Your car is in the shop after a crash on Sunrise Boulevard, and the other driver’s insurer has not called back. Can you just use your own coverage?
Often, yes. First party insurance claims go through your own policy, while third party claims go to the insurer of the driver who may be at fault. Each path has different rules, speeds and limits. Many drivers use both at once, with their own insurer handling repairs while the injury claim runs against the other driver’s carrier.
Your declarations page tells you which coverages you actually bought.
First and Third Party Insurance Claims Defined
California’s claim regulations use these exact terms. Title 10, section 2695.2(f), defines a first party claimant as someone asserting a right under a policy as a named insured, other insured or beneficiary. That includes a driver seeking uninsured motorist benefits.
Section 2695.2(x) defines a third party claimant as someone making a claim against a person or interest insured under a policy. Put simply, you are claiming against someone else’s coverage.
How the Two Relationships Differ
In a first party claim, you are the customer. The insurer owes you duties under your contract, including good faith in handling the claim.
With a third party claim, the insurer’s main duty runs to its own policyholder. It may push back harder on fault and on the value of your losses.
Coverage Used in First Party Insurance Claims
- Collision coverage pays for damage to your car, minus your deductible.
- Medical payments coverage, if you bought it, helps with medical bills no matter who was at fault.
- Uninsured motorist coverage applies when the at fault driver has no insurance.
- Underinsured motorist coverage fills the gap if the other driver’s limits fall short.
- Rental reimbursement helps pay for a rental car in the repair period.
Insurance Code section 11580.2 requires uninsured and underinsured motorist coverage in an auto liability policy unless you waived or reduced it in writing. Medical payments coverage is optional in California.
Why Start a Claim With Your Own Insurer?
Collision and medical payments coverage do not require settling fault first. Repairs and early bills can move faster.
Your insurer can pursue the other driver’s carrier for repayment through subrogation. If that succeeds, you may get your deductible back.
When a Third Party Claim Makes Sense
A third party claim can cover losses your own policy does not, like pain and suffering, lost income and future care. Those losses usually depend on proving the other driver was at fault.
If the facts are clear, the claim may go smoothly. When the drivers tell different stories, it can drag on. A related post covers what to do when the other driver changes the story.
A Sacramento Example
Imagine a driver in Citrus Heights rear ended on Sunrise Boulevard by a driver who carried only minimum limits. Her collision coverage pays for repairs within two weeks, minus her $500 deductible. Medical payments coverage on her policy helps with her first urgent care and therapy bills.
In this hypothetical, she opens an injury claim against the at fault driver’s carrier in parallel. If her losses exceed that driver’s limits, her underinsured motorist coverage may come into play.
Duties You Owe Your Insurance Company in First Party Claims
First party insurance claims come with duties of your own. Your policy requires prompt notice and cooperation. Expect your insurer to ask for documents, an inspection of the car or a recorded statement.
You can ask what each request is for and how the information will be used. Read any medical authorization closely before signing, and ask to narrow it to records related to the crash.
Insurance Response Times for First and Third Party Claims
State regulations give insurers 15 calendar days to acknowledge a claim and generally 40 calendar days after proof of claim to accept or deny it. Those rules protect first and third party claimants. A separate post lays out the insurer response timelines in detail.
Will Using Your Own Coverage Raise Your Premium?
Not for an accident you did not cause. Insurance Code section 491 bars an auto insurer from raising your premium over an accident in which you were not at fault.
Under the related regulation, an insurer treats you as principally at fault if your share is 51 percent or more. Ask your insurer to put its fault finding in writing if you disagree with it.
Mistakes Drivers Make With Insurance Claims
- Waiting on the other insurer while your own coverage could pay now.
- Mixing claim numbers so payments get confused.
- Signing a broad medical release without reading it.
- Forgetting that a third party settlement may affect an underinsured motorist claim.
Disputes With Your Own Insurer
Disagreements can arise over your car’s value or the need for treatment. Ask for its reasons in writing, since a first party denial must list each basis and the policy terms behind it.
If the dispute continues, ask for a supervisor or contact the Department of Insurance through its consumer help page.
Questions About Claim Types
Can I claim with both insurers at once?
Yes. Many drivers let their own collision coverage fix the car while pursuing a third party injury claim. Keep the claim numbers separate and track which insurer paid what, because your insurer may seek repayment later.
Does medical payments coverage depend on fault?
No. Medical payments coverage, when included in your policy, pays covered medical bills whoever caused the crash, up to the limit you chose. Your policy may reduce uninsured motorist benefits by amounts it already paid.
How long do I have to sue the other driver?
Most California injury lawsuits must be filed within two years under Code of Civil Procedure section 335.1. Your policy may set its own notice and proof deadlines for first party claims, so read it closely.
Use first party insurance claims for what your own coverage can pay now, and pursue the other driver’s insurer for the rest. Keep each claim number separate and get key decisions in writing. More posts are in the insurance claims hub.
This article is general information, not legal advice. Laws and deadlines change and every case is different. Talk with a licensed California attorney about your situation.