If your property’s been damaged, your business interrupted, or your health coverage denied, you expect your insurance company to step up. But too often, they don’t. Instead, they delay, deny, or lowball valid claims—leaving you frustrated, financially strained, and unsure of what to do next.
This guide offers essential insurance claims tips to help policyholders better understand the first-party claims process, avoid costly mistakes, and protect their right to fair compensation. Whether you’re dealing with hurricane damage in Louisiana or a fire loss in Texas, these strategies are designed to empower you.
What Is a First-Party Insurance Claim?
A first-party insurance claim is a claim you file with your own insurance company for coverage under your policy. Unlike a third-party claim, where someone else files against your liability insurance, a first-party claim is made by you, the policyholder, directly.
Common examples of first-party insurance claims:
- A homeowner files for hail or windstorm damage.
- A business owner files for lost revenue under business interruption coverage.
- A policyholder uses collision coverage after a car accident.
- A patient challenges a health insurance denial for necessary treatment.
Knowing the first-party claim definition helps you distinguish your rights and obligations under the policy.
Top 7 Tips for Filing a First-Party Insurance Claim
First-party insurance claims can be deceptively complex. From navigating policy jargon to responding to adjuster tactics, many policyholders don’t realize just how much is at stake until it’s too late.
The following tips offer actionable strategies to help you protect your claim from the very beginning—so you can avoid costly missteps and stand your ground when it matters most.
1. Review Your Policy in Detail
Before filing any claim, read your policy cover to cover. Understand the coverage limits, exclusions, notice periods, and documentation responsibilities. Don’t rely on what the agent “told you”—rely on what’s written.
2. Document Everything — Early and Often
Start collecting evidence as soon as possible. Take photos and videos of all damage, gather receipts, track repair estimates, and save every piece of communication. If you wait too long, insurers may argue the damage wasn’t storm-related or question the extent.
3. Notify Your Insurance Company Promptly
Most policies require “prompt” or “timely” notice of claims. In Texas, many policies demand notice within days. In Louisiana, policies and state law may require notice in writing. Waiting too long can jeopardize your right to recover.
4. Be Careful What You Say to the Adjuster
Insurance adjusters are trained to protect their company’s bottom line. Never exaggerate or admit fault, but also avoid casual comments like “it’s not that bad.” Everything you say could be used to justify a smaller payout.
5. Understand the Appraisal and Dispute Process
If you and your insurer can’t agree on the value of your claim, most policies include an appraisal clause. This allows both sides to hire independent appraisers. If needed, a neutral umpire breaks the tie. You also have the right to legal action if bad faith is involved.
6. Keep a Written Record of Everything
Put all communications in writing. Keep a claim diary with dates, names, and summaries of phone calls. If your claim is delayed or denied, this record becomes critical evidence.
7. Don’t Settle Too Soon — Especially for Complex Losses
Insurers may offer quick settlements to limit their exposure. But in serious cases—like fire losses, commercial property damage, or health claim denials—don’t sign off until you understand the full scope of your loss.
Common Mistakes to Avoid When Filing a First-Party Claim
Even a small misstep can give insurers the excuse they need to delay or deny your claim. Avoid these common errors:
- Failing to notify your insurer on time
- Accepting the first offer without understanding the loss
- Not reading your policy thoroughly
- Providing verbal statements without legal guidance
- Letting the insurer delay indefinitely without pushing back
- Signing broad or unclear release forms
If you’re unsure about your rights, speak to an attorney before making major decisions.
When Should You Get a Lawyer Involved?
Many first-party insurance claims are resolved without legal help. But when insurers play games, you need someone who knows how to fight back. Call Daly & Black if:
Your Claim Is Denied or Undervalued
If your insurer outright denies your claim or offers a settlement that doesn’t cover the documented costs of your damage or loss, for example, if you receive a $10,000 offer for a $35,000 roof replacement, you should consider legal intervention to challenge their decision.
Your Insurer Keeps Delaying With No Valid Reason
If weeks or even months pass without meaningful updates, or your insurer keeps asking for the same documents repeatedly, this may signal bad faith tactics meant to wear you down. An attorney can force progress or take legal action for delay damages.
Your Business or Rental Income Is Affected
Commercial property owners, landlords, and small businesses suffering lost income due to a covered event should contact a lawyer immediately. These claims involve complex calculation, and insurers often resist paying for indirect or projected losses.
We work on a contingency fee basis, meaning you pay nothing unless we recover for you.
Think your insurer isn’t playing fair? Call Daly & Black for a free case review.
FAQs
What is a first-party insurance claim?
A first-party insurance claim is when you seek coverage from your own insurance company for a covered loss. This could involve property damage, a car accident, or a denied health treatment.
How can I improve my chances of getting my first-party claim approved?
Start by understanding your coverage and documenting your loss thoroughly from the outset. Clear communication, especially in writing, can help protect your rights if the insurer delays or underpays. If issues arise, don’t hesitate to consult a lawyer.
What mistakes should I avoid when filing a first-party claim?
Avoid missing deadlines, giving unverified statements, assuming the adjuster is on your side, or accepting a check before understanding your full rights. These mistakes can permanently affect your payout.
Get the Full Protection You Paid For
You paid your premiums in good faith, so you are entitled to the full and fair protection provided under your policy. If your insurance company is dragging its feet, making excuses, or flat-out denying a valid claim, Daly & Black is ready to go to war for you.
We’re ALL IN. ALL THE TIME. for policyholders in Texas, Louisiana, and nationwide.
Schedule your free consultation today with a top-rated insurance claims attorney at Daly & Black, P.C. and pursue the full compensation you may be entitled to.