Disclaimer: This article is for informational purposes only and does not constitute legal advice.
Understanding Your Insurance Dispute in North Dakota
Under North Dakota’s Personal Injury Protection (PIP) law, N.D.C.C. § 26.1-41-01, you have first-party rights to medical benefits following a covered auto accident. You can find the statute here: N.D.C.C. § 26.1-41-01.
The North Dakota Insurance Department prohibits unfair claim settlement practices. For example, refusing to pay benefits without reasonable justification violates N.D.C.C. § 26.1-04-01(18). See N.D.C.C. § 26.1-04-01.
Steps to Take When Your Claim Is Denied
- Gather Medical Records and Documentation: Request complete treatment records from your healthcare provider. Ensure they include injury history, diagnostic tests, treatment notes, and billing details.
- Obtain a Treating Physician’s Opinion: Ask your doctor for a written statement linking your medical treatment directly to the car accident. A clear medical nexus strengthens your case.
- Submit a Written Demand: Send a detailed demand letter to the adjuster or insurer’s claim department. Attach all supporting documents and cite relevant North Dakota statutes.
- Attend an Independent Medical Exam (IME): If the insurer requests an IME, cooperate fully and attend on time. If they decline to schedule one, note their refusal for any complaint to the Insurance Department.
- File a Complaint with the ND Insurance Department: If the insurer still denies your claim without proper justification, file a complaint at nd.gov/ndins. Include your claim number, insurer name, and a detailed summary of events.
- Consider Legal Action: If negotiations stall, you may file suit in district court. North Dakota’s six-year statute of limitations for contract claims applies. See N.D.C.C. § 28-01-16.
Helpful Hints
- Keep a daily treatment journal noting dates, pain levels, and activities.
- Follow up on records requests in writing and track delivery confirmations.
- Use certified mail or email with read receipts for all correspondence.
- Review your policy declarations for deadlines and coverage limits.
- Speak with an attorney if your claim remains in dispute or injuries are severe.