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Pedestrian Knockdown, Neck Fracture and Lower Back Surgery – Supplemental Underinsured Motorist Coverage

February 18, 2021 by turkewitz

This was a $290,000 award for a 66-year-old New Yorker that was hit by a car while crossing the street in a crosswalk.

The incident occurred while he was down in Florida, and the $10,000 insurance policy of the car that hit him was quickly tendered.

He proceed against the $300,000 Supplemental Underinsured Motorist  (SUM) policy that he bought for himself with his own carrier, New York Central Mutual Fire Insurance.  This is critical coverage that everyone should buy to protect themselves in the event the car that hits them has insufficient coverage.  (Read more about that here.)

That extra coverage was critical because the claimant suffered a fracture in the neck at C1 – C2 that required the insertion of a screw three months after.  Months after that, while recuperating, he started to feel low back pain. This resulted in two separate fusion surgeries of the low back.

It was our position that the fractured neck alone warranted the full policy, before even considering the lower back injury. But that the lower back injury was likewise caused by the offending car, as per his own doctor.

New York Central Mutual Fire Insurance tried to claim that the lower back injury was not related to being struck by the car and that the broken neck was worth far less than the $300K insurance policy limit.

The matter was tried before an arbitrator with a  verdict in February 2021. The arbitrator wrote that the past and future pain and suffering and his two fractured cervical vertebrae “easily exceeds” the policy limits, without even considering whether his two subsequent lumbar spine surgeries were causally related. Considering those injuries as well, the arbitrator wrote that “the value of the claimant’s pain and suffering substantially exceeds the available policy limits.”

The firm’s client was awarded the full policy ($300,000 less the $10,000 that was already collected from the car that hit him).

Categories: Arbitration, Auto Accident, Cervical, Lumbar, Pedestrian Hit By Car, SUM Coverage Tags: Lower Back Injury, Neck Iniury, Pedestrian Knockdown, Supplemental Underinsured Motorist Coverage

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