What information and documents does an insurance adjuster need to open my injury claim? – North Carolina

Short Answer

In North Carolina, an insurance adjuster can usually open a bodily-injury claim with basic identifying information, the crash details, and a clear statement of the injuries and treatment. If an attorney is involved, the adjuster will typically ask for a representation letter and may request documents that confirm coverage, identify all involved parties, and allow the insurer to evaluate medical bills, records, and wage loss. In uninsured/underinsured motorist situations, the adjuster may also need policy and claim information to set up a separate claim file.

Understanding the Problem

In North Carolina, after a motor-vehicle crash, can an injured passenger open a separate bodily-injury claim when the insurer says the insured person was a pedestrian who died and the adjuster handling uninsured/underinsured issues asks for an attorney representation letter? The practical issue is what the adjuster needs at the start to create the claim file, confirm who can communicate about the claim, and begin collecting the information needed to evaluate injuries and damages.

Apply the Law

North Carolina insurance claims are largely driven by (1) identifying the correct parties and policies, (2) confirming who has authority to communicate and receive claim information, and (3) gathering enough documentation to evaluate liability, injuries, and damages. Adjusters commonly open a claim file with basic facts first, then request supporting documents as the investigation continues. When an attorney represents an injured person, insurers typically require a written representation notice before discussing the claim in detail with the attorney and before routing communications away from the injured person.

Key Requirements

Identity & contact information: Full name, date of birth (often), current address, phone/email, and the best way to communicate.
Accident & coverage details: Date/time/location of the crash, vehicles involved, police report information (or report number), and all potentially applicable auto insurance policies (including uninsured/underinsured motorist coverage).
Injury & damages basics: A description of injuries and symptoms, where treatment occurred (ER/urgent care/chiropractic/primary care), and the types of losses being claimed (medical bills, missed work, etc.).

What the Statutes Say

N.C. Gen. Stat. § 1-540.2 (Property damage settlements and other claims) – A property-damage settlement from a crash does not automatically settle bodily-injury or death claims unless the written settlement terms clearly say so.
N.C. Gen. Stat. § 7A-38 (Prelitigation mediation of insurance claims) – Allows certain insurance claims to be sent to prelitigation mediation and explains how the mediation request can affect timing.

Analysis

Apply the Rule to the Facts: The facts describe an injured passenger reporting neck and back pain, same-day emergency care, and follow-up chiropractic treatment after a multi-vehicle crash. That is typically enough for an adjuster to open a bodily-injury claim file once the adjuster has the crash identifiers (date/location/police report) and the insurance information for all involved vehicles. Because the adjuster requested an attorney representation letter to establish a separate bodily-injury claim, the insurer likely needs written confirmation of representation and the claimant’s identifying information so it can create a distinct claim record and direct communications through counsel.

Process & Timing

Who files: The injured person or the injured person’s attorney. Where: With the correct insurance company’s claims department (often by phone and then in writing). What: A claim notice plus an attorney representation letter (if represented), along with the crash identifiers (date, location, parties, and police report number if available). When: As soon as practical after the crash, especially when uninsured/underinsured motorist coverage may apply.
Claim setup and initial requests: The adjuster assigns a claim number and may send forms or written requests. Common early requests include: a copy of the crash report (or report number), photos if available, basic medical-provider information, itemized bills, and signed medical authorizations (or a request that records be provided through counsel).
Ongoing evaluation: As treatment continues, the adjuster typically requests updated medical records and bills, proof of missed work (if claimed), and a clearer summary of the injury course and current status. If multiple coverages or multiple claim files exist (for example, liability and uninsured/underinsured), the adjuster may request policy declarations pages and confirmation of all available coverages to ensure the claim is routed correctly.

Exceptions & Pitfalls

Multiple claim files in the same event: A fatality claim (wrongful death) and a passenger’s bodily-injury claim can involve different claimants and different authority to negotiate. The adjuster may require separate documentation to open and discuss each claim.
Authority to communicate: Without a representation letter, an insurer may limit what it will discuss with an attorney. With a representation letter, the insurer may stop communicating directly with the injured person about the claim.
Incomplete provider information: If the claim notice does not list all treatment locations (for example, ER plus chiropractic follow-up), the adjuster may treat the file as incomplete and delay requesting or reviewing records.
Releases and “full settlement” language: Signing paperwork to resolve one part of a crash claim can create confusion. North Carolina law recognizes that settling property damage does not automatically settle bodily injury unless the written settlement terms clearly state that all claims are being settled.

Conclusion

In North Carolina, an adjuster can usually open an injury claim with basic identity details, crash identifiers, insurance information, and a clear description of injuries and treatment. When an attorney is involved—especially where uninsured/underinsured motorist issues require a separate bodily-injury claim file—the insurer commonly needs a representation letter plus enough information to identify the correct policies, parties, and providers. A practical next step is to send a written representation/claim notice to the insurer’s claims department with the crash report number and the initial treatment provider list.

Talk to a Wrongful Death Attorney

If a crash involves a fatality and an injured passenger claim at the same time, insurers often open multiple claim files and ask for specific documents before they will discuss coverage and next steps. Our firm has experienced attorneys who can help organize the information the adjuster needs and keep the claim moving on a clear timeline. 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.