First-Party Insurance Frequently Asked Questions

Mindiola Law Firm > First-Party Insurance Frequently Asked Questions

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If you have an insurance policy, you may have questions about the differences between “first-party” and “third-party” insurance. These terms may appear in your insurance policy contract. An insurance policy is a contract between you, the insured, and an insurance company, the insurer.

When an insured, the first party, receives payment from an insurer, the second party, when an accident loss, accident or injury is caused—either by the policy owner or a third party—this is first-party insurance in action.

Depending on the location of your property, you might be required to select specialty insurance coverage in the event of a natural disaster. For instance, a lender might require the property owner in a flood zone to carry flood insurance. A property owner on an active fault line may select earthquake insurance.

Let’s review some of the FAQs of first-party insurance:

1. What is a first-party insurance claim?

A first-party insurance claim is presented by the policyholder to the insurance company. Payment of the claim is contingent upon the precise language used in the insurance policy contract. For example, if a business owner has hurricane damage to his or her insured property, he or she will submit a claim to the insurer to recover the cost of repairs and damages. The insurer compensates the insured according to the insurance policy’s terms and conditions. It’s essential for the insured to understand what’s covered or excluded by the policy.

2. How does first-party insurance work?

The business owner needs an action plan to quickly recover from damages left in the wake of a wildfire, hurricane, tornado, and so forth. The action plan typically includes the arrangement of an insurance policy that allows the owner to recover resulting damages.

Your first-party insurance policy is intended to protect you, the insured, in the manner of financial payments from the insurer, the second party.

First-party insurance is applied when injuries or damages are caused by the insured or by another party (the third party).

3. What is “bad faith”?

Unfortunately, some insurers practice recognized bad faith behaviors when the insured’s person or property is injured or damaged as a result of a catastrophic or accidental event.

Bad faith behaviors may include:

Denial of compensation (without a justifiable reason)
Delayed payment (without a justifiable reason)
Failure to promptly reply or acknowledge a submitted claim
Failure to make good on a claim filed by the insured
Placing blame on the insured instead of the actual cause of the loss(es)
Wrongful statement that the insured’s loss isn’t covered
Attempt to settle the insured’s claim for an unreasonable amount
Failure to explain the reasons why the claim was delayed or denied
Intentional misinterpretation of policy language
Requiring the insured to submit a burdensome amount of documents to process the claim
Biased or inappropriate investigation of the claim, e.g. harassment
Telling the insured he or she doesn’t need a lawyer or shouldn’t hire one
Bullying the insured in hopes that he or she will give up on the claim(s) or drop coverage

4. Does the policyholder have remedies against the insurance company when it acts in bad faith?

Yes. When the insured submits a claim to the insurer and the insurer doesn’t uphold its contractual bargain with the insured, it’s possible to take legal action. An experienced bad faith insurance lawyer will work with you to hold the insurance company accountable.

With legal counsel at your side, the insurer will have few valid arguments for late payout or outright denial of your claim.

5. What’s the insurance company’s duty?

Find out now if the insurer has violated its duty to you. Contact the first-party insurance claim team at Mindiola Law Firm now. We will analyze the insurance policy, assess the facts, and determine if you have a viable bad faith claim (or other claim) against the insurer.

The law protects the first party from abusive insurance companies. It penalizes insurers that engage in bad faith practices. Many first parties don’t file a claim because they’re concerned about loss of insurance coverage or the stress of going to war with a large financial institution.

If you believe an insurance company has treated you unfairly, it probably has. It’s common to experience frustration when the insurer delays or plays games to lessen or eradicate its financial obligation to you.

Insurance law varies between the states, so you need an expert bad faith law firm to provide expert advice. Sometimes, the threat of litigation will prompt the insurance company to straighten up.

6. Why should I contact a first-party insurance claim law firm?

You need expert advice. Insurance companies have access to expert legal advice, and so should you.

Don’t assume that because you paid for an insurance policy that the insurer will pay the claim in full. The insurer is focused on the bottom line. All insurers are in the business of taking in premium income and most do everything possible to minimize (or deny) insureds’ claims.

Insurance laws are complex. The documentation and proof required to show the court that your claim was unfairly delayed or denied can be extraordinary.

Unfortunately, insurers hope that denying or stalling a claim will prompt the insured to settle for less money than it owes.

First-party insurance claimants have the right to file a lawsuit against insurers acting in bad faith. Take action now with a free consultation.