If you can't secure a reasonable settlement offer, your next typical option is litigation. Usually, before filing a lawsuit, your attorney will draft a demand letter, which can take a couple of weeks or sometimes even several months. This depends largely on the medical treatment required. Your personal injury attorney will want to collect as many of your medical records as possible to include this information in the demand letter, detailing your injuries, their severity, and the associated medical bills.
Initial negotiations usually occur pre-suit. If a reasonable offer isn't forthcoming at this stage, then a lawsuit is filed, and litigation begins. Negotiations often continue throughout litigation, possibly immediately after the lawsuit is filed or even after the case has progressed for several months involving depositions and hearings. A settlement can be negotiated at any point in the case.
However, if a reasonable settlement offer is not attainable, you typically want to keep pushing the case forward towards trial. If a reasonable settlement agreement can't be reached even close to the trial or on the eve of trial, you may need to litigate the issues in front of a jury. It's crucial to have an attorney with trial experience, one who isn't afraid to challenge the insurance companies in court and bring cases to trial if that's what your particular case requires.