Detailed Answer
This section explains how to secure the at-fault insurer’s acceptance of liability for medical bills under Texas law.
1. Gather and Preserve Clear Evidence
Document the accident scene, obtain the police report, and collect witness statements. Keep all medical records, treatment plans, and billing statements. Clear evidence makes liability harder to dispute.
2. Send a Complete Demand Package
Submit a written demand letter to the at-fault insurer outlining injury details, liable party information, and a summary of damages. Include medical records, itemized bills, and expert reports. A well-organized package speeds up review.
3. Monitor the Claim Under the Texas Prompt Payment Law
Texas Insurance Code section 542.051 requires an insurer to acknowledge receipt of a claim within 15 days and request additional information within 15 days of notice 542.051. Section 542.055 mandates payment within 5 business days after receiving all required documents 542.055. Track these deadlines closely to ensure timely action.
4. Respond to Denials or Delays
If the insurer wrongly denies or delays payment, Texas Insurance Code section 541.060 prohibits unfair settlement practices 541.060. You can file a complaint with the Texas Department of Insurance or pursue a bad-faith claim seeking penalties and interest under section 542.056 542.056.
5. Consider Legal Representation
An attorney can handle negotiations, prepare a demand, and file suit if necessary. Many offer free consultations and work on contingency, advancing costs until recovery.
Disclaimer: This article is for informational purposes only and does not constitute legal advice.
Helpful Hints
- Maintain a chronological file of all documents and correspondence.
- Send all letters via certified mail and keep delivery receipts.
- Follow up regularly with the insurer to confirm receipt of materials.
- Obtain medical lien releases before settlement to avoid surprises.
- Document all communications, including dates and names of representatives.