Auto Insurance Claims: Dealing With Third-Party Claims

If you've been in a car accident that wasn't your fault, you'll need to file a third-party claim to get your property damage and bodily injuries covered. This is a claim filed with the other driver's insurance company, and it's called a third-party claim because you are not one of the two primary parties in the insurer-insured relationship.

The way third-party insurance claims work depends on whether you live in a liability or no-fault state. In no-fault states, you always make injury claims on your own insurance first, whereas in at-fault states, the at-fault party pays for both bodily injury and property damage costs.

What to do if the other driver doesn't have insurance

If the other driver doesn't have insurance, your first step should be to contact your own insurance company. You may be covered by uninsured/underinsured motorist coverage, which is an optional add-on that most drivers have unless they specifically opted out. This will help pay for your damages if you are hit by a driver without insurance or who doesn't have sufficient coverage.

If you don't have this type of coverage, you may be able to make a claim under collision coverage, which will pay for repairs to your vehicle, regardless of who is at fault for the accident. However, this won't cover any medical costs for your injuries.

Another option is to file a lawsuit against the uninsured or underinsured driver, especially if your damages are substantial and not covered by your insurance. This is more likely to be an option in "fault" states, where the at-fault driver is liable for all damages. However, it's important to note that most uninsured drivers don't have insurance because they can't afford it, so they may not have the assets to pay for your damages even if you win the lawsuit.

In any case, it's recommended to consult with a lawyer to discuss your options and determine the best course of action.

How to handle the other driver's insurance company

After a car accident, it is usually not a good idea to speak with the other driver's insurance company, but there are some situations in which doing so can help you. You are not legally required to speak with them, but if you do, be very careful about what you say and what information you provide.

If the other driver is lying and their insurance company needs you to confirm the lie, or if the other driver refuses to speak to their own insurance company, then you may need to talk with them. In these cases, the other driver's insurance company may not know the extent of the damages you endured, especially if the accident was minor. However, if there is a question as to who is at fault, refrain from speaking to them directly and retain a lawyer to handle the communication on your behalf.

If you do choose to speak to the other driver's insurance company, keep it simple and only answer what is asked. Avoid elaborating or getting into any stories about yourself. If you can respond with a simple yes or no, that is even better. Do not agree to have the conversation recorded, as this can be used against you later if you recall things differently or misspeak. Refrain from speculating about anything regarding your case. If you know something, speak that truth. If you don't know something, just say you don't know.

Remember, the primary goal of almost any car insurer is to pay out as little money as possible for claims. They are continually seeking ways to disprove your claim and dismiss your case. They will attempt to collect information about you to prove you were either negligent or not as injured as you claim to be. No matter how insignificant the damage to your car might be, never tell the other driver's insurance company that you are fine or that your car isn't that bad.

If the other driver was at fault for your car accident, and their insurance company has accepted financial responsibility for the crash, you might find yourself making a "third-party insurance claim" directly with the other driver's insurer. In this situation, you'll need to talk to the other driver's insurer, provide them with all documents related to your claimed losses, and give them access to your accident-related medical records. However, fault for the accident should no longer be in dispute. The bad news is that the insurance adjuster still has the company's interests in mind, not yours. So be ready for some pushback on things like the nature and extent of your injuries and the legitimacy of some of your treatment.

What to do if your claim is denied

If your third-party auto insurance claim is denied, it's important to remember that this isn't the end of the road. Here are some steps you can take to deal with a denied claim:

Get the Reasons for the Denial in Writing

Insurers usually provide a claim denial letter. If they don't, don't hesitate to ask for one. This letter will outline the specific reasons why your claim was denied, which will be important information as you move forward.

Hire an Auto Accident Attorney

It is recommended to hire an auto accident attorney to help you fight the denial. Auto insurers make a profit by taking in more in premiums than they pay out in claims, and a claim presented by a personal injury lawyer will usually be taken more seriously by the insurance adjuster. Your attorney can help you navigate the process and ensure your rights are protected. Many car accident lawyers offer a free case evaluation, so consider taking advantage of that to understand your options.

Draft a Demand Letter

Your attorney may first draft a demand letter, which is a more formal claim for compensation. This letter will detail your side of the story, the financial amount of damages and/or injuries sustained, and why the other driver was at fault. The insurance company will likely either provide a specific reason for denying the claim, reverse its decision, or offer a portion of the damages demanded.

Suspect Improper Claims Practice

If you or your lawyer suspects that the insurer engaged in improper claims practices prohibited by state law, this can be included in the demand letter. For example, refusing to pay claims without conducting a reasonable investigation based on all available information could be considered improper.

Formal Appeals Process

If the insurance company has a formal appeals process, your attorney can use this platform for negotiation, which may lead to a more favorable settlement. This could include the use of arbitration to resolve the matter. Some states, like New Jersey, require insurers to provide a formal appeals process for denied claims.

Deal with Bad Faith Insurance Practices

Bad faith practices by an insurance company can include unreasonable delay in handling your claim, denying a claim without a valid reason, or not conducting a fair and thorough investigation. If you believe the insurance company is acting in bad faith, your attorney may be able to file a bad faith claim on your behalf, which could result in additional damages beyond what was initially claimed.

Remember, it's important to keep detailed records of all expenses and damages related to the accident, as well as any communication and decisions made by the insurance company. This information will be crucial as you work with your attorney to resolve the denied claim.

What to do at the scene of the accident

Being involved in a car accident can be stressful, but knowing what to do at the scene can help save lives, reduce injuries, and make the claims process easier. Here are some detailed steps to follow if you find yourself in this situation:

Keep Calm and Park at a Safe Distance

If you come across a car accident and want to help, it's important to first stay calm and park your vehicle at a safe distance from the crash site. Aim for a minimum of 100 feet away, which will give you a clear view of the scene and allow emergency vehicles easy access.

Turn on Hazard Lights and Alert Others

Activate your car's hazard lights to warn other drivers and set out traffic triangles if you have them. This will help notify passing drivers that assistance is needed.

Call Emergency Services

Dial 911 and provide specific details about the accident, such as the location, the number of people involved, the severity of injuries, and any other relevant information. If there are other witnesses present, ask one of them to make the call while you focus on assisting those involved.

Assist the Victims

If it is safe to do so, approach the scene and help the individuals involved. Do not move any of the victims unless they are in immediate danger, and refrain from attempting to treat any injuries unless you have professional training. Your role is to provide comfort and reassurance, keeping them calm and out of harm's way until emergency services arrive.

Secure the Scene

Once you've checked on the victims, you can help by putting the involved cars in "park" and turning off the ignition, but only if it is safe to do so. Remember, your safety comes first.

Gather Information and Document the Scene

If you are involved in the accident, exchange information with the other driver(s) and collect contact details from any witnesses. This includes names, phone numbers, license and registration information, vehicle details, and insurance information. Take photos of the accident scene, capturing vehicle damage, and make notes about the location, time of day, and weather conditions.

Notify Law Enforcement and File a Report

Alert the police or highway patrol, especially if the accident is serious or anyone is injured. Get the names and badge numbers of the responding officers and inquire about obtaining a copy of their accident report. Even if the police cannot come to the scene, it is important to file an incident report at the nearest police station or through their website. This official report will be crucial for insurance claims and can protect you in case of disputes or unforeseen complications.

Contact Your Insurance Company

Notify your insurance provider about the accident as soon as possible. Starting the claims process early will make it easier to recall important details accurately.

How to get reimbursed for medical expenses

If you've been in a car accident and need to file a third-party insurance claim to get reimbursed for medical expenses, here's a step-by-step guide to help you through the process:

Step 1: Collect Information

First, gather as much information as possible about the accident. This includes:

• The dollar amount of your medical expenses and any property damage.
• The contact information, vehicle information, and insurance details of everyone involved.
• The names and badge numbers of any police officers you dealt with.
• A copy of the accident report, if available.
• Details about the location, weather, date, and time of the incident.
• Photos of the damages and accident scene.

Step 2: File a Claim

If the accident was not your fault, you will need to file a third-party claim with the other driver's insurance company. Contact their insurance company and provide them with the information you've gathered. Most insurance companies have an online claim portal or a mobile app that you can use to initiate the claim process.

Step 3: Provide Medical Documentation

The insurance adjuster handling your claim will need to verify the extent of your injuries and other losses. You will need to provide documentation to support your claim, such as medical records and proof of any lost income or other financial harm caused by the accident.

Step 4: Negotiate a Settlement

The insurance adjuster will likely make you an initial settlement offer. Remember that this is just a starting point, and you may need to negotiate to get a fair outcome. You can choose to handle the negotiation yourself or seek help from an experienced car accident lawyer.

Step 5: Explore Other Options

If the at-fault driver is uninsured or underinsured, you may need to explore other options to get reimbursed for your medical expenses. These options could include filing a personal injury lawsuit against the at-fault driver or seeking coverage under your own insurance policy, such as uninsured/underinsured motorist coverage or medical payments coverage.

It's important to act promptly when filing a third-party insurance claim and to be prepared to provide detailed information and documentation to support your claim. Keep in mind that the process may vary slightly depending on your state's insurance laws and the specific insurance companies involved.

Frequently asked questions