After a married man with three children suffered injuries to his shoulder in a rear-end car crash that required surgery, he sought legal help. This gentleman was receiving calls from the insurance companies, receiving outstanding medical bills in the mail, and was out of work. When he hired our Massachusetts injury lawyers, we got to work.
Despite the issues raised by the insurance companies involved, our Framingham car accident lawyers recovered a total of $100,000 in compensation for this client. This case highlights the importance of underinsured motor vehicle coverage in Massachusetts.
Rear-End Crashes Causing Shoulder Injuries are Common in Highway Traffic
One fall day, our client was driving on the Massachusetts Turnpike. As usual, there was heavy traffic in and around the Natick & Framingham area. When traffic slowed to a near stop, our client slowed down and kept a proper distance from the vehicle in front of him. Unfortunately, the driver behind our client failed to pay proper attention to traffic and negligently rear-ended our client’s vehicle.
After the collision, both vehicles managed to safely pull over to the shoulder of the highway. Since this accident occurred on the Massachusetts Turnpike, the Massachusetts State Police responded to the accident scene after witnesses called 911. The Trooper took down both driver’s information, which was memorialized in a Motor Vehicle Crash Police Report.
Shoulder Injuries are Difficult to Deal With
This accident victim sought medical attention shortly after the crash. His doctors initially suspected a right shoulder rotator cuff strain and a possible labral injury. Physical therapy and cortisone injections were recommended. However, after failed conservative, nonsurgical treatment, his orthopedic shoulder specialist ordered an MRI.
The MRI showed arthritic conditions and changes, but also revealed rotator cuff tendinitis and a superior labral tear. Based upon the MRI results, our client’s orthopedic shoulder specialist recommended surgery. Approximately eight months after the car crash, our client had right shoulder arthroscopy with decompression. After the surgery, he completed a conservative course of physical therapy and made a good recovery.
Dealing With the Insurance Companies
After this client hired our Framingham personal injury firm, we took immediate action. We requested and received the full insurance limits from the other driver’s auto insurance company. This included the bodily injury limits caused to another person. Unfortunately, we learned that the other driver only carried the current minimum requirements in Massachusetts - $20,000 per person. We knew right away that the $20,000 coverage for bodily injury was not sufficient to compensate our client for his injuries and financial losses he suffered in the car crash.
Therefore, we investigated other insurance policies for additional coverage. We discovered that our client carried $100,000 in uninsured motor vehicle coverage with his own auto insurance policy. This was extremely important since our client’s injuries were severe and the other driver had insufficient insurance coverage. Thus, an underinsured motorist claim was filed with his own auto insurance company.
Initially, the bodily injury carrier (the other driver’s auto insurer) pushed back on our demand for the full $20,000 policy limits. They raised concerns about the causal relationship to the rear-end motor vehicle collision. Basically, they did not see how a rear-end collision could have caused a labrum injury. The labrum in the shoulder is a piece of tissue connected to the rim of the socket that helps keep the ball of the shoulder joint in place. In response, our accident lawyers produced a significant number of medical treatises and journals that clearly indicate shoulder injuries, including labral tears, are very common in motor vehicle collisions, including rear-end accidents. We also directed the injury adjuster to our client’s medical records that documented that our client stated that he grabbed the steering wheel and braced for impact when he saw in his rearview mirror the other driver coming up fast from behind. Eventually, the insurance adjuster surrendered the full $20,000 bodily injury limits.
Next, we served our client’s auto insurance company with a demand for the full underinsured motorist policy. Now keep in mind that although his underinsured limits were $100,000, the underinsured carrier will take an offset for the limits that the other driver’s insurance company pays. Therefore, since the other driver’s insurance company paid $20,000, there was $80,000 ($100,000 - $20,000) available from our client’s own auto insurance policy.
Even though the underinsured carrier was our client’s own insurance company, and that he pays extra on his insurance premium for this optional type of coverage, they also employed some of the common tactics insurance companies use to pay the least possible. They presented arguments similar to the bodily injury carrier discussed above. They argued that his MRI showed arthritic and degenerative changes and that the surgery was not related to the injury suffered in the car accident. Their position was that our client had pre-existing medical conditions. We countered with arguments that, although the MRI showed degenerative changes, our client was completely asymptomatic prior to the motor vehicle collision, that he never had a right shoulder injury or complaints in the past, and that he was neither under the care of any physicians nor seeking treatment for his right shoulder at any point in time prior to the accident.
Additionally, we argued that Massachusetts law suggests that “If the injury causes or contributes to a worsening of a pre-existing condition, the person liable for the injury is also liable for the resulting aggravation of that condition.” Therefore, even if the surgery was required due to the degenerative changes noted in the MRI, the rear-end crash aggravated any prior asymptomatic ailments in our client’s right shoulder. Faced with clear evidence and a demand for arbitration, the insurance company agreed to pay the full $80,000, making the total recovery for our client $100,000. Our client was very satisfied with the results.