Updated: October 2017
A vehicle hit a car that my 30-year-old client was driving. It happened in Miami, Florida. The negligent driver made a left hand turn in front of the car that my client was driving.
A photo of the car that my client was driving is above. A crash diagram is below.
My client was driving Vehicle #2. She was heading straight. The other driver was in Vehicle #1, heading straight. He was attempting to make a left hand turn. They crashed.
Progressive insured the other vehicle. The police officer gave a ticket to the other driver for failure to yield the right of way. The property damage to the car that my client was driving was significant. My client was taken to the emergency room by ambulance after the accident.
My client had an MRI of the lower back which revealed a bulging disc at L5-S1 causing impingement of the dural sac. On two separate occasions, my client also had an MRI of the knee. The first MRI revealed a small joint effusion (fluid buildup) in the knee.
The 2nd MRI report stated that the MRI of the knee was normal knee. One month after the MRI of her knee, she had arthroscopic surgery to the knee.
During Surgery She Was Diagnosed with Cartilage Damage
After the surgery, the surgeon diagnosed her with left knee articular cartilage damage.
Cartilage damage can cause symptoms such as pain and limited movement. It can also lead to joint damage and deformity. Pain and limited movement increase the full value of the case. Joint damage and deformity also increase the settlement value, and may lead to a higher offer from the insurance company.
He also diagnosed her with extensive synovitis, multiple compartments with medial synovial plica. (Synovitis is an inflammation of the joint lining, called synovium. Synovial plicae are normal structures found in many knees. Under normal circumstances, these plicae are not associated with any painful conditions.
However, with the right combination of events they can become very painful. I argued to the Allstate adjuster that this car crash was the right combo of events that caused the plicae to become painful.
In total, she treated for over 2 years, with some gaps in treatment, for the injuries.
Each body part has a different full settlement value that I use as a starting point when calculating the pain and suffering component in a personal injury case.
What is the Full Value of a Meniscus Tear With Surgery?
As a starting point for settlement purposes, I estimate the full value of the pain and suffering component of a torn meniscus with surgery as between $40,000 and $80,000.
There is a chance that you do not get any money, less than this amount or more than this amount because there are many factors that affect the value of a personal injury case. The above settlement range does not apply in a case against your employer if you are injured on the job and your employer has workers compensation insurance.
Although my client in this case did not have a torn meniscus, the value of an arthroscopic surgery to a normal knee (but the client has pain) is a little less than value of a torn meniscus with surgery.
Arthroscopic Knee Surgery on People Over 50 Years Old May Lead to a Future Knee Replacement
To get maximum value for an injury case, you need to know what future medical treatment you may need.
Several studies have described that a total knee arthroplasty (TKA) may be later needed for patients who are over 50 years old who’ve had a knee arthroscopy.
A TKA is also known as a total knee replacement. Arthroscopy means arthroscopic surgery.
One study was done on patients who were older than 50 years who had a knee arthroscopy for partial meniscectomy, chondroplasty, or debridement. During a chrondroplasty, a surgeon trims and smooths roughened arthritic joint surfaces.
It found that the reported rates of TKA at 1, 2, and 3 years after arthroscopy were 10.1%, 13.7%, and 15.6%, respectively.
Thus, people over 50 years old who’ve had a arthroscopic knee surgery (due to an accident) can tell the insurance company that they now have an increased chance of needing a total knee replacement. This may add value to the case. They should send the adjuster a link to this study.
Ok. Back to the case at hand.
Progressive Insurance was the bodily injury (BI) liability insurer for the car that was cited for causing the accident. Progressive paid its $50,000 bodily injury limits.
Allstate’s First Offer Was For Only $1,000
The underinsured motorist (UIM) auto insurance carrier was Allstate and it offered $1,000 or so.
I filed a Civil Remedy Notice of Insurer Violation and Allstate responded by offering $15,000 and saying that “there are issues of causality surrounding the injury and treatment. “ Basically Allstate was saying that some, or all, of my client’s injuries were not caused by the accident. I ended of settling the UIM portion of the case with Allstate for $25,000. The entire case settled for $75,000.
This settlement is in line with the range that I use as starting point for the full value component of pain and suffering of a typical bulging disc in a Florida accident. To determine the value of this case, I added the other damages, which were out-of-pocket medical bills.
Unfortunately, our client’s employer did not complete a wage and salary verification form so we did not make a claim for lost wages.
My thoughts: Apart from either the ambulance records or the emergency room records, the medical providers’ (doctors’) notes did not mention knee pain for several months after the accident. This made it more difficult to link my client’s knee pain to the car accident.
Allstate Didn’t Argue That Claimant Didn’t Have a Permanent Injury
Allstate never mentioned to me that my client did not have a permanent injury. In order to get money for pain and suffering in most car accidents in Florida, you have to prove that you have a permanent injury.
Some insurers use this argument. But as you can see from the seriousness of my client’s injuries, Allstate apparently did not feel strong about that argument. Often times, when someone who is injured in a car accident in Florida has surgery, the liability insurer will not argue pre-suit that the injury is not permanent.
This is one of the reasons why surgery cases are generally worth more than non-surgical cases. The Allstate UIM adjuster, John Norton, was a gentleman and a pleasure to deal with. My client had not seen a doctor for 6 months prior to the settlement.
The following were things that helped increase the value of our client’s claim:
1. 911 was called and a police officer arrived to the scene.
2. Fire rescue (an ambulance) transported our client to the emergency room.
Big Damage to Car Helped Get Better Settlement
As you’ve already seen from the photo at the top of this article, the car that my client was in was badly damaged in the crash. This helped us get a higher offer from the careless driver’s insurance (Progressive) and the underinsured motorist insurer (Allstate) of the car that my client was a passenger in.
All things equal, the more damage that the car(s) in the crash sustain, the higher the full value of the case. I gave, and the insurance companies had, pictures of the damage to the car that my client was in. It was towed from the scene.
4. Our client did not have any pre-existing injuries to her back or knee. Thus, Allstate’s adjuster
5. The accident was the result of a t-bone accident instead of a rear end accident. This may make the case more appealing to a jury.
6. The accident happened in Miami-Dade County which is a very good venue for Plaintiff’s. This is even more true for Plaintiff’s who are Cuban, as was our client.
Which Factors Caused a Lower Settlement?
1. She did not complain to the emergency room doctors of knee pain immediately following the crash.
2. After she was released from the emergency room, she waited a month or so to go to her first medical appointment. There were other gaps in treatment as well.
3. Her health insurance company paid the medical providers at a much lower rate than the billed charges. Her out of pocket medical bills were low.
4. She did not treat with a doctor for 6 months or so before we were in final settlement negotiations.
Update October 2016: The same claimant was hurt in another car accident and hired me again. I settled the other case for $20,000.
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