How long will the insurer have to review new medical records in my claim?: North Carolina

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How long will the insurer have to review new medical records in my claim? - North Carolina

Short Answer

North Carolina law does not set a fixed number of days for an auto or liability insurer to review new medical records. Insurers must investigate and act on claims promptly and cannot delay unreasonably once liability is reasonably clear. In practice, many carriers take a few weeks to evaluate supplemental records, but the exact time depends on the complexity and completeness of what you send. If negotiations stall, protect your rights by watching the statute of limitations.

Understanding the Problem

You are asking, in North Carolina, how long the insurer can take to reconsider a settlement after you submit additional medical records in a personal injury claim. The adjuster has called the current offer “final” unless you provide new documentation. You want to know what timeline applies and how to keep your claim moving.

Apply the Law

North Carolina does not give insurers a specific number of days to re-review a claim after you submit new medical evidence. Instead, insurers must promptly acknowledge communications, reasonably investigate, and make good-faith, timely decisions. If liability is reasonably clear, they cannot delay settlement by demanding unnecessary paperwork or slow-walking review. Outside of pre-suit negotiations, your hard deadline is the statute of limitations to file a lawsuit in the General Court of Justice.

Key Requirements

  • Material new documentation: Submit records that add something substantive (e.g., new diagnoses, imaging, treatment plans, or final bills), not duplicates.
  • Reasonable review time: The law requires prompt, good‑faith evaluation; there is no fixed day count. The more complete your package, the faster a decision is reasonable.
  • Written supplement and deadline: Send a dated cover letter identifying what’s new and set a clear response date. Follow up in writing if you don’t hear back.
  • No unreasonable delay: Once liability and damages are reasonably clear, the insurer should not prolong settlement by needless requests or inaction.
  • Limitations period: Most North Carolina personal injury claims must be filed within three years; do not let negotiations run out the clock.
  • Forum if needed: Pre‑suit is with the insurer; regulatory complaints go to the N.C. Department of Insurance; lawsuits are filed in District or Superior Court depending on the amount at stake.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Because the adjuster said the offer is “final” absent new records, sending additional, relevant medical documentation (for example, imaging or a treating physician’s causation note and updated bills) triggers a duty to promptly reevaluate. There is no fixed number of days, but a complete, well-organized supplement supports a reasonable expectation of a timely response. If the carrier does not engage after your written deadline, consider a regulatory complaint or filing suit before the three‑year limit.

Process & Timing

  1. Who files: You or your attorney. Where: Insurer’s claims department (pre‑suit). What: A written supplemental demand with a cover letter, updated medical records, itemized bills/ledgers, and any new physician opinions. When: Set a specific response date in your letter (e.g., a few weeks) and note you will follow up.
  2. Follow up by email and mail if no response by your date; document all contacts. If delay persists, you may file a complaint with the North Carolina Department of Insurance, which can prompt insurer attention.
  3. If negotiations stall and the statute of limitations approaches, file a civil action in the appropriate division of the General Court of Justice to preserve your claim.

Exceptions & Pitfalls

  • Complex or incomplete records extend review time; send a concise package highlighting what is new and why it matters.
  • Repeated, duplicative record requests can signal unreasonable delay; respond narrowly and point out prior submissions.
  • Gaps in treatment or missing causation opinions slow decisions; ask your provider for a brief letter linking treatment to the crash.
  • Do not rely on verbal promises; confirm agreements and deadlines in writing and track the three‑year statute of limitations.
  • If liability is reasonably clear but the carrier stalls, a written complaint to the Department of Insurance may help refocus the review.

Conclusion

There is no fixed North Carolina deadline for an insurer to review new medical records, but the company must promptly and fairly reevaluate your claim and may not delay unreasonably once liability is clear. Send a well‑organized supplement, set a reasonable written response date, and follow up. Above all, protect your rights by filing in court before the three‑year statute of limitations if negotiations do not progress.

Talk to a Personal Injury Attorney

If you're dealing with an insurer that won’t revisit your settlement without new records, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at [919-341-7055].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.

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