Not completely. Health insurance policies have coverage limits and exclude many expenses, such as long-term care and home modifications. And although Texas auto insurance laws require drivers to have “30/60/25 coverage: at least $30,000 of coverage for injuries per person, up to a total of $60,000 per accident, and $25,000 of coverage for property damage”, it falls far short of catastrophic injury recovery costs that often exceed millions of dollars. Even when combining multiple policies, many victims face significant gaps between insurance payouts and actual financial needs.
At Dortch Lindstrom Livingston Law Group, our Texas personal injury lawyers help you understand insurance coverage limitations and explore additional compensation options if you or a loved one experiences life-altering injuries due to someone else’s negligence.
The True Cost of Catastrophic Injuries
Recovering from a severe medical condition creates financial burdens that extend far beyond what most insurance policies were designed to cover. For example, according to research from the Christopher & Dana Reeve Foundation, the lifetime cost of care for a severe spinal cord injury can exceed $5 million. The Centers for Disease Control and Prevention report that emergency department visits alone for traumatic brain injuries average $18,000 to $25,000. If surgery and intensive care were required, costs typically exceed $100,000 in the first week.
Treatment varies by injury but is often extensive and may include:
- Emergency care and diagnostic imaging
- Multiple surgeries
- Pain management and prescription medications
- Physical, cognitive, and mental health therapy
- Long-term procedures and rehabilitation
- Prosthetics and adaptive equipment
- Skilled nursing or rehabilitative facility care
These expenses quickly surpass typical insurance limits, leaving injured individuals with massive financial gaps. Coverage shortfalls often appear in:
- Medical treatment gaps. Most health insurance policies have annual and lifetime maximums that can be quickly exhausted. Even with good coverage, patients typically face significant deductibles, co-pays, and coverage exclusions for specialized treatments.
- Long-term care needs. Many patients also need in-home assistance for daily activities, home modifications for mobility, and specialized vehicles to accommodate or enable driving with disabilities.
- Income replacement limitations. Disability insurance typically replaces just 60% of lost wages, often with monthly caps regardless of your actual salary, while temporary disability benefits typically last only 3–6 months.
Why Insurance Companies Routinely Undervalue Catastrophic Claims
Insurance companies operate as businesses focused on minimizing payouts while maximizing profits. This fundamental conflict of interest often leads to practices that disadvantage severely injured claimants. Insurance adjusters often:
- Focus exclusively on current medical expenses while undervaluing future care needs.
- Disregard non-economic damages like pain and suffering.
- Apply policy exclusions and limitations aggressively.
- Pressure injured individuals to accept quick settlements before the full extent of their injuries becomes clear or they’ve reached maximum medical improvement.
Once you accept an insurance company settlement, you typically waive the right to seek additional reimbursement—even if your condition worsens. So, to achieve a successful result for full compensation you need, you may have to file against the party responsible for the incident.
Strategies Our Houston Catastrophic Injury Law Firm Uses to Maximize Your Potential Financial Recovery
The seasoned legal team at At Dortch Lindstrom Livingston Law Group features former insurance company defense attorneys, so we’re able to anticipate opposing counsel’s tactics. When insurance coverage falls short, these strategies can help secure additional compensation for catastrophic injuries:
- Identify all potential insurance sources. Beyond primary health and auto insurance, we might also consider umbrella policies, homeowners insurance, workers' compensation, and policies held by all potential at-fault parties.
- Pursue third-party liability claims. Our lawyers fully investigate your case to identify responsible parties beyond the obvious, such as vehicle manufacturers, maintenance providers, or property owners. This process is especially important in large truck accident cases.
- Document all damages comprehensively. We work with you to develop detailed records of all medical treatments, expenses, and how the injury impacts your daily life. This documentation becomes crucial evidence in demonstrating the full extent of your damages.
- Consider structured settlements. For substantial compensation awards, structured settlements can provide tax advantages and ensure funds remain available for long-term care needs.
No matter where you live in Texas, you deserve quality representation to help you untangle the insurance red tape involved with catastrophic injury claims. Learn more about our approach from our satisfied clients and how we put our knowledge to work for you.
