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The Forms That Run a File

Intake to Settlement

By Anna Allard-Veillon

 

Published in Paralegals Connect Newsletter in the September 2026 edition, Issue 2

We’re shown the layout of the office (there’s the bathroom, your desk, the copy machine, the coffee machine), the layout of the software (client name here, case number here), the case files, and hopefully some template forms. But we’re rarely shown the layout of a case file. A prelitigation motor-vehicle injury file has a shape; the framework travels, though the statutes, cases and clocks change at the border.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The work overlaps: property damage, bills, evidence and the medical team run in parallel. Repayment claims are  tracked from intake; insurer conduct matters throughout. The bars show relationships, not prescribed durations. Apply the governing law and policy to each file.

 

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1. Open the File — The Volley

Representation letters go out to every involved insurer, including the health insurer, promptly after retention. Notify Medicare or Medicaid through the appropriate process when relevant, and contact the GAP provider, body shop and treating providers as needed. This is not a courtesy — it’s positioning. It lets everyone know where communications belong from the get-go. If the file arrives late, send the notices now and check immediately for deadlines already running.

Request the applicable policies, declarations pages, coverage confirmation and acknowledgment. Tailor the request to the recipient: a request for the at-fault party’s policy or limits is not necessarily a right to receive them before litigation. Check the jurisdiction’s disclosure rules.

Where coverage must be offered or included unless validly rejected, ask for the rejection itself. Washington requires written rejection of UIM and PIP coverage under its statutes; Ohio permits policies without UM or UIM coverage. A missing or defective rejection is a coverage issue for the attorney to evaluate, not an automatic promise that the claim will open. [1]

2. The Property Damage Track

This runs alongside the injury claim and often resolves earlier. The decision point is: whose carrier, which policy? If the client has collision coverage, a first-party claim may be the simplest route. The carrier may then pursue subrogation; whether and when the client gets the deductible back depends on the recovery and governing rules.

Keep repairs or total-loss valuation, rental or loss of use, deductible recovery and diminished value on their own working list. Diminished value makes the policy distinction clear: a claim against the at-fault party and one under the client’s collision policy can produce different results. Mabry in Georgia and Moeller in Washington recognized first-party coverage under the policies at issue. Check current policy language, state damages law and proof of the remaining loss. Same car, same loss — the answer depends on which policy you’re writing to. [2]

3. The Bills

PIP/MedPay, health coverage and liability coverage each operate under their own rules; there is no single national payer order. Repayment claims can arise even when everyone is being paid correctly. Get the available ledgers at intake and build your own: charges, payments, adjustments, outstanding balances and claimed reimbursement.

Track the bills throughout treatment. When benefits exhaust, obtain written confirmation and notify the affected parties so billing can move to the appropriate payer. If an insurer underpays or a provider improperly balance-bills the client, identify the charge and the governing rule first. Then choose the appropriate dispute or complaint route.

4. Evidence, While It Still Exists

This decays on a schedule. Memories fade; skid marks can disappear with the first rain. Preserve perishable evidence now and continue to develop the record throughout the file. Obtain the full police report, available photographs of every vehicle and relevant video before it is overwritten.

Witness declarations preserve recollections; they don’t replace testimony or settle admissibility questions. Ask providers specific questions when requesting narratives: what injury, what connection to the collision, what limitations, what prognosis? These materials support the settlement demand and show the third-party insurer what you could bring to trial against its insured.

5. The Medical Team

Providers are not adversaries, but they are creditors. Build the relationship throughout treatment so you know what remains unpaid and how flexible they may be at settlement. Where appropriate and permitted, the attorney may negotiate a letter of protection or another payment arrangement. It requires the provider’s agreement; it does not automatically prevent a lien or collection activity.

Choose the records-request route deliberately. The patient’s request for their own records, a request by a legally authorized personal representative and a third-party request can carry different fees and requirements. HIPAA’s patient-access fee limits do not apply to a request to transmit records to a third party under current HHS guidance. Check applicable federal and state rules, who is requesting the records and who will receive them. [3]

6. Money Time

To work, a demand has to beat the machine. That means being more meticulous, paying more attention and showing what happened to this client — why it was more real for them than the machine thinks it was. Include the liability facts, medical narrative, treatment ledger, wage loss with supporting verification, and human consequences. Support each claim with an exhibit the adjuster can hand to a supervisor.

 

We always asked for policy limits early, in writing, and noted the answer. Before the client signs a release, the attorney must review its scope and complete any required UIM settlement-notice, consent or subrogation procedure. Check the policy, governing law and response period; do not assume that a request for a signed waiver completes the process.

In Washington, Hamilton describes how a UIM insurer can protect its position by substituting payment for a tentative settlement. Tripp distinguishes consent restrictions from enforceable notice provisions and requires the insurer to prove actual prejudice from a notice breach. A release alone does not establish that prejudice. Keep the notice, proof of delivery and response in the file, and have the attorney resolve the required steps before release. [4]

7. Hands Off the Recovery — Liens and Distribution

We tracked repayment claims from the beginning and kept track of bills all the way through. At settlement, reconcile the figures and identify what gives each claimant a right to repayment. A provider lien, an auto insurer’s reimbursement claim, a health-plan claim, Medicare and Medicaid may require different analysis. Reduction arguments take law as well as math. Where applicable, the made-whole doctrine addresses full compensation; the common-fund doctrine addresses sharing the cost of obtaining the recovery. In Washington, Thiringer, Mahler and Winters are starting points for the relevant insurance claims. They do not supply one rule for every payer. [5]

For an ERISA plan, obtain the governing plan documents and determine whether it is self-funded or insured. Under McCutchen, clear reimbursement terms can control over equitable defenses; the common-fund doctrine can fill a gap when the plan is silent about recovery costs. Medicare has its own federal recovery and procurement-cost rules. Medicaid requires its own federal and state analysis. [6]

Before distribution, document agreed reductions, final repayment figures and any unresolved claims requiring funds to be held. Prepare the settlement statement so the client can see the fees, costs, repayments and net recovery.

8. When the Carrier Misbehaves

Frankly, the attorney handled this one. But from my desk in our Washington office, an IFCA notice often brought a same-day response. The attorney decided whether the conduct supported that remedy. Your job is to know what happened, document it and prepare the appropriate notice for review.

Washington’s Insurance Fair Conduct Act addresses unreasonable denial of coverage or payment of benefits to qualifying first-party claimants. It requires advance written notice to both the insurer and the Office of the Insurance Commissioner; check the twenty-day period and the statute’s receipt rules. A missed deadline, an unsigned waiver or a claims-handling violation alone does not establish an IFCA claim. Other remedies may apply, and the available remedy depends on the conduct, the claimant and the jurisdiction. [7]

The Clocks

Every file runs on several clocks at once. Some are law: statutes of limitation, government-claim prerequisites, pre-suit waiting periods and statutory notice windows. Some are contract: policy notice and any applicable settlement procedure. And some are yours: the opening volley, requested demand-response dates and your own status cadence.

We kept them on one shared Google calendar. Label each deadline by its source and what must happen before it expires. A requested response date is not automatically an enforceable deadline; some jurisdictions also regulate time-limited demands. The firm targets are the ones you can move. The others move you.

The Point

A form library is only as good as the sequence it sits inside, and the sequence is what nobody shows you on the first day. The shape is learnable in an afternoon; applying it takes attention to the claim, the coverage and the jurisdiction.

Find your situation, follow the sequence, send the letter.

 

About the Author
Anna Allard-Veillon spent fifteen years inside Washington personal injury firms — legal assistant to managing paralegal to executive director — and now writes the books she wishes someone had handed her in year one. She is the author of The Paralegal Pocketbook and Cruise Control: Law Firm Essentials, and the creator of The Corner Office, an interactive tool that walks paralegals through building real letters, question by question. She is Deaf, disabled, and based in Seattle. Visit vesupiabooks.com or try The Corner Office.
This article is educational and does not constitute legal advice. Statutes, case law, policy terms and deadlines vary by jurisdiction and change over time; confirm the rules governing the file before relying on them.

 

Authorities
[1] Coverage and rejection
RCW 48.22.030(4) (Washington UIM)
RCW 48.22.085 (Washington PIP)
Ohio Rev. Code § 3937.18(A)
[2] Diminished value
State Farm Mutual Automobile Insurance Co. v. Mabry, 274 Ga. 498 (2001)
Moeller v. Farmers Insurance Co. of Washington, 173 Wn.2d 264 (2011)
[3] Records access
HHS, Important Notice Regarding Individuals’ Right of Access to Health Records
[4] Washington UIM settlement procedures
Hamilton v. Farmers Insurance Co., 107 Wn.2d 721 (1987)
Liberty Mutual Insurance Co. v. Tripp, 144 Wn.2d 1 (2001)
[5] Washington reimbursement and recovery costs
Thiringer v. American Motors Insurance Co., 91 Wn.2d 215 (1978)
Mahler v. Szucs, 135 Wn.2d 398 (1998)
Winters v. State Farm Mutual Automobile Insurance Co., 144 Wn.2d 869 (2001)
[6] ERISA, Medicare and Medicaid
US Airways, Inc. v. McCutchen, 569 U.S. 88 (2013)
42 C.F.R. § 411.24 (Medicare conditional-payment recovery)
42 C.F.R. § 411.37 (Medicare procurement costs)
42 U.S.C. § 1396k (Medicaid assignment and recovery)
[7] Washington insurer conduct
RCW 48.30.015 (Insurance Fair Conduct Act)
Perez-Crisantos v. State Farm Fire & Casualty Co., 187 Wn.2d 669 (2017)