In early 2013, plaintiff in this car accident case was a 56 year-old homemaker who slowed to enter a driveway when she was unexpectedly hit from behind and pushed into a ditch on a semi-rural two lane road by a inattentive motorist. Her car was disabled and so was the full-sized pick-up truck that hit her.
She felt immediate neck and back pain, was confused, had a concussion from the impact, and felt woozy. Her husband took her to the doctor later that day. Her headaches and neck pain worsened to where the pain was radiating down her left arm.
Plaintiff Demands MRI for Neck Injury
Her health plan network providers downplayed her symptoms for weeks, until she demanded an MRI which confirmed a disc bulge in her neck. Despite pressing her health plan’s providers about her severe radiating pain, she got nowhere.
At her request, we gave her names of spine specialists in the area and she chose one to complete the following treatments:
- conservative chiropractic care
- physical therapy
- steroid injections to her neck
After exhausting the treatment options, she could not stand the pain any longer and opted for surgery; a three level discectomy and fusion.
Surgery Not Covered in Health Plan
Her health plan would not cover the surgery outside its system, and the spine specialist performed the surgery on a lien basis. The result: almost immediate relief of her radiating pain complaints. The insurance company and its attorneys fought the entire way, on all fronts.
Dismantling Defense’s Case
First, the claim that the disc bulge wasn’t the result of being slammed into at 40 mph and pushed into a ditch. We defeated this argument with expert testimony from the spine surgeon and forensic examination of plaintiff’s medical history: she never complained of neck pain or radiating pain before.
Second, the defendant’s doctor claimed the radiating pain wasn’t from the neck, that it was a pinched nerve in the elbow. Our experts destroyed this theory again by forensic examination of the medical history and the lack of an injury mechanism in this accident.
Third, the insurance company argued the medical bills were too large. Their expert, an out-of-state unlicensed nurse, used an unreliable database to “cook” the numbers down to what the insurance company wanted them to be. Our firm hired a reputable, local expert with actual experience and evidence of reasonable medical billing rates in this community.
Plaintiff Receives Fair Car Accident Settlement Amount
At the court-ordered settlement conference about a month before trial, the insurance company was stuck on insultingly low numbers. We moved forward with experts and trial preparation, including a three-hour deposition of their doctor and billing expert. On the eve of trial, the defense relented and offered $950,000. This client came to us in April 2013, and over the ensuing four years we never wavered in our commitment to recover what this client was entitled to.