What This Question Is Really Asking
You’re asking when your case can move from “we reported the claim” to “we can negotiate a fair resolution.” In most premises liability cases, the adjuster will want documentation showing (1) what injuries you had, (2) what treatment you received and why, and (3) what the charges and payments were. Until that information is organized, negotiations tend to be limited or slow.
A Practical Step-by-Step Path
- Immediate priorities: Preserve what you already have (photos, the incident report confirmation if you were given one, names/roles of witnesses in general terms, and a simple timeline of symptoms and appointments). If you’re still having head-related symptoms like dizziness, the key legal point is documentation—make sure your symptoms and dates are accurately reflected in your medical records.
- Short-term tasks: Your lawyer (or you) typically sends HIPAA-compliant authorizations to each provider and requests both records and itemized billing. This is where delays commonly happen because a “hospital visit” can generate separate bills from different groups (facility, imaging, lab, physician group, etc.). It’s also common for providers to reject authorizations they consider “stale,” so the timing and formatting of the release matters.
- Later-stage steps: Once the key records and bills are in, the claim can move into a more organized demand/negotiation phase. If you are still treating, negotiations may still happen, but the adjuster often argues they can’t evaluate the claim without a clearer end point (or at least a well-documented treatment plan and prognosis). If settlement doesn’t happen, the next milestones may include filing suit before any deadline and using the court process to exchange information.
Timing: What Can Speed Things Up or Slow Things Down
- Multiple providers = multiple delays: ER care, imaging, follow-up visits, and therapy often come from different billing departments and record custodians.
- Records vs. bills vs. “paid amounts”: For negotiation, it often helps to have not only the charges, but also documentation showing what was actually paid and what remains owed (for example, statements and insurance explanations of benefits). That can take additional time to gather and reconcile.
- Ongoing treatment: If you’re still treating, the file is still changing. Adjusters often push for early settlement, but early numbers can miss future care needs or ongoing symptoms.
- Liability investigation: In a slip-and-fall, the adjuster may focus on how the puddle got there, how long it was there, what the store knew or should have known, and whether any comparative fault arguments apply. That investigation can run alongside medical collection.
- Local variability: Provider turnaround times and record vendors vary widely, and that can affect how quickly a demand package can be assembled.
How This Applies
Apply to the facts: Because this is a retail-store slip-and-fall with a head impact and ongoing care, it’s normal for your firm to focus first on getting complete records (including any imaging reports) and complete billing from every entity involved in your care. It’s also normal to contact the insurer early to confirm where to send documentation and to prevent the claim from going “quiet,” while waiting for the medical paperwork to arrive and your treatment picture to stabilize enough to support real negotiation.
What the Statutes Say (Optional)
- N.C. Gen. Stat. § 90-411 (medical record copy fees) – Allows providers to charge regulated, per-page fees for copies of medical records in many situations.
- N.C. Gen. Stat. § 131E-91 (itemized hospital bills) – Requires hospitals and ambulatory surgical facilities to provide an itemized list of charges upon a patient’s request.
Conclusion
In Durham slip-and-fall injury claims, it’s common for medical records and billing to take weeks to gather—especially when several providers are involved—and that paperwork often drives when negotiations can become productive. You can usually communicate with the adjuster early, but stronger negotiation typically starts once the records, itemized bills, and payment information are organized and your treatment course is clearer. One practical next step is to make a list of every provider involved so nothing is missed in the records and billing requests.
