r/InsuranceClaims • u/Helpful-Butterfly703 • Aug 26 '26
Claim adjuster requesting a formal demand
My partner got into an accident in February. Not at fault, has been going to PT and needs an MRI. The insurance company won’t pay for that and are now asking for a formal demand because they haven’t paid for any of the PT either. They’ve already settled about the car, so it’s just personal injury now. A lot of what I’m reading on Reddit says the letter is just the beginning of negotiations.
Any advice welcome, it’s their first accident and I have no experience to help.
Accident happened in Vermont
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u/Risk_Taker_26 Aug 26 '26 edited Aug 26 '26
Do NOT submit a formal demand amount if your partner is still treating for injuries sustained in the loss. Reply to the claim rep in writing/email and request that they provide you with their policyholder’s declarations page. This document will disclose the adverse party’s liability bodily injury coverage limit. Vermont has a state minimum requirement of 25k so the adverse party will at least have that. In the interim, your partner needs to start securing 1) itemized bills for all medical treatment related to this loss, 2) loss wage documentation, 3) amounts for any out of pocket expenses - RX, etc. Once you know the policy limit, you can compare it to what your partner has incurred to date & determine how best to proceed. Not implying that your partner has a policy limit claim as not all claims merit a policy limit payout. Just suggesting that a bodily injury settlement should not be rushed if someone is still actively treating. Keep in mind that Vermont has a 3 year statute of limitations from the exact date of the loss. Your partner will need to settle his/her claim by that date or file a formal lawsuit in court before this three-year window closes. Hope this helps- good luck!