Q: Value of shoulder labrum tear from rear-end accident.
I know the value can fluctuate but looking for best guestimate range. Rear ended in vehicle accident when I was at a red light. Neck/back and shoulder pain. Neck/back was treated by chiro for a couple of weeks before I got into an orthopedic doctor. Received cortisone shot in right shoulder (right handed) and went to PT for 6 weeks. Still did not get better, MRI showed inflammation and bone spur in shoulder. Two months later had surgery and they also found a labrum tear. On month three of PT with another month to go two times a week and then another month one time a week most likely. Shoulder is causing daily pain still, I have grinding in my shoulder and my range of motion is improving but slowly. What would be the best guestimate in Illinois for the value? Due to getting care asap I used my medical benefits ($5,000) from my insurance and I am not sure the limits of at fault driver but I have 250k/300k plus a 1 million dollar umbrella policy for my insurance.
First of all, let me commend you for having the foresight to carry reasonable limits of insurance. It is exactly this type of situation where that pays off. Irrespective of the at fault driver's policy limits, you have at least $250,000 of coverage available, without looking at the policy.
All of your medical bills beyond the $5000 that you had in med pay coverage need to be processed through your group health insurance. Nobody else will pay them. If you tell a doctor or hospital that it was "the other driver's fault," they see dollar signs and place a lien on your file. So what? So the MRI that your insurance would have paid at $900 (leaving you a liability of $600) will end up costing you $2000 or more.
It is important that you understand even if the other driver admits fault at the scene and never disputes fault, the at-fault driver's insurance company never pays any of the bills. They remain your responsibility because they are your medical bills. With very rare exception, and insurance carrier will not pay one dime on a claim until they have had an opportunity to evaluate what the claim is worth OR they are able to determine that the claim is worth much more than the policy limits in which case they will simply tender the policy limits. BE CAREFUL! If you do not have an attorney and you accept the other driver's policy limits without the express written permission of your own insurance carrier, you could very well eliminate your insurance company's responsibility to pay you on an underinsured motorist claim. It is important that you are represented by experienced counsel who knows how to handle this situation.
If your torn labrum was the only injury to your shoulder, you should not be experiencing ongoing crepitus (grinding sensation) in that shoulder. You may have suffered further injury and you may need an additional surgery. The truth is that no meaningful estimate can be made of the value of your injury until it is known, with certainty, that you do not need further medical care and what, if any, permanent deficits you have sustained. Moreover, it may seem obvious to you that your shoulder injury was related to the auto accident but on your facts, the torn labrum was not diagnosed until at least two months after the accident so the insurance company (both yours and the other driver's) may well deny causation and make you prove it by deposing your orthopedic surgeon.
These matters are complicated. Another factor that is necessary to provide any meaningful estimate is the total amount of medical care that was billed (not paid) to all medical providers. This is yet another great reason to bill all of your medical care through your group health insurance. You would also need to know the total amount of any lost wages related to your injury. If you had a policy of short-term disability or long-term disability that paid any benefits while you are off work, those carriers need to be paid back so it is necessary to include any sums paid by those carriers to the sum billed by your medical providers. That number is called your special damages. Nobody can tell you what it injury is worth without knowing the special damages. Contact a few attorneys to make certain that you choose one with whom you feel comfortable. Good luck.
Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.
The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.
Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.