What is a third party claim?

A third party claim is a claim that arises from a work related injury where someone other than your employer, or a co-worker, causes your injury.  Third party claims allow you to pursue a direct claim against the person who caused your injury.  However, there are strings attached, and this article explains the process.

First, let's start with an example.  You are at work, and asked to run an errand.  While driving across town, you are stopped in traffic, and someone hits you from behind, and you are injured.  You have a workers' compensation claim because you were injured on the job.  You also have a personal injury claim against the person who rear ended you, and that person is the "third party." So, you have two claims from the one incident.  However, because the workers' compensation carrier is paying your benefits, they have a lot of say in what happens with the third party claim.

The workers' compensation carrier will send you a form called a "notice of election."  This form asks you to make a choice, or an election.  You can elect to pursue the the third party claim on your own, or you can let the workers' compensation carrier pursue the claim for you.  We almost always advise clients to choose to pursue the claim on their own. You will still be required to reimburse the workers' compensation carrier the cost of many of the benefits you received.  The best way to think of this is that you and the workers' compensation carrier are in the same boat. You have been injured, and lost your health, or some of it.  The workers' compensation insurance company has suffered a business loss.  You both have a claim against the responsible party.

When you elect to pursue the claim on your own, you still have to keep the workers' compensation insurance company updated on the claim, and you have to obtain the workers' compensation carrier's permission to resolve the claim.  The workers' compensation carrier will want to make sure it is getting reimbursed as much as possible.  Sometimes, there are issues that prevent the workers' compensation carrier from getting full reimbursement.  The careless party may not have enough insurance, or there may be issues about proving who was at fault.  The statute that governs third party reimbursement allows for reduction of the amount you will have to pay back to the workers' compensation carrier in certain cases.

A third party claim is like any other personal injury claim.  There are time limits involved, and you have the right to make the same claim for damages as you would with any other claim, some of which are not included in a workers' compensation claim.

If you have any questions about a third party claim, give us a call at 503-325-8600.  We have handled many third party claims, all the way through trial, and help people with these issues all the time.