Overview Of Filing A First-party Claim Under Your Own Insurance

If you acquired injuries in a vehicle accident, then you may need to file a claim against your own insurance provider, instead of against the other party. A personal injury claim against your insurance is called a “first-party claim,” while a claim against the party at fault is called a “third-party claim.” (List of Top Questions after an Auto Accident)

If you reside in Puerto Rico or a no-fault state, then you don’t have an option. You should file a claim against your own coverage.

3 Reasons for Filing a First-party Claim

1. The responsible party was either uninsured or under-insured. You have UIM insurance.

2. You have PIP (personal injury protection) coverage, and do not have the time to expect the responsible party’s insurance company to begin paying your expenses.

3. You reside in Puerto Rico or a no-fault auto insurance state, and are obligated by the law to do so.

If you acquired injuries in a vehicle accident, then you may need to file a claim against your own insurance, instead of against the other party.
If you acquired injuries in a vehicle accident, then you may need to file a claim against your own insurance, instead of against the other party.

Pros

• You do not have to be anxious about which party was to blame. Your insurance pays your claim irrespective of who caused the incident.

• Your present medical expenses are paid, without the need to settle the sum or argue liability with an adjuster.

• You are paid off for future medical expenses that only relate to the mishap.

• Your out-of-pocket bills are compensated (e.g. crutches, medications, etc.)

• You get your benefits quickly, unlike a third-party claim, taking months (or even years!) before negotiation and payment.

• Your stress is reduced, since a first-party claim isn’t an adversarial course.

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Cons

• You may need to pay your deductible first before your insurance will begin paying for your medical expenses and bills.

• Depending on the state you reside, the most expensive insurance settlement may not be high. A lot of states establish the highest medical coverage under PIP or no-fault at approximately 80% of the total. And the lost wages maximum at only 60%.

• You may need to waive your rights to subjugate.

• You may need to repay your insurance if you get any payment from the responsible party or his/her insurance company.

• You may also need to repay your insurance if you accepted reimbursements from your own medical health plan.

• In a first-party personal injury claim, you cannot get payment for the suffering and pain or emotional misery you underwent due to the accident. You are also forbidden to claim disciplinary damages for deliberate misconduct.