What is a First-Party vs. Third-Party Insurance Claim?

A first-party insurance claim is one you file with your own insurance provider, while a third-party insurance claim is one filed with someone else’s insurance company. In Georgia, personal injury claims can involve first and third-party insurance claims, so it’s important to know how each kind works.

Filing insurance claims after a serious accident can seem like an insurmountable task, but help is available. An Atlanta personal injury lawyer can assess your case and represent you during the insurance claims process.

First-Party Insurance Claims

First-party claims are insurance claims you make with your own insurance company that you pay premiums to. They are called first-party claims because they directly involve the policyholder and are made on their behalf.

The simplest example of a first-party insurance claim is collision coverage with an automobile. When you get into a car accident, you file an insurance claim with your auto insurance provider to pay for vehicle damage. This is a first-party claim because you pay monthly premiums to your auto insurer for coverage under the policy.  

Below are some other common types of first-party insurance claims that one might make after an accident:

• Uninsured/underinsured motorist coverage
• MedPay policy for medical bills
• Rental coverage
• Health insurance
• Homeowners insurance
• Disability insurance

All of these are first-party claims because they only involve you and the insurance provider.

Third-Party Insurance Claims

A third-party insurance claim is an insurance claim that you make with another person’s insurance company. They are called third-party claims because they involve a third-party—i.e., you—who is neither the insurance company nor the policyholder.

Third-party injury claims are most common in cases where a third party is harmed by someone’s negligence or wrongful conduct. In these cases, the injury victim would file a third-party liability claim against the at-fault party’s insurance policy.

For example, if a driver ran a stop sign and caused an accident, the victim could file a third-party liability claim against the driver’s auto liability policy. Similarly, a customer could file a third-party liability claim against a business if they sustained injuries due to unsafe property conditions, like wet flooring.

Key Distinctions Between First-Party vs.Third-Party Insurance Claims

First-party and third-party insurance claims serve the same purposes of insuring losses, but there are key differences between them in their structure and functioning:

• Fault vs. no-fault. First-party claims, like MedPay coverage, are generally no-fault, meaning you don’t have to prove another person was at fault to make one. Third-party claims require proving you weren’t at fault for the accident.  
• Deductible vs. no deductible. First-party claims often (but not always) have a deductible that you must pay before insurance will kick in. Third-party claims have no deductibles or payments.
• Claim complexity. Because they involve determinations of liability, third-party claims involve an in-depth, complex investigation. First-party claims are relatively streamlined in comparison.
• Monetary value of claim. First-party claims usually have lower policy limits, resulting in smaller claims. This is a trade-off for their simplicity and convenience. Third-party claims usually deal with much higher insurance policy limits.

Should I File a First-Party or Third-Party Insurance Claim?

Whether or not you file a first- or third-party claim largely depends on who is at fault for the accident. If another person’s negligence was the cause, then a third-party claim is the most likely option.

This is most obviously the case in things like car accidents. Georgia is an at-fault state for car accidents, meaning that the driver who caused the accident is responsible for paying for injuries with insurance. Below are examples of potentially liable entities in third-party lawsuits:

• Negligent motorists
• Trucking companies
• Business owners
• Hospital or medical professional
• Defective product manufacturers

Can I File Both?

In some cases, you can file both a first-party insurance claim and a third-party insurance claim simultaneously. An example of this would be if you have MedPay coverage on your auto policy. MedPay is optional no-fault coverage you can add to your auto policy in Georgia that will cover medical bills after a car accident up to a certain limit.

MedPay is a type of first-party coverage, so if you get into a car accident, you can initially file a first-party MedPay claim to cover your emergency medical bills. You could then file a third-party liability claim against the at-fault driver to recover any additional losses not covered by your first-party MedPay claim.

Note that if you make a first-party insurance claim and a third-party claim for the same injury, your insurance company may have subrogation rights over any third-party settlement you receive. This means they can legally take a portion of a third-party settlement to pay for the benefits they paid in your first-party claim.

Contact a Personal Injury Lawyer in Atlanta

Regardless of whether you are filing a first-party vs. third-party insurance claim for injuries, the team at John Foy & Associates can handle your personal injury case from start to finish. Our team holds over 350 years of combined legal experience and has recovered over $1 billion in settlements and judgments.

Contact our offices today to speak to a knowledgeable Atlanta personal injury lawyer.