Insurance companies may deny valid claims by citing technicalities or complex policy language, leaving policyholders with little recourse. For example, some insurers claim certain damages are due to “pre-existing conditions” or fall under narrow exclusions, even when the claim is legitimate.
Every day, Texans see polished ads and friendly mascots designed to build trust in their insurance companies, promising help when life takes an unexpected turn. But when disaster strikes, whether it’s property damage, an auto accident, or a sudden medical emergency, many policyholders find the reality far from these comforting promises. Instead, they’re met with delays, denials, and undervalued claims, making it difficult to secure the coverage they deserve.
This is where Mokaram Injury Lawyers step in. As dedicated Texas first-party insurance lawyers, we stand by your side to ensure fair treatment and accountability from insurance companies. Navigating a claim when your insurer works against you can be overwhelming, and our team is committed to advocating for your rights every step of the way. We hold insurers accountable, striving to secure the compensation and support you are entitled to under Texas law so you can move forward with peace of mind.
What is First Party Insurance Law?
First party insurance law protects policyholders from their own insurance companies’ bad practices. Insurers are legally bound to investigate and pay valid claims fairly and promptly. But when they deny, delay, or lowball claims, they are not just acting in bad faith; they are breaking the law.
At Mokaram Injury Lawyers, we don’t hold back when insurance companies try to cheat our clients. We fight aggressively to get you every dollar you are owed, refusing to settle for less. If insurers deny or devalue your claim, we go after them with everything we have got, exposing their tactics and pushing for the compensation you deserve. We are relentless, bold, and unafraid to go to court if that’s what it takes.
Understanding First Party Insurance Claims
First-party insurance is a form of coverage designed to provide financial protection to the policyholder in the event of a loss, damage, or injury. Here is a closer look at what first-party insurance entails:
Direct Protection for Policyholders In first-party insurance, the policyholder themselves are the beneficiaries of the policy. This means that if they suffer a covered loss, they can file a claim with their own insurance company to recover costs directly without involving another party’s insurer.
Types of Losses Covered First-party insurance can cover a range of situations, including:
- Property Damage: Reimburses for damages to a policyholder’s property, such as in cases of fire, theft, or natural disasters.
- Medical Expenses: Covers healthcare costs when the policyholder faces medical needs due to injury or illness.
- Personal Injury Protection: Often part of auto insurance, this covers medical expenses, lost wages, and other costs related to injuries from a car accident.
Filing a Claim When a policyholder experiences a covered event, they file a claim with their own insurer. For example, if a homeowner suffers fire damage, they would submit a claim to their homeowners’ insurance to cover repair or replacement costs.
The insurer then assesses the claim and, if valid, issues payment according to the policy terms.
Policyholders deserve fair compensation for valid claims, but insurers often devalue them. Our Texas first-party insurance lawyers at Mokaram Injury Lawyers fight to ensure you get every dollar you are owed.
What You Need to Know About Bad Faith Conduct?
When you purchase an insurance policy, you enter into a contract that requires both you and the insurance company to act in “good faith” toward each other.
This means that when a claim is filed, the insurer is legally obligated to handle it fairly, promptly, and honestly. However, when insurance companies prioritize their profits over policyholders’ rights, they may resort to “bad faith” tactics, violating their duty to act in good faith.
Bad faith (Texas Insurance Code § 541.060) conduct occurs when an insurance company intentionally disregards its contractual obligation to treat a policyholder fairly.
This can involve unjustly denying a legitimate claim, unreasonably delaying payments, or misrepresenting policy terms to avoid paying what the policyholder is owed.
Texas law protects policyholders from such practices, giving them the right to pursue additional compensation if they can prove their insurer acted in bad faith.
When insurance companies decide to play dirty, they don’t expect policyholders to fight back. But that’s exactly what we do at Mokaram Injury Lawyers. Our Texas bad-faith insurance lawyers don’t just know the law; they dominate it, exposing every shady tactic insurers use to dodge their responsibilities.
First Party vs. Third Party Insurance
When filing an insurance claim, knowing the difference between first party and third party insurance is essential. These terms determine who’s involved in the claim and who’s responsible for compensation.
First Party Insurance First party insurance covers your direct losses with your own insurer. You file a claim with your insurance provider to seek coverage for damages, such as:
- Homeowners Insurance: Covers damage to your property.
- Auto Insurance: Pays for your car damages or personal injury.
- Health Insurance: Covers medical expenses.
In a first party claim, your insurer is required to act in good faith to provide compensation according to your policy. If they delay, deny, or underpay, you may have grounds for a legal challenge.
Third Party Insurance Third party insurance protects you from liability for damages you cause to others. When a third party (someone else) files a claim with your insurer, common types include:
- Auto Liability: Covers damage or injury you cause to another driver.
- General Liability: Protects against injuries on your property.
Common Issues Policyholders Face with Insurance Companies
When filing a claim, policyholders often encounter several tactics used by insurance companies to reduce or avoid payments. Here are some of the most common issues:
Claim Denial on Technical Grounds
Delays in Processing and Payment
Insurers sometimes delay claims by requesting unnecessary documentation or conducting repeated inspections. These delays can pressure policyholders financially and sometimes push them into accepting a lower settlement.
Underpayment of Claims
Low initial settlements are a common tactic, especially for property or auto claims, where insurers offer far less than the actual cost of damages. This leaves policyholders paying out-of-pocket for repair or recovery costs.
Lowball Settlement Offers
Insurers may make unreasonably small settlement offers, hoping claimants will accept rather than negotiate further. This is common in auto and home insurance claims where the initial offer is well below the loss value.
Inadequate Investigation
Some insurers conduct only minimal investigations or ignore relevant evidence to avoid larger payouts. This often happens with property damage claims, where insurers may overlook damage to reduce the settlement amount.
Types of First Party Insurance Claims We Handle
At Mokaram Injury Lawyers, we are dedicated to representing policyholders in a wide range of first party insurance claims, some of them include:
Homeowners Insurance Claims
Auto Insurance Claims
Health and Disability Insurance Claims
Commercial Property Insurance Claims
Life Insurance Claims
Texas Homeowners Insurance Claim Laws
Understanding Texas homeowners insurance claim laws can make a significant difference when filing a claim. These laws set timelines for filing and processing requirements.
Statute of Limitations In Texas, homeowners generally have two years from the date of an incident (like property damage) to file an insurance claim. This statute also applies to personal injury claims related to property incidents.
Claims Processing Timeline: Insurance Company Requirements
Initial Response
Once a claim is filed, the insurance company has 15 business days to acknowledge receipt and start investigating. This timeframe can be extended if they need additional information.
Decision Period
Within 15 days of acknowledging the claim, the insurer must decide on the outcome. If the claim is approved, payment should be issued within 5 business days of the decision.
Rights of Policyholders in Texas Texas offers strong protections for policyholders through its Consumer Bill of Rights, which guarantees that homeowners receive fair and transparent treatment from their insurers. Key rights include:
- The right to a written explanation if a claim is denied.
- The right to reject settlement offers that are deemed unfair.
- The right to have claims processed promptly and fairly.
Documentation Requirements Policyholders should document all damages thoroughly—taking photos or videos before making any repairs. Proper documentation helps support claims and can strengthen your case if there are disputes.
Common Tactics Used by Insurance Companies to Deny or Devalue Claims
Insurance companies are often focused on maximizing profits, which can lead them to employ various tactics to avoid fully paying out claims.
How Our Texas First Party Insurance Lawyer Can Help
When insurance companies put obstacles in your path. Whether through denied claims, delays, or low settlement offers, a first party insurance lawyer from Mokaram Injury Lawyers can make all the difference.
Here is how our team helps ensure your claim is handled fairly and that you receive the full compensation you are entitled to:
- We Know Every Angle – And We Use It Insurance companies craft policies with hidden loopholes and tricky terms designed to trip you up.At Mokaram Injury Lawyers, we know these strategies inside out. We dissect your policy with precision, exposing any attempt by your insurer to sidestep its obligations.Our Texas first party insurance lawyers understand every tactic insurance companies use, and we exploit every legal angle to your benefit, putting the pressure back on them from day one.
- Gathering Evidence That Leaves No Room for Excuses When it comes to evidence, we don’t play games. We build an airtight case with every document, estimate, and expert opinion needed to eliminate any excuse the insurer might have for underpaying or delaying your claim.We bring in the top professionals to assess damages, proving what you are owed and forcing the insurer to face the full extent of their obligations.
- Relentless Negotiation – We Won’t Settle for a Penny Less Mokaram Injury Lawyers doesn’t accept lowball offers. Insurers often try to wear people down with pitiful initial settlements, hoping you will cave.We don’t cave. Our first party insurance claim attorney in Texas engages in relentless, hard-hitting negotiation, pushing back at every turn until we get the payout you deserve.We know the insurer’s playbook, and we leverage it against them, securing settlements that truly reflect your losses.
- Taking Your Case to Court if Necessary If negotiations stall or your insurer continues to act in bad faith, Mokaram Injury Lawyers is fully prepared to escalate the case to court.Our trial attorneys have the skill and experience to litigate insurance cases and hold companies accountable.
- Protecting Against Bad Faith Practices If your insurance company has acted in bad faith through unjust denial, unreasonable delays, or attempts to misrepresent policy terms, we can pursue additional damages under Texas law.
How to Begin Your First Party Insurance Claim?
Starting your claim with Mokaram Injury Lawyers is straightforward. We offer a free initial consultation, where we will assess your situation and discuss potential steps.
Frequently Asked Question (FAQs)
Who Can File a First-Party Insurance Dispute?
Any policyholder who believes their insurer has unfairly denied, delayed, or underpaid their claim can file a first-party insurance dispute to seek fair compensation.
Why Do Insurers Deny or Underpay Claims?
Insurers may deny or underpay claims to protect their profits, often citing policy exclusions, lack of sufficient evidence, or downplaying the extent of the damages.
How Does the First-Party Insurance Claim Process Work?
The process starts with filing a claim, followed by an investigation by the insurer, after which they decide to approve, deny, or issue a settlement based on policy terms.
What Are My Rights If My Claim Isn’t Paid on Time?
Under Texas law, you have the right to receive timely payments; if delayed without reason, you may be eligible for interest on the unpaid amount and additional legal recourse.
My Claim Wasn’t Denied, But I Think I Was Underpaid. What Can I Do?
If you believe you were underpaid, you can request a reevaluation, provide additional evidence, or consult an attorney to pursue a fair settlement.
Awards & Honors
Contact Us Today to Schedule
Your Free Consultation
Fields Marked With An “*” Are Required