What is the difference between a first-party and a third-party claim?

Yes. You can switch insurance companies at any point, even if you have an open claim with your old company. As long as you make the claim before the switch goes into effect, your old insurer is obligated to follow through.

Policyholders occasionally switch companies if their current insurer is stalling the claims process. If you feel that your insurance company is mistreating you, it is your right to obtain quotes from other companies, though specific laws and procedures vary by state.

It depends on your state and the type of insurance. Some states set specific timeframes for when claims should be acknowledged, while others only specify that they should be paid within “a reasonable time.”

When states do designate a timetable, it often falls somewhere between 30 and 45 days. Longer than 60 days is generally considered a delayed payment. These designated payout periods apply mainly to homeowner’s and auto insurance; different kinds of insurance may be subject to different regulations.

However, if you believe that your insurance company is intentionally stalling your claim and delaying payment, you may have grounds to take legal action.

An underpaid claim can be a huge and unexpected blow. However, it doesn’t have to be the end of the story. Morgan & Morgan attorneys have a wealth of experience in dealing with insurers who deliver unreasonably low payouts.

Our attorneys have seen insurance companies severely lowball the clients they claim to be protecting. In some cases, this may be an example of your insurer acting in bad faith. Fill out a free case evaluation today, and one of our attorneys will review your case with absolutely no cost or obligation to you. We will fight to recover the compensation that you deserve.

A public adjuster is an individual that you may hire on your behalf to attempt to resolve claims with your insurance company. A public adjuster does not need to be a member of your state’s bar assocation. Only an attorney may represent you as your counsel in court proceedings pertaining to your claim.

A public adjuster cannot:

• File a breach of contract or bad faith lawsuit on your behalf.
• Take the deposition of the insurance adjuster or the insurer’s “experts.”
• Represent you or your co-insureds in a deposition.

Insurance companies know the limitations of public adjusters, and now so do you.

It is very important that you read any proposed agreement with a public adjuster prior to signing it. In many cases, if you have an agreement with a public adjuster in place, you may still be responsible for paying the public adjuster long after you hire an attorney to represent you.

If you have already hired a public adjuster who is unsuccessful at obtaining an appropriate recovery in your claim, we may still be able to help you. Please contact us to discuss your particular situation. This may be true even if the insurance company made no offers while he or she is representing you.

Beware of adjusters who come to your home unsolicited or who pressure you into signing their agreements.

A recorded statement is an informal method of investigating your claim. It can be conducted over the phone or in person. Most insurance policies require the insured to cooperate with a recorded statement. The failure to cooperate with an insurer’s request for a recorded statement could jeopardize your claim.

A Sworn Statement in Proof of Loss is a form that most insurers require to be completed under the conditions of most property insurance policies. It serves as a formal notice of the claim to the insurance company and is designed to provide information to the insurance company, so that they can set a reserve of money that could be paid out pertaining to your claim. If requested or otherwise required under the policy, this form is required to be completed in a specified period of time. A lawsuit cannot be filed on your behalf if the insurance company has requested this form and you have not completed it.

An assignment of benefits is a legal document that transfers the legal rights of your claim to another party. Assignments of benefits in property claims are most often used by “first-response” vendors such as water mitigation companies. However, any vendor who performs services pertaining to your property may ask for an assignment of benefits.

Because assignments transfer your rights under the policy, you should have one of our attorneys review this document before signing it. We have seen cases where assignments are so broad that they assign ALL of the insured’s rights to the vendor, such that it prevents the insured from challenging an insurance denial through the court.

You should carefully read all documents that are presented to you by vendors who assist in repairing your property and avoid signing documents that contain language that assigns your insurance benefits to any vendor.

An Examination Under Oath (EUO) is a more formal method for an insurer to investigate a claim.

During the Examination Under Oath, a representative of the insurance company will ask you questions in the presence of a court reporter, who will transcribe your answers. Most insurance policies give the insurance companies a right to conduct an Examination Under Oath and an insured has a duty under the policy to cooperate with a request for an Examination Under Oath.

All insurance companies are obligated and legally bound to act in good faith, meaning that they will treat you, the policyholder, with honesty, fairness, and good intention. This also means that the company will not intentionally prevent you from receiving your rightful contractual benefits.

Not to be confused with breach-of-contract cases, if an insurance company intentionally does not follow these guidelines, you have the right to bring legal action against your insurer.

The following are some common examples of bad faith tactics:

• Denial of a claim for an invalid or nonexistent reason.
• Unreasonable delay in investigating a claim and delivering payment.
• Inadequate investigation of a claim.
• Threatening or blackmail-like language.
• Intentional misrepresentation of the policy.
• Deliberately deceitful language.

This list is far from exhaustive. If you believe your insurance company acted in bad faith, contact a Morgan & Morgan attorney today to get the representation that you deserve.

When you’ve concluded your treatment of an injury with a doctor, they will declare that you have reached “maximum medical improvement.” This means that the patient has reached a point where they are as healthy as they can be; they may not be in the condition that they were prior to the accident, but their health has stabilized.

If that is the case, a doctor may assign the patient a permanent impairment rating according to American Medical Association guidelines.

In first-party situations, you – the policyholder – make a claim to your own insurance company. You have signed a contract with your company, and your compensation is dependent on what is in that contract. For example, if your home suffers fire damage, you can make a claim to your insurance company to cover the cost of damages and repairs. The amount you will receive depends on your policy.

In third-party claims, you file the claim with someone else’s insurance. Liability claims are the most common type of third-party claims. Because no contract exists between you and the insurance company, you may make claims for expenses that aren’t covered in the policy. For example, in some states, if you are in a traffic accident but not at fault, you may file a claim with the other driver’s insurance company - requesting compensation for loss of wages or pain and suffering.

At Morgan & Morgan, we understand that claim denials or delayed payments can cause devastating a financial burden in times of greatest need, and we are committed to getting our clients the payouts they deserve. Morgan & Morgan has a powerful history of dealing with the following types of insurance disputes: * Motor Vehicles * Homeowners * Fire Claims * Tornadoes * Sinkholes * Business Property Losses At Morgan & Morgan, our attorneys don’t accept that a lowball estimate or denied claim is the end of the story. [Contact us](/free-case-evaluation/) today for a free consultation.

If you experience a loss or are injured in an accident, one of the first things you should do is file an insurance claim. If you caused the incident, or if no one else is involved, you should file a first-party claim with your own insurance company. While dealing with your own insurance company should be a straightforward process, sometimes this is not the case. Don’t hesitate to [contact Morgan & Morgan](/free-case-evaluation/) for a free consultation if you cannot reach an agreement with your insurance company.

Insurance companies are businesses that aim to make money, and they may use tricky or manipulative language in their policies to avoid payouts in any way possible. Companies may make the following assertions to deny your claim: * Your loss isn’t included in the policy. * The damages don’t total the amount you’re claiming, or they don’t meet the deductible. * The insurance company’s “independent adjuster” determines that your losses aren't covered. * In medical cases, you used an out-of-network provider. * You waited too long to file a claim. Occasionally, simple clerical errors result in denied claims. But if your insurance company continues to deny payment, you may be entitled to file a dispute. In this case, move quickly — insurance companies often place time limits on denied claims. Carefully document your case, and get in touch with a Morgan & Morgan attorney today for your [free consultation](/free-case-evaluation/).