Disclaimer
This article is for informational purposes only and does not constitute legal advice.
Detailed Answer
When you submit additional medical evidence for a personal injury claim in West Virginia, following up promptly and professionally can help keep your claim on track. Here’s a step-by-step approach under West Virginia law:
1. Review Your Evidence Submission
Before contacting the insurer:
- Confirm you sent complete records (medical bills, treatment summaries, imaging reports).
- Verify delivery by checking tracking or return receipts if you used certified mail.
2. Understand Applicable Standards and Timelines
West Virginia does not set strict deadlines for insurers to respond to supplemental evidence, but the West Virginia Unfair Trade Practices Act (WV Code §33-11-4(b)) prohibits unreasonable delays. Keep in mind also the two-year statute of limitations for personal injury claims under WV Code §55-2-12.
3. Make a Clear Written Request
Within 7–14 days after the insurer acknowledges receipt of your new evidence:
- Send a succinct follow-up letter or email to the adjuster. State your claim number, list the documents submitted, and politely request an update.
- Attach a dated cover sheet summarizing what you sent and when.
4. Document All Communications
Track every call, email, or letter:
- Note dates, times, names of representatives, and main points discussed.
- Save email chains and postal receipts.
5. Escalate If Needed
If you receive no substantive response within 30 days of your follow-up:
- Send a formal demand letter by certified mail, return receipt requested. Give the insurer a short, reasonable window (e.g., 14 days) to respond.
- Reference WV Code §33-11-4(b) to highlight that unreasonable delay may violate state law.
6. Contact the West Virginia Offices of the Insurance Commissioner
If delays persist or you suspect bad faith:
- File a complaint online at the WV Offices of the Insurance Commissioner.
- Include your claim number, summary of efforts to follow up, and copies of correspondence.
Helpful Hints
- Use clear subject lines: “Follow-Up on Personal Injury Claim #12345 – Additional Medical Records. ”
- Be concise: state facts and your requested outcome.
- Maintain a centralized folder (physical or digital) for all documents.
- Stay polite but firm in all communications.
- Consider consulting an attorney if the insurer continues to stall.