Do I get to review the demand information before it is sent to the insurance company?

What You Will Usually Review Before the Demand Is Sent

A personal injury demand presents the claim to an insurance company and asks it to evaluate a possible resolution. Depending on the claim and the firm’s process, the demand may include a written summary, supporting documents, and proposed settlement terms.

A pre-demand review gives you an opportunity to check important information before it is shared with the insurer. You may be asked to review or confirm:

• How the accident happened and who was involved.
• The injuries being claimed.
• The names of the medical providers who treated you.
• The dates and general course of your medical care.
• The medical expenses connected to the injuries.
• Any documented lost income or other accident-related losses.
• Important ways the injuries affected your daily activities.
• The proposed demand position or settlement terms.

The precise materials provided for review can vary. You may receive a draft demand letter, a written claim summary, a list of records and bills, or a combination of these items. If you want to review particular attachments, ask counsel whether those documents will be included with the pre-demand materials.

Why the Outstanding Medical Bills Matter

Medical records and medical bills serve different purposes. Records describe matters such as reported symptoms, examinations, treatment, and provider observations. Billing documents identify the services charged, service dates, providers, and amounts associated with the care.

Having the records without the related billing information may leave an incomplete picture. Before preparing the demand, counsel may need to determine whether:

• Every relevant provider has supplied an itemized bill.
• The billing dates match the treatment reflected in the records.
• Separate facility, ambulance, imaging, or physician bills are missing.
• A bill includes services unrelated to the injury claim.
• Additional balances, lien notices, or reimbursement issues require attention.

Waiting for the billing documentation does not necessarily mean that nothing is happening. The information is often needed to prepare an accurate demand, avoid leaving out a provider, and give you a useful pre-demand summary to review.

North Carolina law may also give certain medical providers a lien against personal injury proceeds. Under N.C. Gen. Stat. § 44-49, a provider asserting this type of lien generally must satisfy requirements that include furnishing specified documentation and written notice. Whether a particular lien is valid depends on the facts and documents, but this is another reason counsel may need complete billing information.

What to Check During Your Pre-Demand Review

Read the review materials for factual accuracy rather than focusing only on the proposed demand terms. You know the history of your accident and recovery, so you may notice a missing provider, an incorrect date, or an incomplete description of how the injuries affected you.

Consider checking the following points:

1. Provider list: Confirm that every provider related to the claimed injuries is listed.
2. Treatment dates: Look for missing visits or dates that appear incorrect.
3. Injury description: Make sure the description is accurate and does not overstate or understate what you reported.
4. Prior conditions: Tell counsel about relevant prior injuries or treatment if they have not already been discussed. Insurers may compare prior and current medical information.
5. Lost income: Confirm that any claimed time away from work is supported by appropriate employment or income records.
6. Daily effects: Correct factual statements about activities you could not perform or found more difficult after the incident.
7. Missing documents: Identify photographs, receipts, wage records, or provider information that may not yet be in the file.

Do not edit medical records or try to change what a provider documented. If a record appears inaccurate or confusing, identify the issue for counsel so it can be evaluated and addressed appropriately.

Your Approval and the Insurance Company’s Response Are Different Steps

Approving a demand for submission does not mean that you must accept whatever the insurance company later offers. The demand begins or advances the negotiation process. The insurer may accept the proposal, reject it, ask for more information, dispute parts of the claim, or make a different offer.

If a demand contains settlement terms, your lawyer should discuss those terms with you and obtain the authority needed to communicate the proposal. Later, if the insurer makes an offer, that offer should be explained so you can make an informed decision. Your lawyer may advise you about the strengths, risks, expenses, and available options, but the decision whether to settle belongs to you.

How This Applies to the Current Claim

Here, the medical records have been received, but the medical billing documentation remains outstanding. Counsel therefore does not yet have all the information needed to prepare the planned pre-demand review.

Once the remaining bills arrive, counsel can compare them with the records, identify possible gaps, organize the claim information, and prepare the materials for your approval. During that review, you should point out missing providers, incorrect dates, unreported accident-related expenses, or other factual concerns before the demand is sent.

You can also help by preserving or gathering:

• Recent bills, balance statements, and patient account summaries.
• Receipts for accident-related out-of-pocket expenses.
• Work notes, wage statements, or other income-loss documents.
• Letters or emails from insurers and medical providers.
• Any lien, reimbursement, or collection notices.
• A current list of all providers seen for the claimed injuries.

Waiting for Documents Does Not Extend a Filing Deadline

Obtaining complete records and bills can take time, but claim discussions and document requests do not automatically extend the deadline for filing a lawsuit. N.C. Gen. Stat. § 1-52 provides a three-year period for many North Carolina personal injury actions, although the correct deadline depends on the claim and its facts.

A demand letter is not the same as filing a lawsuit. If timing could be an issue, counsel should evaluate the applicable deadline while the demand materials are being collected.