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Real Injuries, Real Expense… But Who is Liable??

March 4, 2015 by John Varner · Leave a Comment

Unfortunately accidents happen and people and property get injured or damaged, but, who is ultimately responsible is many times left up to the judicial system to determine when the parties cannot sort it out on their own. As anyone in business knows, the future cost of your commercial insurance is largely predicated upon your past claims history. Therefore, it’s hugely important to do all that you can to mitigate risk exposures where possible and actively involve yourself in the ongoing settlement of claims in conjunction with your broker and adjuster. The following case highlights just how emblazoned the plaintiff bar becomes when they think a large verdict is possible. While our client and contracted insurance company consider this a “win”, it still cost lots of money to defend and settle.

Van PhotoThe following details a 3-day jury trial we finished last week for a non-emergency provider in rural America. It was an admitted liability case and plaintiff obtained a verdict for $150,000. The week before trial, we offered $150,000 in response to plaintiff’s last demand of $850,000. At trial, plaintiff asked for $1,850,000 based on $650,000 of medical specials.

The case was filed on behalf of an injured transport, a 70+ year-old mentally and physically disabled man with a very nice, affable disposition. He could communicate his needs but is essentially non-verbal. His younger sister filed the action as his conservator. Our client is a local business in rural America that provides non-emergency medical transportation to Medicaid recipients.

In 2011, the electric-hydraulic wheelchair lift on the non-emergency provider malfunctioned, causing the transport to strike his forehead on the doorway of the van and then fall inside the van. He indicated he was OK and his sister told the attendant to take him on to his adult day care. However, she picked him up an hour later and took him to the local emergency room to have him checked. He complained of pain in his head, neck, and right hand. Diagnostic tests revealed no acute injury. He was released 90 minutes later and his sister took him back to adult day care, where he participated in all of his usual activities that day and several more days that month.

Plaintiff’s witnesses testified that the transport exhibited an immediate and dramatic decline in his mobility and health, culminating in hospitalization for acute renal failure the following month and, a year later, an extensive, 2-day spine surgery, followed by a prolonged hospitalization where he had to be weaned from a ventilator. Since then, he remained significantly debilitated and largely wheelchair bound.

The trial mostly turned on expert medical testimony about causation. Plaintiff had a neurologist and we had both a neurosurgeon and a urologist. Plaintiff contended the past medical specials were $650,000; we contended they were $1,400. The jury awarded $150,000 for past medicals and general damages.

This is not an unusual claim scenario for a non-emergency medical transportation provider. Please contact us for further information, inquiries, or discussion.

Author: John Varner

 

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Filed Under: Commercial Insurance, General, News, Transportation · Tagged: Business Insurance, Claim Scenario, Commercial Insurance, Medical Transportation Insurance, NEMT Insurance, Non Emergency Medical Transportation Insurance, Paratransit Insurance, Sovereign Risk Solutions

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