Can I hold the insurer liable if they ignore my injury claim and delay communication?: North Carolina

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Can I hold the insurer liable if they ignore my injury claim and delay communication? - North Carolina

Short Answer

In North Carolina, slow responses alone usually are not enough to sue an insurer on a third-party liability claim. But if the insurer engages in unfair claim settlement practices—like failing to respond, investigate, or make a fair offer when liability is reasonably clear—you may have a claim under North Carolina’s unfair trade practices law. If the delay involves your own coverage (such as MedPay), you may also have contract or bad‑faith remedies. Key deadlines include three years to file a personal injury suit and four years for an unfair trade practices claim.

Understanding the Problem

You want to know whether you can hold an insurer accountable when they ignore your injury claim and delay communication. In North Carolina personal injury cases, this issue often arises when you are making a claim against the other driver’s liability policy. Here, the same insurer covers both drivers, the police report found the other driver at fault, and you have ongoing shoulder treatment, but you have not received any offer.

Apply the Law

North Carolina law prohibits insurers from using unfair claim settlement practices. For third‑party claims, you generally cannot sue the insurer for negligence directly, but you can seek relief if the insurer’s conduct amounts to an unfair or deceptive practice that causes you harm. If the problem is with your own first‑party benefits (like MedPay), you can pursue breach of contract and, in limited cases, bad‑faith refusal to pay. Personal injury lawsuits are filed in the county’s trial courts (usually Superior Court for higher‑value cases), and strict filing deadlines apply.

Key Requirements

  • Unfair or deceptive act: The insurer used an unfair claims practice (for example, failing to acknowledge and act promptly on communications, not investigating, or not attempting a fair, prompt settlement when liability is reasonably clear).
  • In or affecting commerce: Insurance claim handling qualifies as business conduct covered by North Carolina’s trade practices law.
  • Causation and actual injury: The unfair practice caused you a concrete loss (such as additional expenses, delayed treatment costs, or litigation costs).
  • Third‑party vs. first‑party: For a third‑party liability claim, your remedy is typically under the unfair trade practices statute; for your own coverage (e.g., MedPay), you may also assert breach of contract and, when conduct is egregious, bad‑faith refusal to pay.
  • Deadlines: File any negligence lawsuit within three years; unfair trade practices claims generally within four years.

What the Statutes Say

Analysis

Apply the Rule to the Facts: The police found the other driver at fault and the same insurer covers both drivers. The lack of response by the insurer does not automatically create liability, but if they are ignoring communications, delaying investigation, or refusing to make a fair offer despite reasonably clear liability, that conduct may support a claim under North Carolina’s unfair trade practices law. If the delay affects your own MedPay benefits, you may also consider a contract or bad‑faith path against your insurer.

Process & Timing

  1. Who files: You (the injured person). Where: For a lawsuit, file a Complaint with the Clerk of Superior Court in the county where the crash happened or where the defendant lives. What: Civil Summons (AOC‑CV‑100) and a Complaint; attach or reference key facts (police report, medical records, bills). When: File the negligence lawsuit within three years; an unfair trade practices claim within four years.
  2. Before suit, send a written demand to the liability insurer with the police report, treatment records, and bills, and give a clear response deadline. If communications stall, you can also submit a consumer complaint to the North Carolina Department of Insurance to prompt review.
  3. If the insurer still will not engage, file suit against the at‑fault driver to preserve your personal injury claim. If facts support it, you may add a separate claim against the insurer for unfair or deceptive claim settlement practices. The court will issue a Summons; you must serve the defendant properly.

Exceptions & Pitfalls

  • No direct action (generally): You typically cannot sue the other driver’s insurer directly for negligence; you sue the at‑fault driver. Claims against the insurer focus on unfair settlement conduct, not the crash itself.
  • Same‑insurer complication: When both drivers share the same insurer, adjusters manage competing duties. That alone is not unlawful, but prolonged non‑response or failure to evaluate clear liability can support an unfair practices claim.
  • First‑party vs. third‑party: Bad‑faith refusal to pay is mainly a first‑party remedy. For third‑party liability claims, your path is usually the unfair trade practices statute.
  • No tolling by complaints: A demand letter or a Department of Insurance complaint does not pause the court filing deadlines.
  • Authorizations and statements: Avoid broad medical authorizations and recorded statements that go beyond the crash issues; provide targeted records to keep the claim moving.

Conclusion

North Carolina does not make an insurer automatically liable just for slow responses. But if an insurer ignores communications, fails to investigate, or refuses a fair, prompt settlement when liability is reasonably clear, you may pursue relief under the state’s unfair trade practices law, and first‑party delays may also support contract or bad‑faith claims. Preserve your rights: file any injury suit in Superior Court within three years, and bring any unfair trade practices claim within four years.

Talk to a Personal Injury Attorney

If you’re dealing with an insurer that won’t respond or fairly evaluate your North Carolina injury claim, our firm has experienced attorneys who can help you understand your options and timelines. Reach out 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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