First Party vs. Third Party Insurance Claims

After a personal injury accident, especially car accidents, you typically have the option of filing a first or third party insurance claim. These terms have to do with which insurance company you file an injury claim with. 

What is a First-Party Insurance Claim? 

A first-party insurance claim is filed by a policyholder (the first party) with their insurance company (the second party). For example, after a car accident in Florida, you can file a first-party claim with your own auto insurance company. The reason is that Florida law requires that your own insurance company cover the financial costs of your personal injury and property damage up to the limits of your own policy. In other types of accidents, it may depend on your policy and the kind of coverage you carry. For example, suppose a storm or natural disaster damages your home. In that case, you may be able to file a first-party claim under your homeowner’s insurance policy, depending on the terms outlined in your contract. Some other types of first party claims include: 

  • Health insurance claims.
  • Filing a claim under your underinsured or uninsured motorist (UM/UIM) coverage on your auto policy if the at-fault party does not carry insurance or your expenses exceed their policy limits.
  • Filing a claim under your renter’s insurance policy after a theft

Since you are the policyholder when you file a first party claim, the insurance company should treat you fairly and approve coverage per your contract. If they fail to do so, it is considered a breach of contract, which may subject them to harsh penalties under Florida law. 

Third-Party Insurance Claims

The costs of a personal injury accident can sometimes exceed the coverage you carry or may not be covered by your insurance policy at all. When another party is responsible for causing you harm and any related losses, you may have to hold them directly accountable for the difference. If they carry liability insurance, you have the right to file a claim directly with their insurance company (the third party). Liability insurance is used to protect a policyholder from having to pay out-of-pocket for damages they are at fault for causing. Some common types of third party claims include: 

  • Car accident claim against the at-fault party’s insurer.
  • Truck accident claim against the trucking company’s insurer.
  • Slip and fall accident claim against a property owner’s insurer.
  • Dog bite injury claim against the owner’s homeowner’s insurance liability coverage. 
  • Defective product claim against a manufacturer’s insurer.
  • Construction accident claim against a subcontractor’s insurance company. 

Because you are not the policyholder, when you file a third party claim, there is a risk that the insurance company will not behave in good faith. For example, they may try to reduce your compensation by claiming you were at fault or denying your claim. Therefore, it is in your best interest to let a injury attorney file the claim for you since they have extensive experience dealing with insurance companies and can protect your rights.

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Premises liability

PREMISE LIABILITY

$450,000

James was searching for equipment for painting at Home Depot. In the aisle next to him, there was a worker on a lift stocking the highest shelf. The worker pushed boxes so far across the shelf that they fell off the other edge and hit James in the head. The force almost knocked James unconscious. He sat down and the loud bang got the worker off the ladder to see what fell. When they saw James they offered him a bucket and made a report. James did not recall leaving the store or how he got home. He did not recall much except being at home depot and getting hit in the head. Home Depot told him that it was a small box of dust masks that hurt him. We discovered it was actually a large box of emergency kits that fell off the shelf.

Personal injury

PERSONAL INJURY

$850,000

In this case, our client slipped and fell on water that had accumulated near the hot tubs/showers on the Lido deck of a major cruise line ship. The client suffered torn ligaments to her shoulder that required 2 arthroscopic surgeries. The cruise line took the position that the condition on the floor was open and obvious.

Premises liability

PREMISES LIABILITY

$980,000

Georgia was visiting a friend in the hospital when she walked out of the elevator and into her friend’s room. As soon as she entered the room she slipped on a newly mopped floor without any wet floor sign present. The floor was so wet that Georgia’s entire outfit was soaked. Because of the muted tile floor, the water was invisible. Georgia needed a back operation which was unsuccessful and caused her to slip into a coma. She luckily survived.

Motor vehicle accident

MOTOR VEHICLE ACCIDENT

$1.1 MILLION

AUTOMOBILE REAR END COLLISION

Rodrigo was driving his work truck home when he was rear-ended at a stoplight. Rodrigo needed a fusion of his thoracic spine. A terrible and complex operation. Unfortunately, while Rodrigo was undergoing the spinal operation, one of his children died and he was unable to be with his grieving wife. It was a tragic case that eventually settled.

Bicycle vs car accident

BICYCLE VS CAR ACCIDENT

$1.45 MILLION

David was a teacher at a local high school. He rode his bike to school in the morning and after school would ride another 10 miles for exercise. On a sunny afternoon on his way home an older driver turned right into him as he was riding down the street. He hurt his shoulder and neck and needed two operations. Defendant felt his injury was due to playing football 10 years earlier and would not provide him a fair or reasonable offer.

Car vs commercial truck accident

CAR VS COMMERCIAL TRUCK ACCIDENT

$3.4 MILLION

Joe was driving his 18 wheeler on the Florida Turnpike headed south after a long-haul run.  He was “bobtailing” which means he did not have a cargo trailer on the back of his truck rig.  A drunk driver lost control of his car causing Joe to avoid the accident but drive off the highway and into a canal.  He was injured in the accident but also witnessed a child die when he climbed out of the truck and came to the accident site.  There the injured child was trapped under the car and he was powerless to save the child before it passed.

Auto accident T-Bone

AUTO ACCIDENT T-BONE

$4.5 MILLION

Xao, a Vietnamese immigrant was driving home after work at night to see his pregnant wife. He stopped at a 4-way intersection and looked both ways. He did not see anyone in either direction. As Mr. X when through the intersection he was hit on the passenger side door by a mid-sized black SUV driving without their lights on. Mr. X was catastrophically injured.

Personal injury

PERSONAL INJURY

$8.2 MILLION

This was a hard-fought pedestrian accident case, in which our client was struck by an SUV driven by a teen driver, as they attempted to cross North Military Trail in West Palm Beach, FL. As a result of the accident, our client suffered numerous fractures, partial loss of vision and frontal lobe brain injury that affected his speech, and other personal injuries that required him to be hospitalized for 58 days.

At the time of the accident, our client was a cashier at Walmart and has been unable to return to work.

“This case is the epitome of what we consider part of our Core Culture and broad vision – which is to be Warriors for Justice,” stated Brian LaBovick. “Mr. Jacobus has serious permanent injuries and will continue to fight to regain his life into the foreseeable future. This verdict will allow him to get the professional help he needs to safely navigate the rest of his life.”

Medical malpractice

MEDICAL MALPRACTICE

$15 MILLION

Brain damages child due to medical negligence.  Mother was misdiagnosed upon entry to the hospital while under contractions.  The child was born severely disabled.