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‘Serious Injury’ and Auto Insurance: How Saving Money Impacts Your Ability to Sue for Injuries Sustained in a Crash

If you are thinking about saving money by selecting the limited tort option when purchasing auto insurance in Pennsylvania, keep reading. The decision below from the Court of Common Pleas may cause you to change your mind.

Concussion

In Schmidt-Ramirez v. Burger, a mother was driving her car on Jan. 3, 2014, with her daughter in the front passenger seat when she slid on ice and went partially off the road. A second vehicle subsequently slipped on the same patch of ice and struck the mother/daughter vehicle in the rear, sending it further into a ditch. The daughter, who was a high school student, did not seek medical treatment that night. However, on Jan. 22 she presented at a hospital and was diagnosed with a concussion and released home after staying overnight. On Feb. 10, she had a follow-up visit where she was advised to return if her symptoms persisted. She did not seek further medical treatment and went on to graduate from high school and college and obtained employment at a Wawa.

In a personal injury lawsuit filed against the driver and owner of the striking vehicle, the daughter alleged that the accident caused her to have continuing headaches and difficulty thinking. She described herself as having “scatter brains” and alleged that her injuries affected her school work and employment prospects.

The defendants sought to have the suit dismissed on the grounds that the injuries the daughter alleged were not severe enough to pierce the threshold for limited tort recovery.

The Limited Tort Insurance Option

In Pennsylvania, auto insurers are authorized to offer a limited tort option for insurance coverage at a reduced premium to insureds who give up the right to sue for non-economic damages, such as pain and suffering. As the daughter was a minor, living with her mother at the time of the accident, who did not have her own auto insurance policy, under Pennsylvania law she was considered an insured person under her mother’s policy. Her mother had opted for limited tort coverage.

Because of her mother’s limited tort election, the daughter could only recover non-economic damages if she suffered a “serious injury.” Pennsylvania law defines “serious injury” as a “personal injury resulting in death, serious impairment of body function or permanent serious disfigurement.”

Since “death” and “permanent serious disfigurement” did not apply, the trial court focused its analysis on whether the daughter presented sufficient evidence to show that she sustained “serious impairment of body function.”

Unfortunately for the daughter, the court found that she did not. The trial court reasoned:

[The daughter] has not sought medical attention or treatment for more than six years. Meanwhile, she was able to graduate from high school and earn a degree from Pace University. She is, as of the time of her deposition, employed. Her complaints of continued medical issues are largely subjective. [The daughter] has failed to provide any expert medical testimony regarding the long-term effects of a concussion and how such is affecting her life. The only medical documents available to the Court are from her hospital and doctor’s visit which, again, occurred six years ago. There is no medical diagnosis or findings that tie any of her current alleged physical ailments to the accident. Although we are sympathetic to [the daughter’s] family situation, it is also clear from the evidence that she was, and continues to be, under a number of stressors unrelated to her alleged injuries.

Conclusion

Even though the limited tort option was thrust upon the daughter by her mother’s insurance choices, the lesson of this case is clear: While it might be tempting to pay less money for insurance, the consequences can be severe if you are involved in an accident. By virtue of the mother’s election, the daughter could only sue for economic losses and the “very worst of injuries which manifest with life-altering effects,” as the court characterized it.

Another lesson: If you are in an accident, it is important to obtain all appropriate medical care. While it is unclear why the daughter apparently suffered for many years without seeking treatment, her decision left her with no medical record of her condition for use in litigation.

As always, if you have been injured in a motor vehicle accident, we recommend consulting with a personal injury attorney immediately to ensure that your legal rights are protected.