Short Answer

Yes. In North Carolina, you can escalate inside the insurance company (ask for the adjuster’s supervisor or a claims manager) and, if needed, file a complaint with the North Carolina Department of Insurance. In a workers’ compensation case, if nonresponse blocks lien information you need for a third-party settlement, you can also seek relief through the North Carolina Industrial Commission or ask a Superior Court judge to address the workers’ compensation lien.

Understanding the Problem

In North Carolina, can you escalate or file a complaint when a workers’ compensation insurance adjuster will not respond to your request for a lien amount you need to move a settlement forward? Your attorney now has the claim number and the adjuster’s contact information, but there has been no response for weeks. You want to know your options to prompt action and keep your case on track.

Apply the Law

North Carolina law expects insurers to handle claims in good faith and to respond to reasonable communications. In workers’ compensation, the insurance carrier may have a statutory lien on any third-party recovery equal to what it has paid, and you often need a current ledger to resolve that lien before finalizing a settlement. When an adjuster will not respond, you may escalate within the company, file a complaint with the North Carolina Department of Insurance, and, if the lien itself is the holdup, ask a court to address the lien. The main forums are the North Carolina Department of Insurance for regulatory complaints, the North Carolina Industrial Commission for workers’ compensation claim administration, and Superior Court for third‑party lien issues.

Key Requirements

• Document your efforts: Keep dated emails/letters that include the claim number, what you need (lien ledger or payoff), and a clear response request.
• Escalate internally: Ask for the adjuster’s supervisor or a claims manager and resend your request with your documentation.
• Regulatory complaint: If the insurer still does not respond, file a complaint with the North Carolina Department of Insurance about failure to promptly address claim communications.
• Industrial Commission relief: If silence is delaying benefits or approvals within the workers’ comp case, your lawyer can file a motion or request a hearing with the North Carolina Industrial Commission.
• Lien determination path: If you need the workers’ comp lien to resolve a third‑party settlement and the carrier will not cooperate, a Superior Court judge can address the lien and distribution under North Carolina law.

What the Statutes Say

• N.C. Gen. Stat. § 58-63-15 (Unfair claim settlement practices) - bars insurers from failing to promptly respond and act on pertinent claim communications.
• N.C. Gen. Stat. § 97-10.2 (Third-party claims and workers’ comp lien) - recognizes the carrier’s lien and allows court involvement in distribution.
• N.C. Gen. Stat. § 97-18 (Payment and timing in workers’ comp) - sets key timelines and obligations for carriers handling claims.

Analysis

Apply the Rule to the Facts: You now have the claim number and the adjuster’s contact, and weeks have passed without a response. That satisfies the need to document reasonable attempts and supports escalation to a supervisor. If silence continues, a Department of Insurance complaint is an appropriate next step to address lack of prompt communication. If the issue is obtaining a workers’ comp lien payoff for a third‑party settlement, you can seek court involvement to address or set the lien so your case can move forward.

Process & Timing

1. Who files: Your attorney. Where: First escalate within the insurance company (supervisor/claims manager). If needed, file a complaint with the North Carolina Department of Insurance Consumer Services Division. For lien or claim‑administration relief, file with the North Carolina Industrial Commission or, for third‑party lien disputes, in Superior Court. What: Written escalation email/letter; DOI complaint form; Industrial Commission motion or Form 33; motion to address lien in Superior Court. When: After giving the adjuster a reasonable response window and documenting no reply.
2. DOI acknowledges and investigates complaints; the insurer must respond to DOI. Timeframes vary with workload and the complexity of the issue.
3. If court or Commission action is needed, your attorney files the appropriate pleading. Expect scheduling to vary by county and docket. The outcome is typically a written order or documented resolution that lets settlement proceed.

Exceptions & Pitfalls

• Wrong contact slows everything: confirm the correct carrier/TPA, date of injury, and claim number.
• Authorization roadblocks: some carriers will not release a payment ledger without a signed authorization; include it with your request.
• Relying on phone calls: always follow up in writing so you can show dates and contents of your requests.
• Mixing lien types: in workers’ comp, the carrier’s lien typically covers amounts it paid; ask for an updated ledger right before settlement.
• Process limits: a DOI complaint prompts regulatory oversight but does not operate as a court order; use Commission or court filings if you need enforceable relief.

Talk to a Personal Injury Attorney

If you're dealing with an unresponsive adjuster and need a workers’ compensation lien to resolve your case, 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.