In the state of Texas, do insurance companies have a set time limit in which they must complete a pre-existing investigation?

UPDATED: Jun 10, 2009

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In the state of Texas, do insurance companies have a set time limit in which they must complete a pre-existing investigation?

I do medical billing for a chiropractor in Texas. One of our patients has over $6,000 in unpaid claims. The claims date from Sept. 2007 to June 2008. They say that they are still waiting to hear back from one doctor. They have been saying that for a year. I was told by the insurance company that this could go on indefinitely until they heard from that doctor, because they had denied the claims, and there were none pending.

Asked on June 10, 2009 under Insurance Law, Texas


L.M., Member, California Bar / FreeAdvice Contributing Attorney

Answered 13 years ago | Contributor

I assume this was a personal injury claim with an insurance company.  The statute of limitations on personal injury claims is two years from the date of the incident.  The insurance company has a reasonable time within which to complete its investigation, and that can vary a great deal depending on what information is being sought.  The patient, nevertheless, owes for their chiropractic bill and it is their responsiblity to pay it whether through their own insurance, the responsible party's insurance, or out-of-pocket.

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