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What are your responsibilities when making a claim against your insurance company? | Guy S. DiMartino DC, JD, PA

Guy DiMartino June 6, 2013

Leesburg, Florida personal injury and medical malpractice lawyer explains your responsibilities when making a claim against your insurance company a/k/a “first party” insurance claim.

Many times folks start or make an insurance claim in Florida without first hiring a lawyer. The insurance claims process can be daunting and there are many pitfalls that folks may fall into. Initially, a first party insurance claim is a claim that you (the policy holder or member of your family) makes against your insurance company. The claim can range from a personal injury protection (“PIP” “No-Fault”) because of a whiplash that you received in a fender bender to your house burning down. As a general rule, if you make a first party insurance claim, the insurance company owes you a duty of “good faith and fair dealing”, whether this happens, is up to debate. Anyway, you as the claimant, have a number of responsibilities “duties” under the policy.

Your responsibilities under the insurance policy

Your responsibilities are set out in the specific terms of your insurance policy, which you should read and understand before making the claim. If you dont understand a term or clause, you should contact your insurance agent, insurance adjuster or an attorney. Many times these policies use “terms of art” which have meanings that are different than the meaning we give words in everyday language. Generally, most insurance companies will place the following responsibilities on the policyholder (the claimant – you):

Your duties under the insurance policy

  • A duty to report the claim – all insurance policies require the person making the claim to report the claim as soon as possible. This allows the insurance company to open up the claim and start its investigation if necessary.

  • A duty to provide written documentation – you will be required to fill out some type of claim form.

  • A duty to provide authorizations or releases – depending on the claim – you may be required to provide the insurance company with authorizations or releases allowing the insurance company to go out and get information from third parties (doctors, estimators, body shops).

  • Recorded statements – all insurance policies give the insurance company the right to take recorded statements of folks making a first party claim.

  • A duty to cooperate – this is a catch all clause requiring cooperation on the party of the person making the first party claim.

A person making a claim against an insurance company in Florida has a number of responsibilities to the insurance company. The problem arises when the insurance company becomes adversarial instead of helpful with its policyholder and starts overreaching to the point where it becomes harassing. Making a claim against your insurance company should not make you feel like youre on trial or did something wrong.

If you have any questions about making a first party insurance claim in Florida, you can call me directly on my cell phone at 352-267-9168 or fill out the internet consultation form on the right hand side of the screen.