How long does an insurer have to respond to a claim in NH?

Blogs from January, 2021

Attorney Mark Rufo PC

When you submit an insurance claim for the recovery of benefits, your insurer must respond with a certain timeframe. Failure to respond within the timeframe specified by New Hampshire law may be grounds for an insurance bad faith lawsuit.

If you sustain a personal injury that results in extensive medical bills, lost wages and other monetary losses, time is of the essence. Know that you are not in the wrong for wanting your insurer to respond to your claim in an appropriate and timely manner, and that the law is on your side.

Time limits for acknowledging the receipt of a claim

Per Chapter Ins 1000 Claim Settlement of the New Hampshire legal code, every insurer has up to 10 working days to respond to an insured’s claim. The acknowledgment must arrive in written form, save for in cases in which a speedier method is available — in which case, the insurer must use the speedier method. The response must be complete and accurate, and wholly address your inquiry.

In some cases, an agent of the insurer may receive notice of a claim. If this is the case, the insurer still has within 10 days to respond. However, if the agent notifies you within five working days that he or she does not have the authority to accept notices of claims, then notice to the agent does not constitute notice to the insurer.

Time limits for settling a claim

Just like the law grants your insurer so many days to respond to your claim, it also specifies by when your insurer must make a decision. By law, insurance companies must begin to investigate a claim within five days of receipt of notice of loss. If an insurer comes to a conclusion within the 10-day response period, it may include its decision within the initial correspondence. However, if the insurer needs more time, it must specify the reason for the delay in the notice.

When dealing with a health insurance claim, insurers have up to 30 days from the receipt of the notice of a claim to make a complete decision. However, if the insurer does not come to a conclusion within that 30-day window, it must provide you with a written explanation justifying the delay. For every 30 days the insurer fails to come to a conclusion, it must provide you with written justification.

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