It's easy to assume that dealing with your own insurance company will be simpler than negotiating with the other driver's insurer, after all, you've paid your premiums and expect them to be on your side. In practice, first-party claims still require care, since your insurer's financial interests don't always align perfectly with getting you the full compensation you deserve.
Understanding First-Party vs. Third-Party Claims
A third-party claim is one you file against the at-fault driver's insurance company. A first-party claim, by contrast, is filed with your own insurer, often to access coverage like personal injury protection, medical payments coverage, or uninsured and underinsured motorist benefits. Both types of claims can come into play after the same accident, and it's important to understand that your own insurer is still, ultimately, an insurance company focused on managing costs.
Types of First-Party Coverage You Might Use
Depending on your policy and state, several types of first-party coverage may be relevant after an accident:
- Personal Injury Protection (PIP), which can cover medical expenses and lost wages regardless of fault in states that require or offer it
- Medical Payments coverage (MedPay), a similar but generally more limited benefit for medical costs
- Uninsured/Underinsured Motorist coverage, which applies when the at-fault driver has insufficient or no insurance
- Collision coverage, which can help repair or replace your vehicle regardless of fault
Because PIP and MedPay serve overlapping but distinct purposes, it helps to understand the differences between MedPay and PIP so you know which coverage to rely on and when. Similarly, reviewing how PIP coverage generally works can clarify what expenses it's designed to address.
Why Your Own Insurer Isn't Automatically on Your Side
Insurance companies, including your own, are businesses that aim to manage claims costs. While your insurer has a contractual obligation to handle your claim fairly, that doesn't mean they'll automatically offer you the maximum available benefit without some scrutiny. Adjusters may still question the extent of your injuries, dispute medical necessity, or delay payment on parts of your claim.
This is particularly true with underinsured or uninsured motorist claims, where you're essentially asking your own insurer to pay out money on behalf of someone else's inadequate coverage. These claims can sometimes become more contentious than expected, since your insurer's interests and yours diverge once real money is on the line.
Steps for Handling a First-Party Claim Carefully
A few practices can help protect your first-party claim:
- Report the accident and claim promptly, following your policy's notice requirements
- Keep thorough records of all medical treatment and related expenses
- Respond to reasonable documentation requests, but be cautious about broad authorizations that give an insurer access to unrelated medical history
- Review your policy declarations page to understand what coverage limits actually apply
- Avoid assuming a low initial offer reflects the full extent of available benefits
When First-Party Claims Get Complicated
Some first-party claims proceed smoothly, particularly straightforward PIP claims for modest medical bills. Others can become surprisingly contentious, especially underinsured motorist claims involving significant injuries, where your insurer may dispute the value of your damages much like a third-party insurer would.
If your insurer denies a claim, delays payment without justification, or offers a settlement that doesn't reflect your policy's actual terms, it may be worth understanding the warning signs of bad faith insurance practices, since insurers do have legal obligations to handle claims honestly and in good faith.
Working With an Attorney on a First-Party Claim
Because policy language can be dense and coverage disputes technical, many people find it useful to have an auto accident lawyer review their policy and correspondence with their insurer, especially before signing any releases or accepting a settlement on a first-party claim.
Frequently Asked Questions
Do I need a lawyer to file a claim with my own insurance company?
Not always, particularly for simple, undisputed claims like modest PIP reimbursements. However, if your insurer disputes coverage, delays payment, or the claim involves significant injuries, professional guidance can help protect your interests.
Can my insurance rates go up if I file a claim that isn't my fault?
Rate impacts vary by state, insurer, and policy, and rules around this differ considerably. It's worth reviewing your specific policy or asking your agent directly about how a not-at-fault claim might affect your premiums.
What if my own insurance company denies my claim?
A denial isn't necessarily final. You generally have the right to appeal, request a detailed explanation of the denial, and, if necessary, escalate the dispute, including seeking legal guidance if you believe the denial was improper.
If you're running into resistance with your own insurance company after an accident, discussing your situation with an attorney can help you understand your policy rights and how to move your insurance claim forward.