filing procedures and local court contacts: https://www.nmcourts.gov/
- New Mexico Legislature (statutes and laws): https://www.nmlegis.gov/
Typical timeline and practical expectations
Negotiation: a few days to months, depending on complexity. Mediation: often scheduled within weeks to months. Filing suit: preserves rights and sets litigation in motion; litigation can take many months to years. Realistic recovery depends on the severity of injuries, medical records, witness testimony, liability clarity, and the insurer’s legal exposure.
Helpful Hints
- Do not sign a release or accept a check marked “final” until you confirm the offer fully covers your current and reasonably expected future medical care and other losses.
- Get all offers and claim decisions in writing. If you received a verbal offer, ask the company to put it in writing before acting.
- Identify and preserve witnesses and evidence quickly (photos, video, physical evidence). Evidence fades—act fast.
- Track all medical care and related bills. Future care estimates from your treating physician strengthen demands for higher compensation.
- If an insurer claims policy limits, ask them to confirm in writing and explain the distribution. If an at-fault driver’s insurer offers policy limits but multiple claimants exist, consult counsel immediately.
- Consider a focused written deadline when you send a counteroffer — many adjusters respond more promptly to deadlines.
- If you’re uninsured or underinsured, check whether you have uninsured/underinsured motorist (UM/UIM) coverage, and whether your own insurer will handle your claim. UM/UIM claims can have different procedures (and sometimes different deadlines).
- File a complaint with the New Mexico insurance regulator if you suspect bad faith or unfair handling: this can spur a regulator review and help your negotiating position.
Disclaimer: This article is informational only and not legal advice. It does not create an attorney-client relationship. For advice tailored to your situation, consult a licensed New Mexico attorney.