The Shoulder
The Shoulder
64
Insurancequiet-sparrow-145

Hit by uninsured driver, UM claim in progress — are these lowball offers normal?

So I'm about two months out from getting T-boned at an intersection by someone who had zero insurance. Thankfully I had UM coverage on my own policy, so I filed through that. My injuries were diagnosed as a mild TBI / concussion plus soft tissue damage in my upper back and shoulders. Spent a few weeks dealing with headaches, serious light sensitivity, couldn't look at screens, brain fog, balance issues — basically couldn't function normally for work.

I went to the ER same day, followed up with my primary care doc twice, and did a handful of visits with a physical therapist who specialized in post-concussion stuff. Most of the worst symptoms have cleared up but I still get tension headaches a few times a week and my shoulder tightens up if I'm at a desk too long.

Here's my situation: my state apparently has some kind of threshold you have to hit in medical bills before certain damages "unlock" for a UM claim. My adjuster keeps bringing this up like it settles the whole thing. But then they keep making offers — started super low, I sent a written demand, they bumped it up a bit. If I don't qualify for anything, why are they negotiating at all?

I haven't hired anyone yet. I'm trying to understand:

  • Is this "nuisance value" they're paying just to close the file?
  • Does the threshold rule actually block ALL damages or just certain types?
  • Should I even be handling this myself, or is a concussion + soft tissue claim the kind of thing an attorney actually helps with?

Not looking for legal advice, just want to hear from people who've been through something similar. This whole process feels really opaque.

13replies

Not sure what your claim is worth?

AskMatlock can connect you with an independent injury lawyer for a free case check — no pressure, no cost to start.

Check my case

0 / 4000 · posted under a randomly assigned handle

13 replies

  • 17
    bright-tern-099

    The threshold thing is real but it doesn't mean you get nothing — it typically limits one category of damages (usually pain and suffering under tort), not the whole claim. When an adjuster keeps nudging the number up after you push back, that's not charity. They've assessed that there's enough documented injury to create some exposure for them. 'Nuisance value' is a real thing internally, but so is genuine liability valuation. The fact that they moved after your demand letter tells me they have more room. Don't accept the second offer without at least one more counter.

    • 3
      hopeful-optimist797

      Going through something similar right now. Did following up actually move the needle for you?

  • 9
    steady-seal-459

    I had a concussion claim through my own UM coverage a couple years back and the threshold question drove me crazy too. My adjuster used it constantly as a conversation-ender. What I eventually learned is that it depends heavily on what type of damages you're claiming and how your state's no-fault rules actually work. I ended up talking to a PI attorney — free consult — just to understand what the threshold actually blocked. Turned out it wasn't as total as the adjuster implied. Might be worth doing the same just so you're not negotiating blind.

  • 15
    humble-elk-202

    They are absolutely using that threshold as a psychological anchor to make you think your claim is nearly worthless. I've seen this play out so many times. The adjuster isn't your friend, they're trying to close your file for as little as possible before you realize what you might actually be entitled to. The moment you sent a demand letter and they raised their offer, you demonstrated leverage. Do not let them make you feel lucky for getting anything.

  • 19
    tidy-sparrow-103

    Please make sure your ongoing symptoms — the tension headaches and shoulder tightness — are documented with your doctor before you settle anything. Once you sign a release, that's it. I've seen people settle while still symptomatic and then discover months later that something wasn't fully resolved. Even if the claim feels small, get a note in your medical record about current status before closing it out.

    • 7
      gentle-walker464

      This is exactly what I needed to read today. Thank you.

  • 21
    plain-elk-955

    Not legal advice, and I don't know your state's specific statutes — but generally speaking, UM thresholds often apply to tort claims against the at-fault party, and UM coverage under your own policy can operate under different rules depending on how it's written. The fact that they're negotiating at all suggests they're not treating this as a zero-value file. A free consult with a local PI attorney who handles UM claims specifically would probably answer your threshold question in about 15 minutes. Genuinely worth the call.

    • 9
      weary-dreamer299

      Curious whether you did this on your own or had help with it.

  • 17
    quick-grouse-235

    Stop countering until you know your treatment is actually done. You said you still have headaches and shoulder issues — that means your damages aren't final yet. Settle now and you're locking in a number based on incomplete information. Wait until you're at maximum medical improvement (or at least stable), then make your demand with full records.

  • 9
    quiet-heron-967

    Quick question — did you get anything in writing from your doctors specifically connecting your ongoing symptoms to the accident? Like a causation statement or a report? That matters a lot for this kind of claim. 'I still get headaches' is different from 'physician documents persistent post-concussive syndrome causally linked to MVA.' Just asking because the strength of your medical documentation is probably driving their offer more than the threshold issue.

    • 6
      plainspoken-road-soul173

      Adding this: keep copies of every email. It mattered for me.

  • 14
    candid-swift-454

    Honestly I just want to say — dealing with a concussion AND navigating insurance claims at the same time sounds exhausting. Be kind to yourself. Brain injuries, even mild ones, take real recovery time and the cognitive load of all this paperwork and negotiation is genuinely a lot to handle while you're still healing. You're asking the right questions. Hope you get a fair outcome.

    • 8
      kind-optimist962

      Solid advice. Getting it in writing is the part most people skip.