Spinal cord injuries have an extreme range when it comes to symptoms and severity. Rehabilitation and assistive devices allow many people with less severe spinal cord injuries to lead productive, independent lives. Treatments include drugs to reduce symptoms and surgery to stabilize the spine.

Unfortunately, in the worst case scenarios, there is no comparative treatment. The damage is such that the injured party will require constant and continued care for the rest of their lives. Their dreams, hopes, and lives sadly change forever and, in a lot of cases, so do the dreams, hopes, and lives of their family members.

The most severe of these injuries and the claims processes that follow are some of the most consequential and carry with them high dollar exposure for insurers and defense legal teams. In cases where insurance limits are not enough to cover short- and long-term expenses, insurers will usually offer the maximum amount allowed under the policy and attempt to bring the matter to a close quickly. Typically, this is done when they worry that a higher amount might be, or is likely to be, awarded at trial. That’s why you should not sign anything before discussing your case with an experienced personal injury attorney. In fact, it’s best that all communications between you and an insurance company be handled through an attorney who will be representing your best interests.

What About Ten Years From Now?

When working on behalf of an injured party, a good legal team will leave no potential means of recovery or any potential asset unidentified, and will do the investigative and background research necessary to locate all that apply to your particular claim. Your attorney will also make sure all remedies are identified and exhausted, or determined to have no relation to your injury claim. Finally, your attorney will not settle a claim until there is closure on all available remedies.

In many cases, claims are settled with language allowing for future considerations and recovery from assets generated post injury. That’s why an attorney may need to convince courts, mediators, and arbitrators that the life of his or her client has changed forever. They may also decide to introduce or suggest ‘contingencies’ and include those into the settlement.

An analogy I often use is that if the responsible party wins the lottery 10 years after the accident, that person’s new life of luxury in Tahiti may be somewhat modified by a contingency written into the settlement 10 years earlier. This would happen if an attorney working on behalf of the person who was injured included such a provision in the settlement agreement language. It provides for accountability; the responsible third party cannot just “walk away” after insurance limits have been reached and funds exhausted.

The types of serious spinal injury claims that are more often met with resistance from insurance companies are the claims where the policy amounts are high, with multiple policy types involved – personal insurance, commercial insurance, professional liability, errors and omissions, personal and commercial umbrella policies, and/or individual or corporate assets. I have seen these coverages go into the tens of millions of dollars.

I have seen these coverages go into the tens of millions of dollars.

Each of those insurers or entities involved want the claim resolved at or below the coverage limits. Private persons or organizations do not want to pay high premiums for insurance coverage that does not adequately protect their assets. Whatever level of coverage, each “contributor” wants the settlement agreement to include a minimal contribution from their pocket.

It’s Only Natural?

Serious spinal injuries identifications and treatment regimens are heavily dependent on diagnostics and the injured party’s subjective complaints. Because this is the case, insurance companies heavily attack the diagnostics and any inconsistencies or challenge the credibility of the injured party. They pay a lot of money to hire radiologists and orthopedic surgeons who will challenge diagnostics. They use prior medical records, diagnostics, surveillance, social media, and whatever other means necessary to plant a seed that there were medical problems prior to the accident. In the end, they try to suggest that the accident had only a minimal contribution to the condition.

From when a baby takes their first steps, the spine goes through degenerative change with growth and increased levels of activity. The defense argument becomes and persists that the diagnostics not only show the “injury” but the natural degeneration, degenerative disc disease, and bulges and herniation that appear on most adult spine scans, x-rays, and magnetic imaging. In this way, the insurance company argues that the pre-accident condition of the spine had a significant contribution to the injury and symptoms. They try to say that if the plaintiff was not in that physical state, the injury would not have been as severe and the symptoms not as pronounced or lengthy. The injury merely aggravated a pre-existing condition which made the plaintiff vulnerable to injury and the defendant not solely responsible.

These tactics are often used so that percentages of negligence come into play – not to deny or try to challenge the validity of the claim or injury but to lower responsibility and reduce the amount to be paid out.

Attacking Credibility And More

Insurers will also seek to challenge an injured person’s credibility. For example, if you state in a deposition that you can no longer perform a specific task or activity, know that you might be surveilled and filmed doing that task or activity. Once credibility is compromised in this way, the value of a claim is reduced or worse, lost altogether. The injured party with even a perceived inconsistency can easily go from being on the offense to being on the defense. The greatest asset in these cases is an effective attorney, but you need to be honest with them, or it will affect the final outcome.

The techniques I applied when mediating serious spinal injury claims were rather simple. First, I would be sure to know the case file better than my counterpart. I would identify even minor details and use this information to my advantage. Second, I would take note of personal dynamics. Through settlement conferences, depositions, statements, dialogue, and observation, I would identify which person in the mix thought they were the smartest person in the room. It could be the mediator, the attorney, or the plaintiff; it didn’t matter. I would hone in on and attack that person’s arguments and get them to show by words and actions their points could be successfully challenged.

Everything Matters

I mention my approach to upending claims to underscore the importance of allowing an attorney to handle your case. Cooperate with your attorney, learn that listening and following is more important than speaking and leading. Learn to speak when asked to speak, and respond as your attorney directs you to. This will help you have the best possible chance of recovery.

Serious spinal injury claims require methodical and impeccable attention. If you compromise your case in any way, you can expect an inadequate settlement. Honesty and following an attorney’s instructions and recommendations are important. Complying with the doctor’s instructions is important. Letting your attorney know your medical history is important. Give your attorney accurate and complete information and your claim will go well. Misinformation, hiding information, and lack of transparency can turn a solid claim that should have a positive financial outcome into a nightmare. The more serious the spinal injury, the more all of these details matter.