How Does the First-Party Insurance Claim Process Work?

When disaster strikes—whether it’s hail damage, a burst pipe, or fire loss—you expect your insurance company to honor the policy you’ve paid into. But all too often, policyholders face unnecessary delays, underpayments, or flat-out denials. If you’re asking, “how does the first-party insurance claim process work?”, you’re not alone.

This guide walks you through the process, explains your rights, and outlines how Daly & Black, P.C. stands ready to fight back when insurers fail to hold up their end of the bargain.

What Is a First Party Insurance Claim?

A first-party insurance claim is a demand for payment that a policyholder files with their own insurance company after suffering a covered loss. Unlike third-party claims—which involve another person’s insurer—a first-party claim is between you and your insurance provider.

For example, if your roof is destroyed by a Louisiana hailstorm or your business operations are halted due to a flood, you’d file a first-party property claim with your insurer to cover the damage.

At Daly & Black, P.C., we pride ourselves on making sure our clients don’t get shortchanged by their insurance companies.

What Happens After You File a First Party Insurance Claim?

Understanding the process can help you protect your rights and hold the insurer accountable. Here’s what to expect:

Step 1: Filing the Claim
Notify your insurance company as soon as possible. Most policies require prompt notice after a loss, and failing to act quickly could weaken your position.

Step 2: Documenting the Damage
Take photos, save receipts, and create a thorough inventory of all losses. The burden is often on the policyholder to prove the extent of the damage.

Step 3: The Insurance Company’s Investigation
Your insurer will assign an adjuster to inspect the damage. Be cautious—adjusters often work to minimize payouts, not maximize them. In many cases, they’ll undervalue the cost of repairs or argue the loss isn’t covered.

Step 4: Payment or Dispute
If your claim is approved, the insurer issues payment. But delays and denials are common—especially when policies contain ambiguous language or exclusions the insurer can exploit.

Why First Party Claims Get Delayed or Denied

Insurance companies are in the business of profit, not payouts. Here are a few examples of the mechanisms that insurance companies use to delay, undervalue, or reject your claim.

Vague Policy Language

Insurers use complex language to create wiggle room. They may argue your loss is excluded based on narrow interpretations of the policy.

Delay Tactics

You may be asked to submit repetitive documentation or wait through long investigation periods while your property deteriorates or bills pile up.

Undervalued Repairs

Insurers often bring in biased experts to estimate damage at a fraction of its true value, forcing you into a low settlement.

When this happens, you need a lawyer who knows how to fight back. Daly & Black, P.C. challenges bad-faith tactics head-on to secure the compensation you deserve.

Why Legal Representation Is Essential

Navigating a denied insurance claim can be overwhelming—especially when you’re up against an industry built to protect its own bottom line. The Government Accountability Office (GAO) highlights just how often policyholders face obstacles from the outset. In some cases, insurers deny up to 19% of applications for individual coverage, with certain companies rejecting more than 40%. Even when claims are filed, denial rates have ranged from 11% to 24%, depending on the insurer and jurisdiction.

What happens next? Consumers who appeal these denials see insurers reverse their decisions in only 39% to 59% of cases. That means more than half of appeals are either denied again or settled for less than what may be owed.

Without an attorney, you risk getting steamrolled by a system designed to limit payouts. Legal representation gives you leverage—an advocate who can interpret policy fine print, gather critical evidence, and pressure insurers into honoring their obligations.
Don’t leave your settlement up to a coin flip. Get in touch with Daly & Black, P.C., and let us fight to get you what you’re rightfully owed.

How Daly & Black Can Help

At Daly & Black, P.C., we don’t just push paper—we go to war for our clients. As a policyholder, you’re entitled to full compensation under your contract. But insurance companies won’t pay up unless you make them.

That’s where we come in. Our team:

• Investigates your loss in detail
• Reviews your policy for full coverage opportunities
• Negotiates aggressively—or litigates when needed

We operate on a contingency fee basis—you pay nothing unless we win. With accolades like Super Lawyers recognition and a win as Insurance Litigation Firm of the Year, we’ve proven we don’t back down.

We’re ALL IN. ALL THE TIME.

FAQ

What is a first party insurance claim?

A first-party insurance claim is a request you make to your own insurance provider for coverage under your policy—typically involving property, auto, or business interruption losses.

How does the first-party insurance claim process work?

You notify your insurer, document your losses, cooperate with their investigation, and either receive a payout—or dispute an unfair denial or underpayment.

Why would my first party insurance claim be denied?

Common reasons include alleged exclusions in the policy, missing documentation, or undervalued damages. Many of these denials can be successfully challenged with legal help.

Take Control of Your Claim Before the Insurance Company Hijacks the Outcome

Insurance companies have armies of adjusters and attorneys whose job it is to protect their bottom line. You deserve a law firm that fights just as hard for you.

If your first party insurance claim has been delayed, underpaid, or denied—don’t let the insurer win by default.Schedule your FREE consultation now. Daly & Black is ALL IN. ALL THE TIME.