Your insurance policy contains a set of promises that your insurer makes to you about what it will pay for if a “covered” event happens. The insurance policy also contains a set of rules that you, the policyholder, must follow to receive payment from the insurer, including making timely payment of your premiums. An insurance policy is therefore a contract between the you and your insurance company. It is worth noting that any event not covered in your policy (usually referred to as “exclusions”) will not be paid for by your insurance company. Common exclusions include injuries resulting from intentional or reckless acts like street racing, or from extraordinary sources like nuclear radiation. Another exclusion that has become common in recent years is injury that results while driving in a ride-sharing program like Uber or Lyft.
There are two types of insurance claims that an injured person may generally bring, depending on the factual situation.
A first-party insurance claim is a claim filed with your own insurance company for damages covered by your own policy. For instance, if you damage the trunk of your car by backing into a pole, filing a claim with your own insurance company would be a first-party claim. After filing the claim, the insurance company looks at your policy to determine whether you carry the type of coverage needed for them to compensate you for the particular type of loss. In this example, the relevant policy would be collision coverage. If you have the necessary coverage, the insurance company will reimburse you for the amount of money your trunk repairs cost, less your deductible.
Making a claim on your uninsured/underinsured motorist policy is also considered a first-party claim, which you can read more about on our page: Four Benefits of Uninsured/Underinsured Motorist Bodily Injury Insurance.
A third-party insurance claim is claim filed with someone else’s insurance company. For example, if a drunk driver runs a red light and collides with your vehicle, you would likely file a claim with the drunk driver’s insurance company. This would be a third-party claim. In this example, the other driver’s insurance company would be responsible for your damages because drunk the driver’s liability coverage covers injuries caused by his negligent driving.
Because there is no contract between you and the at-fault driver’s insurance company, there are several benefits of filing a third-party claim. You are entitled to make claims for damages that may not be covered under your own insurance policy, such as payment for medical expenses, pain and suffering, mental anguish, and lost wages.
The claims process can be complex and overwhelming. Regardless of whether you are dealing with a third-party or first-party claim, an experienced personal injury attorney can assist you with your claim. The attorneys at Armstrong & Lee LLP are knowledgeable and experienced in the rules, procedures, and the law relating to first-party and third-party claims. Contact our Firm today for a free consultation regarding your claim or potential claim.
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