A “serious injury threshold,” sometimes called a “verbal threshold,” can make a huge impact on your car accident claim. Often, this rule will dictate what damages you can get and potentially block you from receiving pain and suffering damages in your accident case. But what exactly is it, and why do we have this rule?
No-fault insurance policies do not provide pain and suffering damages for a car accident, and your ability to sue for pain and suffering is blocked unless your injuries are “serious.” Meeting this “serious injury threshold” usually means having permanent or very severe injuries. This threshold is in place to help smooth and speed up insurance claims, but it also prevents many victims from getting full compensation.
What is the “Serious Injury Threshold” in a Car Accident Case?
States that use no-fault insurance systems require drivers to have insurance to cover their own damages after a crash. These insurance policies pay damages somewhat quickly, helping injury victims to get medical bills and lost wages covered – at least partially – without having to wait for an insurance company or a court to decide who is at fault. The trade-off is that insurance covers less.
In no-fault car insurance, and even in other areas with no-fault insurance, these policies do not usually cover pain and suffering damages. While you might get compensation faster, these insurance policies do not look into how the injury affected your well-being, your enjoyment of life, or other intangible harms, just the economic damages you can prove with receipts, bills, and financial records.
Before you can get the additional pain and suffering damages you are missing, you have to meet the state’s definition of “serious injury.” Your ability to sue or file an insurance claim against the other driver for other economic damages like medical bills and pain and suffering depends on the state’s specific rules, but non-economic damages are usually walled-off unless you meet the serious injury threshold.
What Constitutes “Serious Injuries” for a No-Fault Car Accident Case?
The definition of what constitutes a “serious injury” will vary from state to state. Florida, for example, includes permanent loss of function in a body part, a permanent injury, or death. In most states, scarring is not considered a “permanent injury” in and of itself unless the scarring is substantial.
Many states also include the loss of a fetus as a serious injury, though that could conceivably fall under “death” in states that do not explicitly include this.
How Do I Know if I Meet the Serious Injury Threshold in My Car Accident Case?
Different states will have specific rules on how to prove you’ve met the serious injury threshold. Looking at Florida again as an example, the law there relies on a medical opinion that your injury is permanent. This means that your Ft. Lauderdale car accident lawyers will be able to present doctors or medical records to the court to show that your injury is serious enough to get these damages.
Other states have more specific rules that could actually include more injuries, such as a rule stating that if the injury affects your daily activities for a certain number of days, it is serious enough.
For help understanding whether your injury is severe enough to sue for pain and suffering, you will often need to consult with a physician and a lawyer. The doctor can tell you, from a medical perspective, how bad your injury is and whether permanent effects are to be expected. Your lawyer can then help you understand whether that meets the threshold to sue and what pain and suffering damages you could be entitled to in your case.
Can You Get Pain and Suffering Damages Through Car Insurance?
In no-fault states, your auto insurance typically will not cover pain and suffering damages. However, you might be able to file a third-party insurance claim against the at-fault driver’s insurance to get damages covered above and beyond what your no-fault insurance covered.
For this to work, the other driver must actually have a liability policy. If they did not have insurance, then you might not be able to file with their insurance for damages. However, your own policy might have UM/UIM coverage – coverage to make up for “uninsured motorists” or “underinsured motorists” – that can help you recoup additional losses.
In most states with a verbal threshold, you cannot file this third-party claim unless you meet the serious injury limit first.
Serious Injury Limits for PIP Insurance Policies
A personal injury protection (PIP) policy is the type of policy typically used in no-fault insurance states. These policies are designed to cover your own medical bills and lost wages in the event of an accident, and you do not need to prove who was at fault before you get damages paid through this policy. However, PIP policies, as discussed above, are subject to a serious injury threshold and do not pay pain and suffering damages.
Again, as with any other no-fault policy, you must usually file a claim against the at-fault driver’s insurance or a lawsuit against them to recover pain and suffering damages after meeting the serious injury threshold.
Limits on Lawsuits for No-Fault Insurance Policies
The serious injury threshold typically acts as a limit on lawsuits. Insurance is designed to generally keep people from having to go to court by paying for their medical bills without a court filing. However, this often means blocking lawsuits in more cases than might be necessary.
The serious injury threshold blocks third-party insurance claims against at-fault drivers as well as lawsuits against them for pain and suffering damages. So, if you want to sue the driver who hit you for pain and suffering, and you are governed by a no-fault policy, you will often need to meet the serious injury threshold first.