Traumatic brain injuries: A growing liability claims trend

Every year more than two million people seek treatment for traumatic brain injuries (TBIs) in the United States, according to the Centers for Disease Control and Prevention. Another concerning trend is that over a six-year period, TBI-related emergency department visits increased by more than 50 percent. TBIs are typically caused by a bump, blow, or jolt to the head and can lead to trouble with memory, sleep, movement, and vision or hearing, and can cause emotional issues. Although treatments for TBI vary depending on severity, an individual who has suffered a catastrophic injury may require years, or even a lifetime, of specialized care.

TBI claims are being asserted in less serious accidents, such as slips and falls and whiplash from fender benders. One factor driving the increase is growing public awareness of these types of injuries. The high-profile concussion lawsuit between former professional football players and the National Football League and the well-publicized cases of chronic traumatic encephalopathy (CTE) have drawn attention to the serious and sometimes long-lasting effects of TBIs.

Another factor driving the rise in claims is the potential for large settlements. When third parties, such as businesses, are liable for accidents that result in catastrophic TBIs, litigated liability claims often include life care plans, which project medical treatment and self-care needs and associated costs. These plans can include legitimate needs, but they can also include treatment or care that is not currently being provided and that may not be medically necessary in the future. Therefore, TBI claims with life care plans often involve input from a variety of experts as well as independent medical exams and other tests, all of which can increase litigation costs and settlement amounts.

Dizziness, lightheadedness, blurred vision, ringing in the ears, and difficulty concentrating are all potential signs of a mild or moderate brain injury. Often temporary in nature, many of these symptoms dissipate as the brain heals. However, in some cases, they could be indicative of a severe and debilitating injury with lasting damage.

Tests such as MRIs and CAT scans can be helpful in determining internal damage associated with severe TBIs, but these screenings have a wide degree of variability. Tests also don’t always tell the whole story — brain damage may not be visually present. And because most individuals don’t have documented baseline tests of normal brain function, measuring any changes after an injury can be difficult.

With the rise in TBI injuries and growing costs of settlements, businesses should partner closely with their insurers to manage these types of claims. Insurers have experience managing complex liability cases like TBIs and can offer the expertise and resources to properly evaluate and defend legitimate claims and better manage overall claims costs.

Two ways insurers can deliver better outcomes on TBI claims include the following:

Given the current trends, it seems that TBI claims will continue to be a challenge for businesses and insurers. And although the best-case scenario is to prevent these types of incidents from occurring, businesses that stay informed and that work with an insurer that knows how to manage these cases for the best outcomes can better mitigate their risk.