What to do when someone files a claim against you starts with one critical step: notifying your insurance company immediately, before making any statements, signing any documents, or responding to the other party directly.
An Okeechobee personal injury lawyer helps protect your rights during this process, particularly if the claim is large, disputed, or involves injuries on both sides.
Florida's no-fault insurance system adds a layer of complexity that many drivers do not fully understand until they receive that first call or letter. Under this system, most injury claims begin with each driver's own Personal Injury Protection (PIP) coverage, regardless of who caused the accident.
But when injuries are serious, the other party may step outside the no-fault framework and file a liability claim or lawsuit directly against the at-fault driver.
Familiarizing yourself with how that process works, what your insurance company is required to do on your behalf, and where your own rights and potential claims fit into the picture may help reduce the anxiety that comes with a claim landing on your doorstep.
What the Law Says
- Notify your insurer immediately: Most Florida auto insurance policies require prompt notification of any accident or claim. Delaying that call may jeopardize your coverage and your insurer's ability to defend you.
- Do not admit fault or give recorded statements without guidance: Anything you say to the other party's insurance company may be used to increase your liability. Even casual admissions at the accident scene may become part of the claim file.
- Understand that a claim is not the same as a lawsuit: An insurance claim is a request for payment through your policy. A lawsuit is a legal action filed in court. The two follow different processes and carry different implications.
- Florida's no-fault system limits when the other party may sue: Under Florida Statute § 627.737, a person injured in a car accident may only pursue a liability claim against the at-fault driver if their injuries meet the "serious injury threshold," which includes permanent loss of a bodily function, permanent scarring, or death.
The First 48 Hours Matter
The steps you take in the first two days after learning about a claim against you set the tone for everything that follows. Mistakes made early, especially unguarded statements, tend to become permanent parts of the case file.
Notify Your Insurance Company About the Claim Against You
Your policy almost certainly requires you to report any accident or claim promptly. When you call, provide the basic facts: the date, time, and location of the accident, the other party's information, and the police report number if one was filed. Your insurer will assign an adjuster to investigate the claim on your behalf.
Do Not Speak to the Other Party's Insurance Company
If the other driver's insurer contacts you directly, you are under no obligation to give a recorded statement. Politely decline and direct them to your own insurance company. In our experience, recorded statements taken without legal guidance frequently contain admissions or phrasing that the opposing insurer later uses to shift fault.
Preserve Your Own Evidence
Gather everything related to the accident: photos, the police report, medical records if you sought treatment, repair estimates, and any communication you have received about the claim. This evidence is just as important for your defense as it may be for any claim you file yourself.
What Kind of Claim Has Been Filed?
Not every claim against you looks the same. The type of claim determines what process follows, who handles it, and what your exposure may be. The most common scenario after a Florida accident is a third-party insurance claim.
The other driver (or their attorney) submits a demand to your liability insurance carrier for medical bills, lost wages, pain and suffering, and property damage. Your insurer investigates the claim, evaluates liability, and either negotiates a settlement or denies the demand.
In most cases, your insurer handles this process without requiring you to appear in court or take any additional action beyond cooperating with the investigation.
When a Claim Against You Becomes a Lawsuit
If the insurance claim does not resolve, or if the other party's injuries meet the serious injury threshold under § 627.737, they may file a lawsuit. At that point, you are a named defendant in a civil case. Your insurer typically provides legal representation under the terms of your policy, but you may also want independent legal counsel, particularly if the claim exceeds your policy limits. Reach out to a Pembroke Pines personal injury lawyer if thing begin to escalate.
A Property Damage Claim
Some claims involve only vehicle or property damage, not injuries. These tend to resolve more quickly through the insurance process and rarely escalate to litigation.
Knowing which category the claim falls into helps determine the urgency of the response and the level of legal involvement required.
How Florida's No-Fault System Affects the Claim Against You
Florida's no-fault auto insurance framework shapes what to do when someone files a claim against you in ways that are not always obvious.
PIP Covers the Other Driver's Own Injuries First
Under Florida Statute § 627.736, every Florida driver must carry at least $10,000 in PIP coverage. After an accident, each driver's own PIP policy pays for their medical expenses (up to 80 percent) and lost wages (up to 60 percent), regardless of fault.
This means the other driver's initial medical bills are typically covered by their own insurance, not yours.
The Serious Injury Threshold
The other party may only step outside the no-fault system and file a liability claim against you if their injuries meet the threshold defined in § 627.737. Qualifying injuries include significant and permanent loss of an important bodily function, permanent injury within a reasonable degree of medical probability, significant and permanent scarring or disfigurement, or death.
If the injuries do not meet this threshold, the other driver's recovery is limited to their own PIP benefits. A liability claim against you may not proceed.
Why the Serious Injury Threshold Matters When a Claim Is Filed Against You
Our attorneys evaluate whether the other party's injuries actually meet the serious injury threshold as part of every case our Plantation personal injury law firm reviews. A claim that does not satisfy this standard may be challenged and potentially dismissed, which directly protects the person facing the claim.
When You May Also Have a Claim
One of the most overlooked aspects of knowing what to do when someone files a claim against you is recognizing that you may have a claim of your own.
When You Also Have a Claim After Someone Files Against You
If you sustained injuries in the same accident, your PIP coverage should pay for your medical treatment and a portion of your lost wages. If your injuries meet the serious injury threshold, you may also have a liability claim against the other driver.
That claim may include pain and suffering, additional medical costs, and other damages beyond what PIP covers.
Comparative Negligence May Work in Your Favor
Florida's modified comparative negligence system means fault is not all-or-nothing. If the other driver was partially responsible for the accident, their share of fault reduces their recovery against you and may support your own claim against them.
Our team has worked with clients who initially came to us only because a claim had been filed against them, only to discover that they had a viable counter-claim worth significantly more than what the other party was seeking. Evaluating both sides of the equation from the beginning is critical.
The 14-Day Rule for PIP Benefits
If you were injured, Florida law requires that you seek initial medical treatment within 14 days of the accident to qualify for PIP benefits. Missing this deadline forfeits your right to PIP coverage entirely, regardless of the severity of your injuries. This timeline runs whether or not someone has filed a claim against you.
What Happens If the Claim Exceeds Your Policy Limits
Most Florida drivers carry liability coverage with set policy limits. If the claim against you exceeds those limits, the financial exposure becomes personal.
The Gap Between Coverage and Exposure
Florida's minimum insurance requirements do not include mandatory bodily injury liability coverage. Drivers who carry only PIP and property damage liability have no coverage for the other party's bodily injury claim. Even drivers with bodily injury coverage may have limits that fall short in serious accident cases.
When Personal Assets May Be at Risk
If a judgment exceeds your policy limits, the claimant may pursue your personal assets to satisfy the remainder. Florida law does provide significant protections, including the homestead exemption, which shields a primary residence from forced sale.
Retirement accounts and certain jointly held marital property may also be protected. But non-exempt assets, including bank accounts, investment portfolios, and non-homestead real estate, may be vulnerable.
Why Legal Counsel Matters in Excess-Exposure Cases
When a claim threatens to exceed policy limits, independent legal counsel becomes particularly important. Your insurer's attorney represents the insurer's interests, which may not always align perfectly with yours. Our attorneys can evaluate the full scope of your exposure and, where applicable, explore both defensive strategies and any cross-claims that may offset the risk.
Ask Frankl Kominsky Injury Lawyers About What to Do When Someone Files a Claim Against You
Will my insurance rates increase if someone files a claim against me?
Rates may increase, particularly if your insurer determines you were at fault. The amount of the increase depends on the insurer, the severity of the claim, and your driving history. Not all claims result in rate increases, especially if the investigation finds shared or disputed liability.
Can I refuse to cooperate with my insurance company's investigation?
Your policy likely includes a cooperation clause requiring you to assist in the investigation and defense of any claim. Refusing to cooperate may give your insurer grounds to deny coverage, leaving you personally responsible for any damages awarded.
What if the other driver's claim is exaggerated or fraudulent?
If you believe the claim is inflated or based on false information, inform your insurance company and provide any evidence that contradicts the claimant's account. Your insurer has a duty to investigate claims thoroughly, and fraudulent claims may be challenged, denied, or referred to law enforcement.
Should I contact the other driver after learning about the claim?
No. Direct contact with the other party or their attorney may create legal complications. All communication should go through your insurance company or your attorney. Even well-intentioned conversations may be interpreted as admissions or used against you later.
Do I need my own attorney if my insurance company provides one?
Your insurer's attorney represents the insurer's interests under the policy. In many cases, that representation is sufficient. However, if the claim exceeds your policy limits, involves disputed liability, or if you also sustained injuries with your own potential claim, independent legal counsel may provide a more complete picture of your rights and options.
The Claim Against You May Not Be the Whole Story
Receiving notice that someone has filed a claim against you is stressful. But it is only one piece of a larger legal picture, and it may not be the most important one. If you were also hurt in the same accident, if fault is genuinely shared, or if the claim is inflated, the situation may look very different once all the facts are on the table.
What would it mean to have an attorney review the full picture, not just the claim against you, but any claim you may have as well? Frankl Kominsky Injury Lawyers is available 24/7 to discuss accident claims across South Florida.
Call our Boynton Beach office at (561) 800-8000 for a free consultation in English, Spanish, or Creole.
