How long does an insurer have to reply to a compensation claim?

51

Settling a claim as quickly as possible is hugely important to all our claimants, especially those suffering the stress of losing income whilst they can’t work. It’s less important to the defendant insurers who have to pay the settlement, and who are trying to minimise the amount paid.

Insurer response times – ‘pre-action protocols’

It will not surprise you to learn that insurers are not always great at acting quickly and often drag their feet at every stage of the claims process. Of course, it is their job to minimise any settlements and pay out as little as possible, and it is our job, and that of our solicitors, to ensure that claims are settled quickly and to their maximum value.

The good news for claimants is that there are legal protocols in place designed to make sure that claims are processed in an expedient manner and help defendant insurers to investigate and settle claims quickly. These timeframes are called ‘pre-action protocols’ and they set a deadline for defendant insurers to respond to claims and carry out their investigations into allegations made against their insured.

The pre-action protocols allow maximum response times for defendant insurers. The times and guidelines can vary depending on the claim type. For example, road accident claims have different protocols to other personal injury claims.

Personal injury protocols

Time limits for personal injury claims allow a maximum response time that is effectively 3 months and 21 days from the date that a claimant’s solicitor has submitted a letter of claim. This usually plays out as follows:

  • Claimant solicitor submits a letter of claim to the third party outlining the specifics of the claim and why they are being held responsible.
  • A response to this must be provided to the claimant solicitor within 21 days.
  • At this point a defendant insurer has a period of 3 months to properly investigate the allegations made in the claim and then respond to the claimant solicitor.
  • After the 3 month period, the insurer’s reply has to state whether or not they admit liability. If there is a denial of liability, the response has to state disclosure evidence that details why they have not admitted liability and what their defence is.

In the rare case where an insurer fails to provide a response within the time allowed, a solicitor will go to the courts to progress the claim.

Road traffic accident protocols

Time limits for road traffic accident claim protocols allow a maximum response time of 15 working days. Such claims are run via the claims portal and work using this method:

  • Claimant solicitor submits a Claim Notification Form (CNF) to the insurers defending the claim. This notification has to provide all of the details and information that a defendant insurer will need to be able to fully investigate the claim and decide upon their view.

When a defendant insurer fails to respond within the 15 working day limit, the claim will then continue via the pre-action personal injury protocol, stated previously.

As you would expect with two opposing parties, there are many issues that can arise during the personal injury claims process that are beyond our control and can slow things down. As each case is different, there is no way of knowing exactly how long it can take to receive compensation. However, what we can do is ensure our claimants aren’t waiting on us for their case to progress.

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  1. I had a slip in lidl they have admitted liability and my solicitor has emailed them the medical report and an offer of settlement . How long before I hear back if they accept it or not? Tia

    • In cases where liability is not disputed and the defendant has accepted the claim, the process of reaching an agreed settlement does not usually take too long. If your Solicitor is working on the basis of a medical report and expert opinion for the value of the claim, as long as the defendant does not query the experts report, it is likely that they will make an offer within a short period of time, such as 3 weeks or thereabouts. Of course, this period could be quicker or longer!

  2. Ive been in the process of a whiplash claim for over a year now what can i do to hurry it along …. and why would my solicitor need my credit card statements and bank statements and tax return ?

    • Your bank/credit card statements and tax return are most likely needed to provide proof of identity (to satisfy Money Laundering regulations) and the tax return for proof of loss of income.

  3. Thanks for the quick reply, it was the fact that the last 10 months all they would say to me is the third party has not replied, and when I said is there not a protocol for situations like this, I would just simply get ignored, and up until I complained over 7 times to my solicitor then they said they were going to go ahead with court proceedings…

    Now the third party failed to even acknowledge the court proceedings, I am now being told they will have to contact the court for my compensation…

    How long do you think this will take now?
    And what is this procedure?

    As my solicitor always ignores my questions and when I ring they always seem to be busy

  4. I was a passenger of a vehicle that was involved in a crash, we was hit on the back door on the driver side by the police, I have been waiting 10 months for this claim to be sorted, all I get from my solicitor is that there has been no reply, I had to urge them to push it forward so they said they sent them court proceedings in which the third party again failed to respond, now I am being told that my solicitor had written to the court requesting a judgement in my favour, but I feel that my solicitors already know the outcome from the start and have just been wasting my time delaying this process so they can make more money, my representative is a trainee solicitor which has got me really confused… please help what can I say or do here to resolve this claim ASAP THANKYOU!!!

    • Why do you feel that your Solicitors are not acting in your best interests? Remember, if you are instructing a Solicitor to act for you on a No Win No Fee agreement basis, they will not receive any funds until they succeed with your claim and their fees will not be increased simply because of the time that a claim takes to settle.

      If you do feel that your Solicitor has acted poorly, the very first thing you must do is formally complain to them in order that they can investigate your complaint and respond to you. If they are unable to satisfy your complaint, you should then escalate the matter to the Legal Ombudsman Service.

      • Thanks for the quick reply, it was the fact that the last 10 months all they would say to me is the third party has not replied, and when I said is there not a protocol for situations like this, I would just simply get ignored, and up until I complained over 7 times to my solicitor then they said they were going to go ahead with court proceedings…

        Now the third party failed to even acknowledge the court proceedings, I am now being told they will have to contact the court for my compensation…

        How long do you think this will take now?
        And what is this procedure?

        As my solicitor always ignores my questions and when I ring they always seem to be busy

  5. I’m in year 4 of my MIB claim for serious injury (double above knee legs amputated) in a hit and run. Given I’m now in my late ’60’s is it likely that they’ll just string it out till I’m dead to save themselves some money?

    Latest ridiculous example: Accommodation expert suggested by them in Aug ’16. Took the MIB a YEAR to lift the phone and instruct him!! Even took MIB 6 weeks to photocopy his report and post it to my lawyer. Finally received Dec ’18.

    MIB = not fit for purpose!!

    And am I right in thinking that they have no supervising regulator (including court) to complain about it to?

    • Claims via the Motor Insurers Bureau (MIB) for untraced and uninsured driver scheme matters can be lengthy processes. In some cases this could be down to the failings of the MIB claims handler dealing with the matter, but in many cases it is a product of the area of claim type that it covers. Given that the MIB not only have a client to liaise with, they must also liaise with the Defendants, the Police, Hospitals/GP’s and medical experts to reach a point of settlement on the claim. As you can imagine, this process can take some time to confirm. That said, 4 years is a very long claim period.

      However, you have sustained permanent, life changing injuries in this accident and with such situations comes great responsibility and thoroughness. The claims handler and MIB will wish to ensure that you are fully and correctly compensated and it could be that the full damage to you and cost to you is yet to be agreed.

      • Thanks for the reply. Unfortunately it doesn’t make any sense other than as some sort of apologism for a dead dog organisation (MIB) in a lame duck system.

        This MIB has neither respect nor thought for claimants. In my case it’s “cost” 2.5 years of effective limb-wearing because that’s how long it’s taken the NHS to make me functional sockets. Given my age and the time I’m supposed to have left as a limb wearer that 2.5 years is a significant loss. Pity I haven’t had access to the private prosthetists who could have given me that 2.5 years, isn’t it?

        I was also a high earner before the accident and have had to spend the last several years watching our finances slowly erode and disintegrate as the remaining income producing assets which keep us going gradually have to get sold off and the downward spiral continues.

        These kind of things actually cause depression to seep in. But of course I’m scared to mention that because next it would be a Psychologists report which, given the experience of the “Accommodation Expert” (not to mention the Medical (poor), Prosthetic (nonsensical) and OT (very good) reports which could easily have been ordered concurrently rather than consecutively) would probably add another, what, 18 months to the claim…..

        I was in a rehab physiotherapy session for a few hours today. Got talking to a bloke who’d lost a leg to work injury 23 years ago. Know how long his compensation claim took to be settled? TWELVE YEARS!!

        Of course my claim isn’t no win no fee. It’s covered by legal insurance. So my solicitor has no personal interest in settling it speedily. I imagine he’ll be ordering a new Mercedes a year on its fees, so I’m sure he’s in no hurry to see the end of it.

  6. I had a trip at a bar and the insurance company wrote to me “accepting full liability” They have since made me interim payments( NOT on a WOP basis) for travel and loss of earnings. We were waiting for hospital to give idea of optimum recovery time etc before settlement figure for actual injury agreed. At this point I instructed a solicitor to help with obtaining reports and to ensure compensation for injury was fair. They wrote to the insurance company and then recieved a letter stating they are disputing liabily. There is no new evidence and they made original acceptance following CCTV footage review and a report by their own investigator. Can they just withdraw liability and why would they do this? Causing me great distress.

    • Yes, they can withdraw an admission of liability, but if they do not have new evidence to present to support this withdrawal or cannot provide detailed reasoning, it is unlikely that a court would find in favour of them should your claim proceed that far.

  7. The other side has accepted liability but there insurer is disputing the amount of compensation to be paid. My solicitor sent over the court proceedings and they haven’t responded within the time frame. What happens now?

    • In a claim for personal injury compensation, the first important hurdle is to obtain an admission of liability. It is good news for you that this has been achieved as it confirms that you will receive compensation for your injuries and losses. However, the next stage after admission of liability is to reach agreement on the appropriate value for the claim settlement. The value of a personal injury settlement will be reached in two parts. Firstly, you have the element of personal injury settlement that is made in relation to the injuries sustained. The value of this element will be reached on the basis of medical evidence and an expert medical report that will provide a detailed prognosis on severity of injury and recovery of the same. This will then need to be considered by Counsel who will assign an appropriate value range on the basis of the medical report. You then also need to demonstrate your lost income or incurred costs caused by the injuries and accident and this will be the special damages element of the claim. The injury settlement and special damages settlement will form the total value of the compensation claim.

      When agreement cannot be reached on settlement (which is not uncommon), the matter will need to be considered by an independent Judge in a court hearing. The hearing will have evidence from both the claimant and defence and then a decision will be made on the level of damages that the defendant will have to pay to settle the claim.

      In your case, the defendant has missed the deadline. As such, your Solicitor will likely provide them with a further deadline to meet. If they then fail to meet that deadline, the matter will proceed directly to hearing and will be decided by the Judge – who will take in to consideration the defendants lack of cooperation.

  8. my solicitors have put the report to the 3rd party involved they didnt respond within 15 working days my file has now been past to another department what happens now?

    • Typically, when an insurer misses a deadline, the acting Solicitor will contact them to make a formal request for a response within an agreed reasonable time frame – say 21 working days for example – with the threat of court proceedings if they do not cooperate. If the defendant then fails to meet the agreed revised deadline, the Solicitor will issue court proceedings to seek a judgement to force them to respond and cooperate with the claim.

  9. I have to meet with my solicitor tomorrow to answer some questions which axa insurance have asked for. I have also seen there doctor about 3 weeks ago. My question is: how long will it take axa insurance to make a settlement?

    • Before you can ask how long it will take the defendant insurer to make an offer of settlement in your claim for compensation, you’ll need to obtain an admission of liability from them. To get to the stage of admission of liability can take anything from a few weeks to 4 or more months. Each claim will be different and this period will be decreased in cases where strong supporting evidence is available.

      If liability is admitted, the next stage is for the injuries to be agreed by way of a medical examination with a subsequent written report from a suitable medical expert. The agreement of injuries and prognosis will then enable a settlement to be agreed. From the date of a settlement agreement, claimants should usually expect to receive their settlement somewhere between 15-30 working days.

  10. My son had an accident may 2017
    He lost his no claims and we paid the excess to get car repaired he was found to be at fault.
    Today almost 18 months after the accident he has received a letter from the insurance solicitor asking him to sign a form admitting liability
    Why is this and what’s it for
    He has since change insurance companies

    Thanks John

  11. Car driver ran over my feet while i was filtering traffic on the motorbike in traffic. I called police and recorded injuries in A&E. I submitted claim for personal injury 4 months ago. Insurance passed my claim to claim handlers. So far the car driver did not accept liability and the claims handlers are waiting for a police report.
    Is there any chance they can make me pay legal fees for the claim investigation?

  12. I had a accident with my supercar in June the third party have not admitted liability yet the claim has gone into a period of investigation how long am I looking to wait until it comes to an end?

  13. I fell in a pothole and broke my patella 7 months ago and the defendants have not admitted liability. My solicitor claims she has allowed extra time for them, but how much longer are they legally allowed? Should I change solicitors?

    • Whilst we can understand your frustration at the length of time it is taking for the defendant insurers to respond, it is not that uncommon for these matters to take sometime. We do not think that there is any need for you to change Solicitors as your Solicitor is acting correctly. It is likely that your Solicitor has given the defendant a deadline to respond. Should the defendant fail to respond by that deadline, your Solicitor would then issue proceedings against them.

  14. I was involved in an accident back in June 2018 whereby the other party drove into the back of me.
    It has gone through Solicitors and an offer was made by the third party insurers on 4th September and agreed the following day.
    I was advised normally it takes 2-6 weeks for them to receive the money but the Solicitors still haven’t got the money yet and when I asked if there was any maximum time frame they basically said whenever. Surely there must be some kind of timescales that the third party insures need to adhere too?

    • There is not a prescribed time limit and it is unusual for settlement to take longer than 2-6 weeks to arrive (usually it is around 21 days or so). However, if the defendant insurers fail to make payment as agreed in a reasonable time (3 months), your Solicitor could issue proceedings against them to force payment.

      • It’s been 9 weeks since settlement figure was agreed and still
        No further forward. Current solicitors (On a no win no fee) have said they will pass it their Meriut team to try to recover payments.

        Is 9 weeks classes as a reasonable time? And what options are likely
        To be Avaliable to enforce payment? Am I entitled to change solicitors if it’s on no win no fee or do I have to stick to the current ones which seem to be slow

  15. I was involved in an accident on Saturday where another vehicle went into the back of our vehicle.
    They admitted liability at the scene but no police were called & we have no witnesses and he wants to settle the car damage outside of the Insurance.
    Once the shock wore off, my back has been in pain ever since. I’m yet to go to seek medical attention due to thinking the pain would subside, but the aches are still there. I have booked to go to the GP on Friday.
    Would you recommend seeking legal advice?

    • We would 100% recommend that you DO NOT settle this matter directly with the 3rd party driver. It is understandable from their point of view that they wish to settle the damage to your car, but in doing so, that would undermine your rights and remove any proof or supportive evidence if you were to discover that your back injury was worse than you hoped and you later wished to make a claim for compensation.

      Undoubtedly, the best course of action for you would be to advise your own car insurers of the accident and allow them to deal with the vehicle damage element of this matter. However, you would be wise to keep any personal injury compensation claim separate to this and instruct a specialist in personal injury compensation such as us at Direct2Compensation to pursue a claim for your injuries and any associated loss of income or incurred costs.

      You mention no police involvement in this matter. That is not unusual in road traffic accident matters where the highway is not obstructed and there are no serious injuries or fatalities. Indeed, the police will not attend an incident such as the one you describe as long as both parties have exchanged details.

      You are wise to make a GP appointment regarding your injuries as it is important to ensure that any injuries and symptoms are checked and appropriately recorded in your medical records as that would provide important evidence for use in any claim for compensation that you were to pursue.

      Regardless of whether you wish to instruct my firm to help you make a claim for compensation or not, I would be very happy to further discuss this matter with you and invite you to email your contact details to me at: ian@direct2compensation.co.uk

  16. I was a passenger in a cab. I have been in hospital with fractured neck spine plus cervical c5c6 disc has exploded and I have been traumatised. Had surgery. Three months on, I’m waiting to hear about my claim progress from my solicitor. The cab man excepted liability. Sent all my documents of the accident & updating my recovery. My question, is What happens now.? What does my injury likely to be worth?

    • It is not possible to provide an honest estimate of the value of your claim at this stage as the long term prognosis will not be known and we do not have the contents of a medical experts report to review and consider – which is how the value of the injury element of a claim is equated and worked out. However, your claim is clearly of a high value given the lengthy hospitalisation and surgery you have undergone.

  17. Mesothelioma case submitted by solicitor 9 month ago. Liability still hasn’t been accepted. Solicitor is not worried but I am. What should I do now?

    • It can be very frustrating when you have a long period of time between claim submission and the defendants admitting liability. In your case, it could well be that there is more than one defendant and that detailed evidence is required and needs to be considered before any decisions can be made.

      If your Solicitor is not concerned, then you probably should not be either. However, if you are not confident in your Solicitor, you should express that concern to them and ask them to clarify to you in writing as to the current state of play with your claim.

  18. Hi i was a passenger in my friends car (they were the driver) who crashed into another car. The driver (my friend) had failed the breathalyser test which meant he was over the limit due to alcohol. I wasn’t aware he was drink driving. This accident happened a year ago. After the accident I suffered neck pain, shoulder pain and back pain but I did not attend hospital at that time. Although I was sore, my initial thoughts wee that the injuries were minor and that the pain would soon reduce.

    A few months after the accident, the stiff neck pain was still ongoing so I decided to seek some massage therapy to relax the muscles from my shoulder, neck and lower back which cost me quite a lot.

    On the day of the accident the police attended the scene took my name, and arrested my friend who was the driver due to drink driving. The driver has accepted liability for the other party (the other car crashed into)I have rang the police they have given me crime reference number but they said my name isn’t on the accident scene and they did reassured me the officer who took my name down on his book can still be chased and that can prove I was there. The point is my name isn’t on their database so what if they can’t find the officer who attended the scene because the police have said this incident was booked in by another officer. I do not know the name of the police officer that day of the accident. Also I did not go to hospital straight away at that time but after 9 months I had been to doctor they are aware of the accident and referred me to physiotherapy. My head was all over the place as I felt depressed from the accident and lost my job. Could you advice me if I have a claim?

    • Clearly, pursuing this claim could be difficult as there may be problems proving two issues – firstly, your presence in the accident (due to the police log not being definitive in this area) and causation in that you didn’t seek medical attention for some 9 months for your injuries. This will allow any proposed defendant to argue that your injuries may have been sustained in another accident as you cannot prove otherwise.

      • I understand that i did not go to the hospital straight away because after the accident i was suffering from nightmares, anxiety and depression which i wasn’t aware off til i had medical help also my friend died in car accident. since the car accident i had lost few jobs due to depression this is when i realised i needed medical help. After 3 months of the car accident, I had been to doctor they have diagnosed me with anxiety and depression and currently taking antidepressants. I spoken to the police officer via telephone they have said they can trace the police officer attended the scene therefore this could prove i was there on the day of accident. The police officer wrote my name on their handbook and they do not throw handbook away (was told by the police). The police said sometimes they do not put passengers name on the scene but this can be traced if necessary. I have pictures of the accident. surely the other party (car crashed into) can say there was a passenger which can also prove i was there. Surely after the medical check they can see the damages caused on my neck muscles, shoulder and lower back. Do i have a right to claim compensation? you said the injuries can be difficult to prove but that time i was battling depression and anxiety and did not have the strength to put a claim. i remember 4 weeks after the car accident i signed with a law firm but then cancelled within cooling of period due to my mental health depression and anxiety.

  19. I was in a crash where a bus pulled out in front of me. As a result, I was left suffering a broken wrist, broken clavicle, 11 broken ribs and a perforated bowel. The police have said I was going too fast for the road and overtook a car 100 yards before the bus pulled out. Does that mean I can’t claim personal injury compensation?

    • You have clearly been badly injured in this incident and as such, it would seem reasonable and fair for you to pursue a claim for road traffic accident compensation.

      Whilst there is a police report in place that is not particularly helpful to your claim as it states that you were partially responsible, it does not mean that you cannot make a claim for compensation. My initial view is that the best outcome for you would be having to accept a portion of shared liability. What that shared percentage would be cannot be stated at this time, but given the severity of your injuries, it would still be worthwhile pursuing a claim further.

  20. A lady ran me and my daughter over 7 months ago. The police were called and I was taken to hospital so I didn’t get any of her details, but the police did. The lady hasn’t reported it to her insurance company and they asked for the 3 months investigation then 4 months down the line they are waiting on police reports. I’ve damaged my spine and the solicitor is not answering.

    • On the basis of your description of the road traffic accident, it would appear that you have a valid claim for road traffic accident compensation and you ought to expect this to settle in your favour in due course.

      The insurers are within their rights to request a police report and there should be no reason why the evidence within that report does anything other than support your claim.

      If you have not already got a specialist Solicitor pursuing this claim for you, then please contact us. We’d be very happy to run this claim for you and have expert specialist road traffic accident compensation Solicitors available to represent you.

  21. Hi, i was in a car crash on 2/6/2017! The other driver has admitted full responsibility in writing in October 2017!! So should i still be waiting for my compensation after a year? My solicitor started court proceedings in may 2018

    • The admission of liability in a claim for personal injury compensation is an important milestone, but it doesn’t always follow that settlement will come immediately. Without knowing the full details of your situation and injuries, it is of course hard for us to advise. However, it may be that the full extent of your injuries or losses is not yet finalised and therefore, your Solicitor may not be quite ready to settle the claim for you. Alternatively, the defendant insurers could be responding very slowly or the court schedule could be busy?

      • HI IAN thanks for the reply.

        All loses and medical reports was done and finalised well before christmas 2017. I had whiplash(moderate) injured both shoulders ,back and chest and left knee and concussion . 3 months off work. Why would the other side drag thier feet when they got all the evidence they need?

        • It is hard to understand the delay on the basis of the information you have described, but there must be an issue of some sort that is holding things up. Perhaps the defendant insurers are not prepared to agree with the medical evidence or your Solicitor and they are unable to reach an agreed settlement value?

          I would suggest that you speak to your Solicitor regarding this issue and ask for a full explanation of the situation.

  22. Good morning,

    Is it normal for a company to take over a year to respond with liability? My personal injury claim started last January 2017, and they still haven’t replied. Apparently they’re still investigating, though never asked for an extension in this case. Threatening letters have been sent to no avail.

    Christine

    • It certainly isn’t normal for a defendant insurer to take a year to investigate a claim. However, it isn’t completely unheard of. However, it is very surprising to hear that they haven’t requested an extension in this case. It is common for an extension to be requested and granted, but not such a long extension.

      Do you already have a Solicitor acting for you?

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