What happens if the insurer says my claim has to be handled by a different adjuster due to a conflict? – North Carolina

Short Answer

In North Carolina, an insurer can reassign a claim to a different adjuster if it believes a conflict exists (for example, when the same crash involves both a fatality claim and an injury claim, or when uninsured/underinsured motorist issues overlap with liability issues). A reassignment does not cancel the claim, but it can change who communicates, what information is needed, and how the claim is evaluated. The practical next step is to confirm the new adjuster’s name, claim number, and what the insurer needs to open or separate the bodily-injury file.

Understanding the Problem

In North Carolina wrongful death and injury claims, an insurer may say a claim must be handled by a different adjuster “due to a conflict.” The decision point is whether the insurer is simply separating claim files and assigning different people to different coverage issues, or whether the insurer is using “conflict” as a reason to delay opening or handling the bodily-injury claim. The core issue is how the reassignment affects communication, documentation, and timing for the bodily-injury claim arising from the same crash.

Apply the Law

North Carolina law does not require one specific adjuster to handle a claim. Insurers commonly assign different adjusters when different coverages or different claimants are involved (for example, a liability bodily-injury claim versus an uninsured/underinsured motorist claim, or an injury claim alongside a fatality claim involving an estate). Even with a reassignment, the insurer still must handle the claim in a way that is reasonably prompt and organized, and it may use pre-suit mediation procedures in certain insurance disputes through the Clerk of Superior Court.

Key Requirements

Clear claim separation: The insurer should identify which claim is being reassigned (for example, uninsured/underinsured issues versus a separate bodily-injury claim file) and provide the correct claim number and contact person for each file.
Proper authority and representation: If the insurer requests a representation letter, it is usually trying to confirm who is authorized to communicate and receive claim information for the specific claim file.
Reasonable progress: Reassignment should not become a reason to stall basic steps like confirming coverage positions, identifying needed documents, and scheduling statements or medical record collection.

What the Statutes Say

N.C. Gen. Stat. § 7A-38 (Prelitigation mediation of insurance claims) – Allows certain insurance claims to be sent to pre-suit mediation through the Clerk of Superior Court and provides tolling rules tied to that mediation process.
N.C. Gen. Stat. § 1-540.2 (Settlement of property damage claims from motor vehicle collisions) – Clarifies that settling property damage does not automatically settle bodily injury or death claims unless the written settlement terms clearly say so.

Analysis

Apply the Rule to the Facts: The facts describe a multi-vehicle crash where an insurer reports its insured was a pedestrian who died, while the passenger reports neck and back pain with same-day emergency care and follow-up chiropractic treatment. In that setting, an insurer may separate (1) a file involving the fatality and estate-related issues and (2) a separate bodily-injury file for the passenger, and it may also separate uninsured/underinsured handling from liability handling. The request for an attorney representation letter is consistent with the insurer trying to confirm who will communicate for the bodily-injury claim and to open or re-route that claim to the correct adjuster.

Process & Timing

Who files: The injured claimant (or the claimant’s attorney). Where: With the insurer’s assigned adjuster(s) for the correct claim file(s) in North Carolina. What: A written representation letter that identifies the claimant, date of loss, parties/vehicles involved as known, and requests the claim number, adjuster contact information, and confirmation of which coverages are being handled in each file. When: As soon as the insurer raises “conflict” or asks to reassign the file, so the bodily-injury claim does not sit in the wrong department.
Next step: The new adjuster typically confirms the claim number, sends authorizations or requests for records/bills, and may request a recorded statement or a written description of injuries and treatment. If multiple adjusters exist (for example, one for uninsured/underinsured and one for liability), each should be asked in writing what issue that adjuster is responsible for.
Final step: Once the insurer has the core documentation (treatment records, bills, wage information if relevant, and liability facts), it evaluates the bodily-injury claim and either negotiates resolution, denies, or requests additional information. If the dispute becomes formal and qualifies, pre-suit mediation may be initiated under North Carolina’s insurance-claim mediation statute through the Clerk of Superior Court.

Exceptions & Pitfalls

“Conflict” used as a delay tactic: If the insurer will not identify the new adjuster, will not confirm the claim number, or keeps bouncing the file between departments, the claim can lose momentum. A short written request that demands the correct adjuster contact and confirms the claim type often prevents this.
Mixing claim types: Uninsured/underinsured issues, liability bodily-injury issues, and estate-related wrongful death issues can involve different rules and different decision-makers. Confusion about which adjuster handles which issue can lead to missed requests, duplicated statements, or inconsistent information.
Signing broad releases too early: When multiple claims exist from one crash, paperwork meant to resolve one part (like property damage) should be reviewed carefully so it does not unintentionally sweep in bodily injury or death claims. North Carolina law addresses how property-damage settlements relate to other claims, but the written terms still matter.

Conclusion

In North Carolina, an insurer can reassign a claim to a different adjuster when it believes a conflict exists, especially when one crash involves multiple claim types (injury, uninsured/underinsured issues, and a fatality/estate claim). The reassignment should not stop the bodily-injury claim, but it can change who handles it and what documentation is required. The most important next step is to send a written representation letter and request written confirmation of the correct bodily-injury claim number and the newly assigned adjuster.

Talk to a Wrongful Death Attorney

If a fatal crash has created overlapping insurance files and the insurer says a “conflict” requires a different adjuster, our firm has experienced attorneys who can help clarify who should handle each claim, what information is needed, and what timelines matter. Call us today at (919) 341-7055.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.