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What you can do to speed up insurance claims

Posted at 6:54 PM, Dec 08, 2017
and last updated 2017-12-08 20:58:47-05

If you file an insurance claim, how long should you have to wait for it to process?

Jim in Mesa let Joe know he bought travel insurance, and filed a claim in September, "before the hurricanes."

Months later he says his claim is still in limbo, and when he tries to get in touch with the insurance company he can't leave a message, "only a call back number."  Once the call is returned, "the only information is that your claim is being processed."

It's been weeks since the last hurricane hit land, and Jim is tired of waiting. So, how long can the insurance company drag their feet?

According to the Arizona Administrative Code, insurers have 15 working days after proof of loss to approve or deny a claim. (pg 47 section G paragraph 1a)  

However, that time can be extended 45 days at a time for additional review.

Consumers are to be notified of the delay, but because the law is flexible a spokesman for the Arizona Department of Insurance suggests filing a complaint if you feel, "the insurer is not paying the claim in a timely fashion."  You can do that here

Those rules apply for most types of insurance policies offered in Arizona; except for heath insurance.

Those claims have their own rules. 

According to state law, "clean claims" or simple health insurance claims that don't require additional investigation, have to be taken care of within 30 days unless the contract specifies differently.  

If a claim requires additional time for investigation, insurers must "send a written request for additional information" to the healthcare provider with specific reasons for the delay.

Once the information is received, it has 30 additional days to make a determination.