State Rights & Deadlines
Every state has specific laws governing claim handling timelines, acknowledgments, inspections, payments, and appeals.
Why state-level rules matter
State statutes set the clocks for acknowledgments, inspections, investigations, and payments. They override carrier “policies” and create leverage when deadlines are missed or communications lag.
Knowing the mandated windows lets you push back on unreasonable requests, escalate silence, and request penalties or interest when timelines are violated.
- Required acknowledgment timelines
- Required inspection timelines
- Reasonable communication requirements
- Payment deadlines
- Appraisal rights
- Mediation rights
- Right to file regulatory complaints
Core rights categories
Use these mandates to keep your claim moving and compliant.
Payment Deadlines
- Statutory windows for undisputed sums
- Interest and penalties for delays
Undisputed Payment Requirements
- Pay promptly when coverage is clear
- No leverage via avoidable delays
Response Deadlines
States set firm clocks for acknowledging claims and keeping communication reasonable.
- 7–15 day acknowledgment windows after FNOL submission.
- Adjuster assignment must be communicated with contact details.
- Required cadence for status updates, often every 14–30 days.
- Overdue responses can trigger interest or regulator complaints.
- Silence is not compliant; written follow-ups preserve your record.
Stay ahead of response clocks
Send a dated acknowledgment request if you do not receive contact within the statutory window.
- How to comply: Log dates in the Claim Journal and set reminders.
- Documents that matter: FNOL confirmation, emails, and certified mail receipts.
- When violated: Escalate with a regulator notice and request interest.
Payment Deadlines
Undisputed funds must be issued within statutory windows once coverage is confirmed.
- Payment windows range from 10–20 days after liability acceptance.
- Interest may accrue on late payments depending on the state.
- Partial payments do not pause the clock for remaining undisputed sums.
- Denials must be written; vague delays can be challenged.
- Keep a ledger of promised vs. received payments.
Document every dollar
Track when estimates are accepted and when payments are due; send a deadline notice if timing slips.
- How to comply: Align your estimate submissions with clear due dates.
- Documents that matter: Payment letters, checks, EFT confirmations, and estimates.
- When violated: Request statutory interest and file a complaint if ignored.
Acknowledgment Rules
Carriers must promptly confirm receipt, assign an adjuster, and start meaningful contact.
- Written acknowledgment with claim number and contact info is required.
- States often mandate first meaningful contact within a set number of days.
- Adjuster changes should be documented with reasons and continuity plans.
- Failure to acknowledge can support bad-faith arguments.
- Keep proof of submission for all correspondence.
Lock in the paper trail
Send a concise acknowledgment request if you have not received claim details within the window.
- How to comply: Include claim number and date in every follow-up.
- Documents that matter: Intake confirmations, emails, and certified mail proofs.
- When violated: Escalate to a supervisor and copy the regulator contact.
Inspection Timelines
Inspections must be scheduled promptly with reasonable notice and limited cancellations.
- Inspections must be scheduled within the state’s reasonable timeframe.
- Advance notice is required; repeated cancellations can violate handling rules.
- Policyholders may request alternative times when notice is short.
- Reinspections should state their purpose and scope.
- Document any delay tactics tied to missing inspections.
Control the schedule
Propose two dates that meet statutory timing and log any carrier changes.
- How to comply: Confirm access, photos, and safety requirements in writing.
- Documents that matter: Inspection notices, adjuster emails, and photos.
- When violated: Request a replacement adjuster and note missed deadlines.
Undisputed Payment Requirements
When coverage is clear, carriers must issue payment without leveraging delays.
- Undisputed amounts cannot be withheld pending unrelated investigations.
- Partial acceptance triggers payment obligations for the accepted portion.
- Requests for excessive documentation should not pause undisputed sums.
- Keep a dated ledger of all undisputed amounts acknowledged.
- Escalate if funds are not released within statutory windows.
Separate what’s undisputed
Identify the amounts the carrier has agreed to and set payment due dates in your journal.
- How to comply: Send a written request that cites undisputed totals.
- Documents that matter: Acceptance letters, estimates, and payment logs.
- When violated: Demand release plus interest and note the delay for complaints.
Appraisal Rights
Many policies allow appraisal when the dispute is about price, not coverage.
- State rules may require good-faith participation and timelines for selection.
- Both parties must appoint impartial appraisers and agree on an umpire process.
- Appraisal should not be used to stall undisputed payments.
- Document invitations to appraisal and responses.
- Confirm scope of items included before proceeding.
Invoke appraisal correctly
Use state language and policy provisions when requesting appraisal to avoid objections.
- How to comply: Propose an appraiser and timeline in your notice.
- Documents that matter: Appraisal clause, notice letters, and appraisal agreements.
- When violated: Note refusals as potential bad-faith behavior and escalate.
Mediation Options
Some states offer mediation programs to resolve disputes before litigation.
- Eligibility may depend on claim type, amount, or catastrophe declarations.
- Carriers must respond to mediation requests within required timeframes.
- Mediation does not waive rights to appraisal or litigation.
- Prepare evidence packets before requesting mediation.
- Log attendance, offers, and outcomes for follow-up steps.
Use mediation strategically
Request mediation when negotiations stall to trigger additional accountability.
- How to comply: Submit requests through the state program with claim details.
- Documents that matter: Mediation requests, evidence packets, and meeting notes.
- When violated: Note carrier refusals and proceed to appraisal or complaints.
Engineering Requirements
Policyholders can request independent reviews and transparency on engineering findings.
- States may require disclosure of engineer credentials and full reports.
- Re-inspections should be justified and documented.
- Policyholders can submit their own engineer findings for consideration.
- Disputes over causation should be escalated with written evidence.
- Track changes between initial and revised reports.
Insist on transparency
Request complete engineering reports and compare them to photos and prior inspections.
- How to comply: Keep all versions of reports and response letters.
- Documents that matter: Engineering reports, CVs, and photo logs.
- When violated: Challenge unsupported conclusions and request another reviewer.
Bad Faith Indicators
Spot behaviors that violate fair-claims rules and strengthen your leverage.
- Silence beyond statutory windows for acknowledgment or decisions.
- Misstating state laws or misquoting policy language.
- Repeated document requests without clear relevance.
- Unreasonable delays in inspections, payments, or communications.
- Low offers tied to ignored evidence or timelines.
Escalate with evidence
Document each instance with dates, communications, and missing actions to support bad-faith claims.
- How to comply: Keep a running log with citations to statutes.
- Documents that matter: Denial letters, emails, call logs, and requests.
- When violated: Send a bad-faith notice and prepare a regulator complaint.
Examples of State Variations
Deadlines and requirements change by state—verify your local rules.
Payment Windows
10–20 day issuance timelines once liability is accepted.
Acknowledgment Windows
7–15 days to confirm receipt and assign an adjuster.
Denial Requirements
Detailed written denials with evidence citations and appeal paths.
Mediation Availability
Catastrophe-specific or permanent mediation programs with state forms.
Appraisal Restrictions
Limits on when appraisal applies or timing for appointment.
Engineering Transparency
Disclosure rules for reports, credentials, and changes between drafts.
Red Flags to Watch
Escalate quickly when these behaviors appear.
- Silence for more than 30 days without explanation.
- Repeat documentation requests without tying to coverage.
- Inspection delays or repeated no-shows.
- Lowball estimates that ignore statutory timelines.
- Misstatements of state laws or claim obligations.
- Withholding undisputed payments to gain leverage.
Use these tools to enforce your rights
Pair state rules with the right workflows to stay compliant and proactive.
Evidence Organizer
Keep inspections, photos, and reports ready for quick submission.
Go to Evidence OrganizerDocument Generator
Create acknowledgment requests, payment notices, and complaints.
Generate DocumentsUse Your State Rights to Strengthen Your Claim
Check your state’s deadlines, log them in your journal, and act before carriers miss their clocks.