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Difference Between First-Party and Third-Party Personal Injury Insurance Claims

on  Personal Injury

You’re sitting at a stop light on Ocean Drive, and another driver slams into the back of your car. As a result of the collision, you suffer serious injuries and significant damage to your vehicle. Understanding the difference between first-party and third-party insurance claims becomes crucial in this case. These terms refer to the relationship between the injured party, the insurance company, and the liable party involved in the accident.

If you want to cover your medical expenses and vehicle repairs immediately, you must file a first-party claim under your Personal Injury Protection (PIP) coverage with your insurance company. 

This would be sufficient if your injuries are minor. However, if your injuries are severe, resulting in long-term medical treatment and substantial pain and suffering, you might need to pursue a third-party claim against the at-fault driver’s insurance company. Knowing the distinction between these two types of claims can help you navigate the insurance process effectively and maximize your chances of obtaining the compensation you need – and deserve.

If you want to explore all your legal options – both first-party insurance claims and third-party insurance claims, it is best to consult with an experienced car accident lawyer. Attorney Prosper Shaked can meet with you in a free consultation, so you can get the answers you need after a car crash in Florida. 

Understanding First-Party Personal Injury Insurance Claims

When a car accident victim files a claim with their insurance company, it is known as a first-party insurance claim. If they file a claim with another driver’s insurance company, it is known as a third-party insurance claim. 

Personal injury protection (PIP) insurance is mandatory for all vehicle owners in Florida. This is because Florida follows a no-fault insurance system, meaning that regardless of who is at fault in an accident, individuals seek compensation from their own insurance company. PIP benefits cover medical expenses, lost wages, and other expenses up to the policy limit.

Under Florida law, PIP coverage typically provides up to $10,000 in benefits. However, coverage limitations may apply for certain types of injuries, such as non-emergency medical conditions. It is important to know these limitations while filing a first-party claim.

To obtain PIP benefits, you must seek medical treatment within 14 days of the accident. This is known as the PIP 14-Day Rule. If you do not, your insurer may deny your claim. 

Florida law requires injured individuals to seek medical treatment within 14 days of the accident to be eligible for PIP benefits. Failing to adhere to this timeline may result in denial of the claim.

Understanding Third-Party Personal Injury Insurance Claims

Third-party insurance claims arise when an injured accident victim seeks compensation from the other driver’s insurance company. In third-party claims, the injured car accident victim must establish liability before they can file a claim. Florida follows a modified comparative negligence system, which means that if the injured party is partially at fault, their compensation may be reduced by their degree of fault.

Florida imposes a statute of limitations on personal injury claims, including third-party claims. Generally, accident victims have two years from the accident date to file a lawsuit against the at-fault party. Failing to meet this deadline may result in losing the right to seek compensation.

In a third-party claim, injured accident victims can seek various compensation, including:

  • Medical expenses
  • Lost wages
  • Loss of future income
  • Future medical expenses
  • Pain and suffering
  • Emotional distress
  • Property damage

Understanding the difference between first-party and third-party personal injury insurance claims in Florida is crucial when seeking compensation for injuries and damages resulting from an accident. While first-party claims involve seeking benefits from one’s own insurance company, the amount of compensation you can collect is limited by your PIP policy. When your injuries are more extensive, you can quickly exhaust your insurance policy, leaving you with unpaid medical bills and lost wages. When this occurs, you must file a third-party claim to pursue additional compensation according to Florida law.  

First-Party and Third-Party Claims & Bad Faith Insurance 

Sometimes insurance companies don’t play fair – even with their own customers. You might think you’re in “good hands,” but the reality is that insurance companies want to pay you as little as possible. This can occur when you file either a first-party claim or a third-party insurance claim. The only real difference is which insurer is acting in bad faith. 

Bad faith insurance refers to an insurer’s improper or unethical handling of an insurance claim. It occurs when an insurance company unreasonably denies, delays, or underpays a valid claim made by its policyholder. Bad faith insurance practices can include various actions such as:

  • Unreasonable Claim Denial. The insurance company denies a claim without a proper investigation or valid reason.
  • Delayed Claim Processing. The insurance company unreasonably delays processing the claim, causing the policyholder financial hardships or other damages.
  • Inadequate Investigation. The insurer fails to thoroughly investigate the claim, resulting in an unfair denial or settlement offer.
  • Lowball Settlement Offers. The insurance company offers a significantly lower amount for the claim than reasonable or fair, disregarding the policyholder’s rights.
  • Failure To Communicate. The insurer does not respond to the policyholder’s inquiries or requests for information regarding the claim.
  • Misrepresentation Of Policy Provisions. The insurance company misrepresents the policy’s terms, conditions, or coverage limits to avoid paying a claim.

When faced with bad faith insurance practices, a car accident attorney can advocate for your rights and fight against the insurance company’s wrongdoings. They will thoroughly review the policy, gather evidence, and assess the insurance company’s conduct to determine if bad faith has occurred. Your attorney can then take legal action against the insurance company, seeking the maximum compensation. To obtain this compensation, they may file a lawsuit and pursue remedies such as damages for your losses, including the initial claim amount, additional expenses incurred due to the denial or delay, emotional distress, and even punitive damages.

How Can a Florida Car Accident Lawyer Help?

A car accident attorney at Prosper Shaked Accident Injury Attorneys, PA., can help car accident victims obtain maximum compensation by strategically handling both first-party and third-party insurance claims. First and foremost, our attorneys will ensure that the injured party’s first-party claim is filed correctly, emphasizing the extent of their injuries, medical treatment, and other relevant damages. We will work diligently to gather all necessary documentation, including medical records, bills, and lost wage statements, to present a solid case to the injured party’s insurance company. By doing so, our lawyers can secure the maximum allowable benefits under your first-party policy.

Simultaneously, our lawyers will assess the viability of pursuing a third-party claim against the at-fault party’s insurance company. We will thoroughly investigate the accident, gather evidence such as witness statements, police reports, and expert opinions, and build a compelling case to establish the negligent driver’s liability. Attorney Prosper Shaked knows how to skillfully negotiate with the insurance company to seek fair compensation for our client’s additional damages, including pain and suffering, emotional distress, future medical expenses, and loss of earning capacity. 

Contact Our Car Accident Lawyers Today

If you suffered an injury in a car accident in Florida, you need someone on your side to help you obtain the compensation you deserve. The attorneys at Prosper Shaked Accident Injury Attorneys, PA., know Florida injury laws inside and out. We know the best way to build successful cases, and we fight insurance companies every step of the way. 

While based in Miami, Florida, we represent clients involved in car accidents throughout Florida.  Call (305) 694-2676 for a free and confidential consultation, or schedule a consultation using our online contact form. At Prosper Shaked Accident Injury Attorneys PA, we will do our best to help you rebuild your life and get back on your feet after a devastating car crash.