When Will the Insurance Company Offer a Settlement?
If you’re in the middle of a workers’ compensation claim, it’s normal to reach a point where you wonder, “So, when will the insurance company finally offer a settlement?” The truth is, there isn’t a universal timeline. Every case moves at its own pace, depending on one’s injury, recovery, or how complicated the claim is. However, many injured workers eventually receive a settlement offer. Read on to learn more about what determines the timing and how an attorney can help speed things up for you.
What Determines When the Insurance Company Decides To Make a Settlement Offer
Several factors may be considered before you get the call for a settlement offer.
- Reaching Maximum Medical Improvement (MMI)
A settlement offer may not be presented to you until your doctors say you’ve reached maximum medical improvement. This means that your condition has stabilized, and further treatment is unlikely to impact your outcome significantly. Once you reach MMI, the insurer finally has information to measure any permanent limitations on long-term medical needs.
- The Severity and Long-Term Impact of Your Injury
More serious injuries may require longer treatment and evaluation. For instance, if your case involves surgery or rehabilitation, the insurance company may wait until there’s a clearer picture of your prognosis before offering anything.
- Disputes About Liability
If there is doubt about whether your injury is work-related or whether you followed proper procedures, the process can slow down. The insurance company must investigate or request an independent medical examination (IME) before offering you a settlement.
- The Need for Medical Records or Exams
If the insurance company takes its time to gather medical records, schedule IMEs, or wait for test results, this can extend the settlement timeline.
- Administrative Delays
Even when you have a straightforward claim, administrative delays stall your claim.
Typical Workers’ Compensation Timeline
The typical timeline before receiving a settlement offer involves several key steps.
- Reporting the Injury
In Vermont, you must notify your employer of a workplace injury immediately or within 72 hours. Waiting any longer can delay or cause issues with your claim.
- Filing the Claim
To kickstart the compensation process, your employer must file a First Report of Injury (FROI) with the Vermont Department of Labor. Always follow up to make sure it’s submitted promptly.
- Medical Evaluation and Ongoing Care
Next, a healthcare provider documents your injuries and treatment plan. These records will be used for the settlement discussions. If something doesn’t feel right, you can request a second opinion.
- Receiving Benefits and the 21-Day Rule
Once the insurer receives notice of your injury, they have 21 days to accept or deny the claim or request more time if they truly need it. If they fail to act within that window, the Commissioner can order compensation to begin.
As you continue with treatment, remember to document your symptoms, attend appointments, and follow any restrictions given. Once the doctor clears you and the claim has run smoothly, you’ll typically move into settlement negotiations.
How a Workers’ Comp Lawyer Can Help
A skilled attorney can help speed things up by:
- Pushing back when insurers delay
- Gathering missing records
- Challenging unfair IMEs
- Calculating the actual long-term value of your claim
- Negotiating a settlement that reflects your needs.
Need Help With a Delayed Settlement?
If your claim is dragging on or the first offer is too low, contact an experienced Vermont workers’ comp lawyer at Sluka Law PLC today to protect your benefits and legal rights.
