Having Cheap Automobile Insurance Can Affect Your Health

Many people buying car insurance are unaware that the type of automobile insurance that they buy may affect their ability to sue after an accident. This does not seem comprehensible to most. Some may ask, what does my choice of car insurance have to do with someone else’s negligence?

Several States including New Jersey, require people seeking automobile insurance to elect between a “zero threshold” or “verbal threshold” option.

Verbal Threshold

The Verbal threshold prevents victims (regardless of fault) from pursuing claims unless they have sustained injuries in six limited categories. These are:

(1) Death

(2) Dismemberment

(3) Loss of a fetus

(4) Displaced fractures

(5) significant disfigurement or significant scarring

(6) Permanent injury other than scarring or disfigurement.

An injury shall be considered permanent when the body part or organ or both has not healed to function normally with further medical treatment. The verbal threshold (Tort or Limitation or Lawsuit Threshold) option is offered at a much lower price. While the lower monthly premiums seem appealing to the unwary, victims’ rights are extremely limited under a verbal threshold plan.

Under the Verbal Threshold, the last category is the most problematic for injured claimants. People attempting to show that they have sustained permanent injuries may find themselves in a long protracted battle with wealthy insurance companies and their lawyers. Even in cases where you are barely able to move from severe intractable pain, the experts working for insurance companies will try to show that you are exaggerating your condition.

Zero Threshold

A “Zero Threshold” imposes no imitation on a person’s ability to file a lawsuit for injuries. Individuals with this type of coverage may sue for unreimbursed economic losses and for pain and suffering. The insurance premiums for a zero threshold are more expensive.

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If you select the cheaper verbal threshold option you may find yourself unable to protect your rights after a car accident. This is so even if the other driver is at fault. If you have a fractured arm you may find that no lawyer will accept your case if your fracture was not displaced. A displaced fracture is one where the broken bones are separated. A non displaced fracture is one whereby the broken bones are still aligned. The rationale is that a non displaced fracture will heal in time with immobilization and does not require surgery. Nonetheless, many fractures may take 6-10 weeks to heal resulting in pain, inconvenience and time lost from work.

If you have a large unattractive scar you may be unable to sue if others decide that the scar is not significant to them. Ironically, if you want the scar removed, you may be stuck with the cost since scar removal is a cosmetic procedure that most health insurance companies will not cover.

If you suffer a disfigurement you may be unable to sue if experts determines that the disfigurement is not significant to them. A person who suffers a soft tissue injury (damage to muscles ligaments and tendons such as a sprain or strain ) will be unable to sue despite weeks of
agonizing pain and inconvenience. Lawyers usually accept personal injury cases on a contingency basis (attorney will recover fees from proceeds) and are usually unwilling to take a gamble where the financial cost of hiring experts is often more than the case is worth.

There are several types of soft tissue injuries that may appear after the statute of limitation (SOL) for bringing a law suit has expired. The statute of limitation is the time period within which a claim must be brought after an injury occurs. In New Jersey the SOL for automobile accidents is 2 years. An exception to the SOL is the discovery rule that allows you to initiate your claim after discovery where your injuries changed and became more serious.

Certain neurological condition may appear many years after an automobile accident. A condition that shows up years after a car accident may impose problems for victims with verbal threshold insurance options.

Post traumatic TN may develop following trauma to the head or face from a car accident that causes irritation to the Trigeminal Nerve. The Trigeminal nerve is a cranial nerve that helps to control proper function of the face and head. Trauma to the Trigeminal Nerve may cause severe pain in the eyes, lips, nose, jaw and forehead. Trigeminal Neuralgia (TN) is characterized by severe aching, burning pain along areas controlled by the Trigeminal nerve.

The pain of trigeminal neuralgia is characterized sharp, throbbing, shock like or constant, burning pain. The pain may run in cycles and can include periods of remission where there is no pain for days or even years. Each time it returns that periods of remission are shorter.

An MRI does not always rule out Trigeminal Neuralgia. As such, doctors have to rely on the subjective descriptions of symptoms experienced by plaintiffs. An insurance lawyer will quickly challenge your subjective findings that cannot be objectively revealed by standard tests such as an MRI.

The symptoms of TN may come on suddenly while you are smiling, blowing your nose, brushing your teeth, shaving, eating or drinking. This chronic debilitating condition can profoundly affect activities of daily living. According to one study, one third of people living with Trigeminal Neuralgia commit suicide after living with the condition for three years or more.

The bones of the spinal column are supported by multiple discs. The discs can bulge or swell outward during the impact of an automobile whiplash accident. This places pressure on the surrounding nerves causing pain. A disc is considered herniated when the material from inside seeps out. This leads to tingling, pain and numbness in the area where the nerves travel. TN is diagnosed by patient description of symptoms, an MRI or CT scan.

Pain and discomfort from herniated and bulging discs may continue to affect victims for many years after an accident. One study shows that 5 years after a whip lash some patients still suffered from symptoms, post traumatic stress and depression.

A herniated or bulging disc may satisfy the verbal threshold if a doctor certifies that the condition is permanent and related to the car accident. Diagnosis via an MRI would be considered an objective finding in New Jersey. Pennsylvania has a Full Tort and Limited Tort options which are similar to the verbal and zero threshold options in New Jersey. Under the limited tort options, individuals may sue for “Serious Injuries” that includes: Death, serious disfigurement, or serious impairment of body functions. Under the full tort option claimants are not limited in their ability to sue for pain and suffering. In one recent Pennsylvania case the Supreme Court determined that a herniated disk coupled with severe pain in the neck and numbness in the toes did not constitute serious injury.

Insurance companies experts who handle herniated or bulging disc cases may attempt to show that the condition is pre-existing or the result of degenerative conditions.

Insurance companies are more likely to settle case where claimants have a “zero threshold” or full tort” policy. Verbal threshold claims may warrant use of multiple experts and entail protracted litigation. This usually takes a toll on claimants who are already traumatized and now forced to relive their suffering every day that a court case drags on.

Injuries to your spinal column may become permanent.

Injuries to your cervical, thoracic and lumber regions may affect you in the following manner:

• C1-C2-Inability to breathe. You may require a ventilator.
• C3- problems with chest wall functioning. You may eventually end up on a ventilator.
• C4- Problems with range of motion and discomfort at the biceps and shoulders.
• C5-Pain and numbness in wrists and hands. You may also have problems with functioning in the biceps and shoulders.
• C6- Discomfort, pain, swelling possible loss of function in your wrists and hands.
• C7- Problems with fine motor coordination in fingers and hands. Limited range of motion in your arms.
• C8- Feelings of severe weakness and numbness in hands, neck, shoulder, arm
• T1 to T12- Lack of function in bowel and bladder areas. Sexual dysfunction, leg paralysis.
• L1 to L5- Paralysis in the legs, loss of bladder and bowel function. Decreased or total loss of physical sensation. Loss of sexual function.
• Severe limitation in bending lifting and stretching.
• Chronic pain that limits continued engagement in routine activities.

You may also develop scar tissue in the areas of ligaments and tendons with long term pain.

If you sustain any forceful impact to a body part during a car automobile accident you need to get an X-Ray, MRI or CT scan of the affected area. Follow up with your doctor or go to the emergency room as soon as possible after your accident. A serious injury left unattended can become a more harmful problem. Even [an] injury that [causes] minimal pain should be examined by a doctor in order to avoid further complications and injury to the area.

Medical evaluations of your injuries are your best evidence during pursuit of a claim.

X- Ray

X-rays are the fastest of all bone scans and will quickly alert you to a fracture or dislocated joint. An X-ray will show changes in bone texture or density. Your doctor will not be able to properly exam your injured body area and determine whether a fracture is simple (closed) or displaced without use of a scan. A displaced fracture occurs when the two ends of bones are completely separated after an injury. Only a displaced fracture meets the New Jersey verbal threshold requirement. Bones usually remain together after a simple fracture. Sometimes an X-Ray may not show a fracture. Even where X- rays show fractures they do not usually reveal all fine details.

MRI

A magnetic resonance imaging (MRI) is usually done after an X-Ray. An MRI will detect cracks, torn ligaments and tendons, spinal cord injuries, joint effusions and other problems that were not initially picked up on an X-Ray. An MRI is a great way of determining whether there is nerve involvement. Contrast or dye may be used with an MRI to clearly define certain structures.

CT scan

A computed tomography scan (CT scan) is within the same price range as an MRI. It is great for outlining bone structures and to determine if there is stability in bones. A doctor may order a CT scan to determine if the nerves are at risk after a fracture. CT Scans also pick up images of blood vessels and soft tissues. A CT Scan is good for showing differences between tissues. CT Scans can view areas in slices for better evaluation of bones and tissues and the spinal area. A CT scan has higher resolution than an MRI.

Learn from my mistake. Many years ago I was injured at a particular location. I did not follow up and properly document my leg injury that I am now forced to deal with on my own. Today I still suffer from that injury. A noticeable permanent lump appeared in the area of my injury. My only comfort is that the MRI did not show any other abnormalities. However, I was taking steroid shots in my injured leg years after the injury. My leg still hurts especially during winter! The statute of limitation has expired on any possible claim for that injury.

Here is a list of New Jersey Cases that reflect how the New Jersey Courts have ruled on the issue of verbal threshold:

• “In our view, a plaintiff’s loss of the physical ability to continue to engage in social or recreational activity which had a significant and important component of that plaintiff’s way of life constitutes a qualifying “serious impact”’ Brown v. Puente, 257 N.J. Super 203 (App. Div. 1992)

• "Because most range-of-motion tests are based only on patient’s pain responses, they ordinarily will not suffice unless the restricted mobility is verified by physical examination and observation” Oswin v. Shaw, 129 N.J. 290 (1992).

• “In NJSA 39: 6A-8A the nine classes of compensable injuries include type 4, namely a ‘fracture’ Although, plaintiff’s vertebrae did not fracture, the intervening disc herniated, creating potentially more painful and long-lasting problems.”Foti v. Johnson, 269 N.J. Super 198 (App. Div. 1993)

• “Although serious impact is often associated with specific objective limitations upon employment responsibilities, we have concluded that “serious impact” may encompass recreational, social and academic activities,” Dabal v. Sodora, 260 N.J. Super 397 (App. Div. 1992)

• The court found that muscle spasms were still present twenty six months after the completion of medical therapy clearly constituting “prima facie objective evidence of permanent injury” Owens v. Kessler, 272 N.J. Super 225 (App. Div. 1994)

The cases above may be found at the following sites in the order listed above:

1. http://www.leagle.com/decision/1992460257NJSuper203_1438.xml/BROWN%20v.%20PUENTE

2. http://www.leagle.com/decision/1992419129NJ290_1406.xml/OSWIN%20v.%20SHAW

3. http://www.leagle.com/decision/1993467269NJSuper198_1452.xml/FOTI%20v.%20JOHNSON

4. http://www.leagle.com/decision/1992657260NJSuper397_1613.xml/DABAL%20v.%20SODORA

5. http://www.leagle.com/decision/1994497272NJSuper225_1478.xml/OWENS%20v.%20KESSLER

People purchasing Car insurance policies should avoid purchasing verbal threshold options if possible.

Try to buy a policy with insurance limits that approximates the following:

A Standard Policy

No limitation on Liability (Zero threshold)—No limitation on ability to bring a claim for pain, suffering and other non economic damages.

Personal Injury Protection (PIP) expense benefit of at least $250,000- PIP allows the owner of the car insurance to submit their medical expenses to their own automobile companies so that needed medical benefits will not be delayed.

Property Damage minimum of $50,000- This covers property damage for claims and lawsuits by people whose property is damaged as a result of an auto accident.

Uninsured Motorist Coverage minimum of $100,000- Uninsured Insurance Coverage protects the motorists in case he or she is involved in an accident where he is injured by another motorist who has no liability coverage.

Under Insured Motorist Coverage minimum of $100,000-- Under-insured Insurance Coverage protects a motorist in case he or she is involved in an accident where the motorist is injured by another motorist who has liability coverage that is less that the victims liability coverage.

Liability coverage minimum of $100,000 or more- Liability Insurance is intended to protect the owner of the insurance from the risk of a law suit in case he is sued for injuries to others.

• When renewing you insurance in states such as New Jersey you should choose the “no threshold option.” If you fail to select an option the verbal threshold will be selected for you.
• The lower cost of a verbal threshold policy is not a savings because your rights to pursue a claim against a negligent driver are severely limited.

Remember that under a zero threshold policy you will retain your right to file a law suit if you are injured. On the other hand, if you choose a verbal threshold policy you will limit your right to sue if you do not have injuries that fall within the categories defined by your state’s Insurance law. Always get medical evaluation to preserve evidence of your injury. Immediate medical care also prevents an injury from worsening without attention.

1. Scaphoid Fractures. Available at :http://www.assh.org/Public/HandConditions/Pages/ScaphoidFractures.asp
2. Burcan, Michael. Resolution of Trigeminal Neuralgia Following Chiropractic Care to Reduce Cervical Spine Vertebral Subluxations. A Case Study. Available at:http://ww1.prweb.com/prfiles/2011/04/25/10750992/trigeminal1.pdf
3. Back Pain Health Center, http://www.webmd.com/back-pain/tc/herniated-disc-topic-overview Available at : http://www.webmd.com/back-pain/tc/herniated-disc-topic-overview
4. Merrick, Daniel., Stalnacke, Britt-Marie. Five years post whiplash injury: Symptoms and psychological factors in recovered versus non-recovered. Available at:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2912943/
5. Spinal Cord Injury. Available at: http://medical-dictionary.thefreedictionary.com/spinal+cord+injury
6. Should I Get an X-Ray, MRI or CT scan for my Injury? Available at: http://www.doctorsimaging.com/x-ray-mri-ct-scan-injury/
7. Understanding Bone Fractures Diagnosis and Treatment. Web MD. http://www.webmd.com/a-to-z-guides/understanding-fractures-treatment
8. Verbal Threshold. Available at: http://www.njlaws.com/verbal_threshold.html

Cecile D. Portilla 2014