What to Do When the Adjuster Won't Call You Back

Silence is not an accident

You reported the claim. You left messages. Weeks go by. When someone finally calls back, it is a new adjuster who needs you to start over.

Some of that is caseload. Adjusters carry a lot of files. But delay also works in the insurer’s favor. Money paid later is money kept longer. People who are frustrated, out of work and buried in bills are more likely to take whatever is offered just to be done with it. And people who cannot get an answer sometimes stop going to the doctor, which hurts the claim later.

California sets deadlines for insurers

California’s Fair Claims Settlement Practices Regulations put time limits on how insurers handle claims. In general terms:

• When an insurer receives notice of a claim, it has 15 calendar days to acknowledge it, provide the forms and instructions you need, and begin investigating (10 CCR § 2695.5).
• When you send the insurer a communication that reasonably calls for a response, it has 15 calendar days to respond (10 CCR § 2695.5).
• Once it has proof of the claim, it has 40 calendar days to accept or deny it, in whole or in part, or to explain in writing why it needs more time (10 CCR § 2695.7).

There are details and exceptions, but the point is simple: an insurer cannot ignore you indefinitely.

What you can do

Put it in writing. Phone calls disappear. Emails and letters do not. After every call, send a short email confirming what was said: “Per our call today, you said you would send the rental authorization by Friday.”

Keep a log. Write down the date, time, name and what was said for every contact, and every message you left that was not returned.

Use the claim number on everything. It makes it harder for anything to get “lost.”

Ask for a supervisor. If your adjuster has not responded in more than two weeks, call the claims department and ask for the adjuster’s supervisor by name.

File a complaint with the California Department of Insurance. The Department takes complaints from consumers about claim delays, including from people with claims against someone else’s insurer. A complaint creates a record, and insurers respond to it.

What not to do

• Do not settle out of frustration. The first offer after a long silence is usually low. Read should I accept the first offer?
• Do not stop treatment while you wait. A gap in care hurts the claim far more than the delay does. Read why gaps in treatment hurt a claim.
• Do not give a recorded statement just to get things moving. Read why you should decline.
• Do not assume the delay stops the clock. The deadline to file a lawsuit keeps running whether or not the adjuster ever calls you back.

When it is time to stop waiting

If the insurer has gone quiet for weeks, has lost your paperwork twice, or is still “investigating” a crash that was plainly its driver’s fault, it is time for a lawyer to take over the communication. Once a firm is involved, the conversation usually moves to a demand letter with a deadline to respond.

Talk to Boyd

If you cannot get an answer from an insurance company, call. The consultation is free, and Boyd takes the call himself: (714) 656-2400.