$325,000 POLICY LIMITS UNDERINSURED MOTORIST INSURANCE CLAIM RECOVERY FOR FLORIDA CRASH VICTIM WITH FROZEN SHOULDER INJURY

Juan Pablo Gonzalez-Sirgo

Case Conclusion Date:June 6, 2014

Practice Area:Car / Auto Accident

Outcome:Settlement

Description:Our client was injured while working as a bus driver when another vehicle collided into his bus. Following the accident, our client consulted doctors via his workers compensation insurance because of pain to his left shoulder. An MRI was taken of his shoulder that showed a micro size stress fracture involving the shoulder bone head. Also, rotator cuff tendon inflammation was seen. He was then referred to an orthopedic surgeon who provided an injection into his shoulder, gave him the pain medication Percocet, and ordered physical therapy three times a week. He was told not to go back to work as a bus driver because he was limited to the use of one arm. At the follow up meeting with the doctor it was assessed that our client possibly developed scar tissue which prevented him from having full range of motion. He was provided Ambien for sleep, because the shoulder pain was detrimentally affecting his sleep and more physical therapy was ordered. After still seeing no improvement, the orthopedic surgeon recommended surgery as a result of his decreased range of motion and ongoing pain. The doctor advised of the need for our client to discuss his Coumdain dosing (when to stop taking it, before or after surgery, as our client was chronically on a blood thinner, Coumadin, due to two previous deep vein blood clots which prevent him from taking anti-inflammatory medication). Our client underwent surgery after receiving clearance from his primary care physician. While our client was under anesthesia his range of motion was tested and established to be limited in all planes. He was manipulated in all planes with steady pressure until the adhesion released. A scope was then inserted inside the shoulder to clear away any extra growth and inflamed tissue. After the surgery, our client was seen by the surgeon and some improvement was noted. He continued on his physical therapy regimen but still complained of pain going down his arm and back with swelling below his shoulder blade. Two months after his operation his range of motion, especially reaching behind, was not as full in the left arm compared to the right. Our client suffered what is commonly described as a frozen shoulder or adhesive capsulitis. The pain in the shoulder is due to inflammation of the surrounding tendons; as a result, range of motion in the shoulder is lost. The driver of the car that crashed into our client’s bus only carried $25,000 of insurance which they paid. Our client was also covered for up to $300,000 of underinsured motorist coverage (UIM) available under the insurance policy for the bus. Based on our review of the case, we concluded that the value of our client’s case required payment of the $300,000 of UIM coverage. As such, we demanded that the UIM insurance company tender or pay the $300,000. In response, the insurance company mailed us a check for $24,000. We rejected this offer, returned the check, and filed a lawsuit on behalf of our client in the Circuit Court for Miami-Dade County. In response, the insurance company removed the case to federal court and litigation began. Eventually, we succeeded in getting the insurance company to pay the full $300,000 of available UIM coverage.