What can I expect as a timeline for an initial insurance offer after we send a demand? — California (CA) | California Estate Planning | FastCounsel
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What can I expect as a timeline for an initial insurance offer after we send a demand? — California (CA)

Timeline for an Initial Insurance Offer After Sending a Demand — California

Short answer: California law does not prescribe a single, fixed deadline for an insurer to make an initial settlement offer after it receives a demand. Insurers must investigate and handle claims promptly and reasonably; in practice, an initial offer often arrives anywhere from a couple of weeks to several months after a complete demand, depending on the claim’s type and complexity.

Detailed answer — what controls the timeline

Two things govern what you can reasonably expect: (1) legal duties that require insurers to investigate and act reasonably and without undue delay, and (2) practical variables that affect how quickly the insurer can evaluate and price a claim.

Legal framework

California’s unfair-claims-practices law requires insurers to act fairly and reasonably when investigating and settling claims. See California Insurance Code § 790.03 for a list of prohibited practices, including unreasonable delay and failure to properly investigate or communicate with claimants: Cal. Ins. Code § 790.03. That statute does not give a specific number of days for a settlement offer. Instead, it creates a duty of reasonableness. If an insurer unreasonably delays, you may have a basis to complain to the California Department of Insurance or, in some circumstances, pursue remedies in court.

Practical timeline ranges (typical scenarios)

  • Simple property damage or straightforward liability (minor auto accidents, clear liability): initial contact/acknowledgement within a few days; initial offer often within 2–6 weeks after a complete demand.
  • Moderate injury claims with medical records to review: insurer often needs 4–12 weeks to evaluate medical bills, records, and lost-wage documentation and then make an initial offer.
  • Severe injuries, disputed liability, or claims requiring independent medical exams or complex valuation: evaluation can take 3–6 months or longer before a meaningful offer appears.
  • Policy-limit or catastrophic claims: insurers may respond faster for a full-value policy-limits demand, but they also may need extra time to confirm reserves, investigate, and obtain internal approvals; expect anywhere from a few weeks to a couple months depending on how complete the demand is.

Key factors that lengthen or shorten the timeline

  • Completeness of your demand package (medical records, bills, lost-wage documents, photos, repair estimates).
  • Whether liability is undisputed or contested.
  • Need for third-party investigations (surveillance, accident re-creation) or independent medical exams (IME).
  • Internal insurer procedures and approval chains — some offers require supervisor/committee approval.
  • Whether the claim implicates policy limits or potentially multiple insurance carriers.
  • Volume and backlog at the insurer (high-volume carriers may respond more slowly).

Actions you can take to speed a reasonable response

Prepare a clear, organized demand and follow a consistent follow-up plan:

  • Submit a complete demand: include a concise demand letter, itemized damages, key medical records, invoices, and any liability-supporting evidence (photos, police reports).
  • Set a reasonable response deadline in your demand (commonly 30 days) and state that you will follow up. A deadline signals seriousness and gives the insurer a target without implying a legal cutoff.
  • Follow up promptly — call or e-mail 7–14 days after submitting the demand to confirm receipt and ask for the expected response window.
  • If the insurer requests additional records, provide them quickly. Keep a trail of every communication (dates, names, content).
  • If you get repeated, unexplained delay or evasive responses, escalate internally to a claims supervisor or unit manager.

When delay or a lowball offer may be a problem

If the insurer unreasonably delays investigation or denies/lowballs without a reasonable basis, you may have a claim for bad-faith handling under California law. Unreasonable behavior could include ignoring reasonable proof of loss, failing to communicate, or refusing to consider valid medical records. California’s unfair-claims-practices statute, Insurance Code § 790.03, explains prohibited insurer practices that courts may consider when evaluating whether the insurer acted improperly.

Practical next steps if you don’t get a reasonable initial offer

  • Send a firm follow-up (reference original demand, summarize what’s outstanding, and restate your deadline).
  • Request escalation to a claims supervisor or manager.
  • Consider mediation or demand for appraisal if the policy allows.
  • File a complaint with the California Department of Insurance if you believe the carrier engaged in unfair practices.
  • Consult an attorney experienced in California insurance claims if the insurer unreasonably stalls, refuses to negotiate, or issues a clearly inadequate offer.

Example timelines (hypothetical)

Example A — Minor auto accident with clear liability: demand sent with photos, repair estimate, and one medical visit. Expect an acknowledgement within 2–7 days and a first offer within 2–6 weeks.

Example B — Soft-tissue injury with ongoing treatment: demand with medical records and wage documentation. Expect insurer investigation and need for additional medical records; typical time to a realistic offer: 6–12 weeks.

Example C — Multiple fractures and surgery (catastrophic): policy-limit demand necessary. Insurer may prioritize but still needs time to confirm reserves and approvals; timeline can be 2–8 weeks or longer depending on completeness of records and insurer process.

Helpful Hints

  • Include everything: full medical records, itemized bills, lost-wage proof, photos, police report, and a clear demand letter.
  • Set a clear but reasonable response deadline in the demand (30 days is common).
  • Follow up within 7–14 days to confirm receipt and ask for an expected decision date.
  • Keep careful records of every call and e-mail — note names, dates, and summaries.
  • Ask for the adjuster’s file notes or summaries of what they relied on if you get a low offer.
  • Consider a policy-limits demand if injuries are severe — but only after you have sufficient documentation and legal advice.
  • If the insurer ignores or stonewalls you, you can file a complaint with the California Department of Insurance and consider counsel for a bad-faith evaluation.

Disclaimer: This article is for general informational purposes only and does not constitute legal advice. It explains typical California practices and statutes in plain language, but it is not a substitute for consulting a licensed attorney about your specific situation.

The information on this site is for general informational purposes only, may be outdated, and is not legal advice; do not rely on it without consulting your own attorney.