Personal Injury & Insurance: First-Party and Third-Party Claims in California

Most people are familiar with the premise of personal injury lawsuits: If you suffer an injury due to another’s negligence or wrongful acts, you may have grounds to pursue a claim for a financial recovery of your damages.

As with many things that fall within the realm of personal injury, matters are often not as straightforward as filing a claim with your own insurer.

Some cases require victims to explore their options for available insurance coverage and seek compensation through the negligent party’s insurance.

These are known generally as third-party insurance claims.

First-Party vs. Third-Party Insurance Claims

In general, any claim that is not filed through your own insurance company is a third-party claim.

Auto liability insurance is a common example of third-party insurance designed to protect a policyholder from claims brought by other people (“third parties”). This differs from first-party insurance, such as uninsured motorist coverage, which covers only losses directly sustained by a policyholder.

• In a first-party claim, the insurance company has a direct relationship to the insured making the claim.
• In a third-party claim, the insurance company is defending and paying to settle a claim or lawsuit brought by a third party who suffered injury and / or loss caused by the insured.

Depending on the facts of your accident, you may be able to recover compensation for personal injuries through either a first-party or third-party claim.

Examples of First-Party Insurance Claims

First-party insurance claims are those you file with your own insurance company under a policy you have purchased. While you may not call an insurance claim a first-party claim, it is likely you have filed one (or several) before. Some of the most common examples of first-party claims include:

• A homeowner’s insurance claim for property damage to your home.
• A claim for vehicle repairs under your own auto collision coverage.
• A health insurance claim submitted through your health insurance company.
• A business interruption claim filed with your commercial insurance company.

In the context of personal injury cases, the most common examples of first-party claims are:

• UM / UIM Claims: If you were injured in a car accident, you may recover compensation by filing a first-party claim with your own insurance company, provided you have purchased sufficient uninsured / underinsured motorist (UM / UIM) coverage, which you should. In UM / UIM cases, you file a claim with your own insurer, who pays out under the available limits of your policy.
• Med Pay Auto Insurance Claims: If you carry Medical Payments coverage, a form of optional auto insurance, you may file a first-party claim to recover medical bills or funeral expenses for damages you or any of your passengers suffered in a car accident, regardless of who is at fault.
• Bad Faith: By law, insurance companies owe policyholders a duty of good faith and fair dealing. If you suffered losses because your insurer failed to uphold its good faith duty when processing your first-party claim (i.e. a UM / UIM claim), you have the right to recover against your insurer for bad faith. Bad faith actions arising from personal injury often involve unfair settlement activities, unreasonable delays, and other conduct that adversely affects the policyholder.

Read more about first-party injury claims and bad faith actions.

Examples of Third-Party Insurance Claims

Victims of personal injury and the attorneys who represent them will always look to third-party coverage when exploring options for a financial recovery, as it is the victim’s right to recover against negligent parties.

There are numerous examples of third-party personal injury claims. Some of these include:

• Personal injury claims against a negligent driver’s insurance company.
• Premises liability claims against a property owner’s commercial insurance.
• Product liability claims against product manufacturer responsible for defective products.
• Third-party workplace injury claims against a contractor / subcontractor responsible for a construction accident that injured a worker they do not employ.
• Any situation where a third party negligently caused an accident in which a victim is injured.

Other Issues of Importance in Third-Party Cases

There are many other issues pertinent to third-party injury cases. Though many are complex matters of law and insurance, they can be critical to effectively resolving a claim.

In this blog series, we will address these important issues with posts covering:

• California’s Workers’ Comp Exclusive Remedy Doctrine
• The Difference Between Workers’ Compensation & Personal Injury
• First-Party Injury Claims & Insurance Bad Faith
• Workers’ Comp Subrogation: Liens & Credits
• Special Considerations When Settling Third-Party Injury Claims
• Investigating Potential Third-Party Cases

An Overview of California Third-Party Insurance Claims & Personal Injury Law

Personal injury cases can introduce an array of complex and nuanced laws concerning civil torts and insurance, which is why they demand the insight of experienced attorneys.

At Biren Law Group, our award-winning legal team focuses exclusively on protecting the rights of clients following all types of accidents and injuries and has cultivated a proven record of success in challenging claims – including those which implicate complex insurance matters.

Our Father-Son legal team is readily available to speak with victims, families, and fellow lawyers across Los Angeles and Southern California about third-party injury claims and high-stakes insurance litigation. To request a free consultation, contact us.