first-third-party-insurance There are two types of insurance claims: first party claims and third party claims. A first party insurance claim is one that you file with your own insurance company. A third party insurance claim is one that you file with the insurance company of another person or entity, such as a business.

The type of claim you should file depends on who was at fault in your accident. If you were hurt in an accident, one of the first things you should do is file an insurance claim. An insurance claim is one way to pursue compensation for your injuries and other losses, such as medical bills, lost wages, and pain and suffering. The other is to file a personal injury lawsuit.

This page contains basic information about insurance claims, and it may not apply to you. It is not a substitute for consulting with an experienced personal injury lawyer. Only a licensed attorney in your area can give you legal advice about your situation.

Filing an Insurance Claim: First Party Claim, or Third Party Claim?

As discussed above, a first party insurance claim is one you file with your own insurance company, and a third party insurance claim is one you file with the insurance company of another person or company. Which type of insurance claim you should file largely depends the answer to the question: “Who was at fault in the accident that caused your injuries?”

Fault

If you caused the accident that led to your injuries, you should file a first party insurance claim with your insurer. For example, if you failed to stop at a stop sign and were injured when you hit another driver’s car, you should file a first party insurance claim with your auto insurance provider.

If your injuries were caused by the negligence of another person or entity, you should file a third party insurance claim with their insurance company. Most people and businesses who have liability insurance are covered in the event that their negligence causes someone to suffer a personal injury. For example, if you were hit by a car while crossing the street on foot (i.e., you were hurt in a pedestrian accident), you should file a third party insurance claim with the driver’s insurance company. Similarly, if you were hurt in a slip-and-fall accident in a grocery store, you should file a third party insurance claim with the grocery store’s insurance provider.

You may need to open both a first party insurance claim with your own insurance company and a third party insurance claim with the other driver’s insurance company. An example would be where it is unclear whether the at-fault driver had adequate liability insurance coverage.

To learn more about fault for personal injuries is determined, visit:

The Insurance Claims Process

Regardless of what type of accident you were involved in, you should report the incident to the appropriate insurance company as soon as possible. Many insurance companies require you to file a report within 24 hours of the incident. If you were not at fault for the accident, contact the insurance provider for the at-fault driver, business, or building owner. You will need to provide accurate information about the cause of the accident and the extent of your injuries.

The insurance company will assign a claim number to your claim and give it to someone known as a “claims adjuster.” The claims adjuster will open an investigation into your claim. At this point, the claims adjuster may ask you to make a recorded statement about the incident. It is usually best to talk to a lawyer before making a recorded statement about an accident. The insurance company may try to use your statement against you, so it is highly recommended that you have guidance from a personal injury attorney about what to say.

After the liability investigation and your medical treatment concludes, you may send a demand letter to the insurance company describing the accident, your injuries, and how much compensation you seek. To learn more about writing a demand letter to an insurance company, click here.

When the insurance company concludes its investigation into your claim, the insurance adjuster will do one of three things:

  1. Offer you the full sum of money you requested in your demand letter;
  2. Offer you less money than you requested in your demand letter; or
  3. Deny your claim in its entirety, offering you nothing.

Since writing a demand letter and negotiating with an insurance company is a complicated process, it is recommended you consult with an attorney before doing either one. When the insurance company concludes its evaluation of your claim, the insurance adjuster will do one of three things:

  • Offer you the full sum of money you requested in your demand letter;
  • Offer you less money than you requested in your demand letter; or
  • Deny your claim in its entirety, offering you nothing

If the claims adjuster did not offer you the full sum of money you requested in your demand letter, you may begin negotiating with the claims adjuster for a better settlement offer.

If you and the claims adjuster agree on a settlement that you feel properly accounts for the severity of your injuries and full financial losses, you can accept the settlement offer from the insurance company. Because accepting a settlement can have serious legal and financial consequences, you should speak to a lawyer before doing so.

If you cannot reach an agreement with the insurance company, the next step may be filing a personal injury lawsuit against the person or entity responsible for your injuries. Because filing a personal injury lawsuit can have serious legal and financial consequences, and requires a thorough knowledge of the laws and legal system, it is best to consult with a personal injury lawyer before doing so. To learn more about filing a personal injury lawsuit and hiring a lawyer, visit:

Disclaimer: Information provided on this site is NOT formal legal advice. It is generic legal information. Under no circumstances should the information on this site be relied upon when deciding the proper course of a legal action. Always get a formal case evaluation from a licensed attorney if you think you might have a personal injury lawsuit.