December 19, 2024
When navigating the complexities of insurance claims in Texas, it’s crucial to understand the distinction between first-party and third-party claims. Each type of claim involves different processes, responsibilities, and parties. Here, we’ll break down the differences and explain how Patout, Fontana, & Dellis can assist with first-party claims across the Lone Star State. What is a First-Party Insurance Claim? A first-party insurance claim is filed by the policyholder—the “first party”—against their own insurance company (the “second party”). This type of claim is based on the terms and coverage outlined in the policyholder’s insurance contract. Common situations that lead to first-party claims include: Homeowners Insurance: Filing a claim for damages caused by storms, fires, or other covered events. Auto Insurance: Seeking coverage for repairs or medical expenses after an accident, provided the policy includes comprehensive or collision coverage. Health Insurance: Requesting reimbursement for medical expenses covered by your plan. In these cases, the insurance company is obligated to evaluate the claim and provide the benefits stipulated in the policy. What is a Third-Party Insurance Claim? In contrast, a third-party insurance claim is made by someone who is not the policyholder. This type of claim occurs when a third party (someone other than the policyholder) seeks compensation from another person’s insurance provider. Examples include: Auto Accidents: Filing a claim with the at-fault driver’s liability insurance to cover damages or medical expenses. Premises Liability: Seeking compensation for injuries sustained on someone else’s property. Third-party claims typically require the claimant to prove the other party’s liability for the damages or injuries. The Challenges of First-Party Claims in Texas Even though first-party claims involve your own insurance company, they can still be challenging. Insurance companies may: Dispute the value of your claim. Deny coverage for specific damages. Delay the claims process unnecessarily. Texas law holds insurance companies accountable for handling claims fairly and in good faith. If you believe your insurer is not honoring its obligations, you may have grounds for legal action. Why Choose Patout, Fontana, & Dellis for Your First-Party Claim? At Patout, Fontana, & Dellis, we specialize in assisting Texans with first-party insurance claims. Our team understands the tactics insurance companies use to undervalue or deny claims, and we’re committed to ensuring policyholders receive the benefits they’re entitled to. Here’s how we can help: Comprehensive Claim Evaluation: We review your policy to ensure all applicable coverages are included in your claim. Expert Negotiation: Our attorneys negotiate directly with your insurance company to secure fair compensation. Litigation Support: If necessary, we’re prepared to take your case to court to protect your rights. Serving Texans Statewide From Houston to Dallas, Austin to El Paso, Patout, Fontana, & Dellis proudly serves policyholders throughout Texas. Whether you’re facing a denied claim, underpayment, or unnecessary delays, our team is ready to advocate for you.