What happens if the adjuster offers a full and final settlement and I need more treatment?

Short answer: A “full and final” settlement usually requires you to sign a release that gives up future claims for the incident. If you sign that release and later need more medical care, you typically cannot make a new claim against the insurer unless you can show fraud, a mistake, or some other legal basis to undo the release. Before you sign, take steps to protect yourself: get a clear medical prognosis, consider reserving future medicals, and consult a lawyer.

Detailed answer — what a full and final settlement means

When an insurer or adjuster offers a “full and final” settlement, they expect you to sign a release or settlement agreement. The release generally states that in exchange for the payment, you give up the right to pursue further claims for the same accident or injury. In plain terms: you get money now, and in return the insurer gets finality.

Why this matters if you still need treatment

• If you accept the check and sign a clean release, you usually cannot go back and ask for more money for additional medical care related to that accident.
• If you have unpaid medical bills or expect future care, signing without reserving those rights can leave you responsible for future costs.
• Medical providers, Medicare, or TennCare (Tennessee’s Medicaid program) may have a right to recover money from your settlement (subrogation or lien). That can reduce the net amount you receive.

Common exceptions and ways to protect yourself

There are a few situations where you can protect the possibility of future recovery or avoid losing rights by mistake:

• Delay signing until you reach Maximum Medical Improvement (MMI). MMI means your condition is stable and future care needs are predictable. Waiting reduces the risk of unforeseen expenses.
• Negotiate a reservation for future medicals. Ask the insurer to exclude future medical expenses from the release, or to leave part of the settlement as a holdback for future care. Put any agreement in writing.
• Structured settlements or medical expense set-asides. These tools preserve funds for future treatment or set money aside specifically for medical care.
• Account for liens and subrogation. Check whether TennCare, Medicare, or any health insurer has a recovery claim. TennCare has a third-party liability unit that may pursue repayment of benefits paid. See TennCare: https://www.tn.gov/tenncare.html
• Get a written release and read it carefully. Make sure the release clearly lists what claims you are giving up and whether future medicals are included or reserved.
• Consult an attorney before signing. An attorney can evaluate future care needs, advise on lien resolution, and negotiate appropriate language in the release.

What if I already signed a full release but later need more treatment?

If you already signed a valid and unambiguous full release, options are limited but may include:

• Challenge the release. You may be able to rescind or avoid enforcement of the release if you can prove the release was procured by fraud, material misrepresentation, duress, or mutual mistake. These are fact-specific claims and often difficult to win.
• Seek alternative payment sources. If the release prevents recovery from the insurer, pursue health insurance, Medicare/Medicaid coverage, or payment plans with providers.
• Negotiate with providers. Some medical providers will negotiate discounts or payment plans when they learn a settlement left you without funds for continued care.
• Ask about reopening the claim. In rare circumstances and depending on the settlement language, an insurer might negotiate an adjustment, but they are not legally required to do so after a proper full-and-final release.

Important Tennessee resources

• Tennessee Department of Commerce & Insurance (consumer assistance for insurance disputes): https://www.tn.gov/commerce/insurance.html
• TennCare (Tennessee Medicaid) — information on third-party liability and recovery: https://www.tn.gov/tenncare.html
• Tennessee Code and statutes (official legislative site): https://www.capitol.tn.gov/

When to call a lawyer

Talk to an attorney if any of the following apply:

• You haven’t reached MMI but the insurer demands a release.
• You face significant future medical costs or lost wages.
• Liens or subrogation demands (Medicare, TennCare, private health insurers) will reduce your recovery.
• You already signed a release and later discover you need more care.

Final checklist before signing any full-and-final settlement

• Get a current medical opinion about future treatment and costs.
• Ask the insurer for a breakdown of how they calculated the offer and whether liens will be deducted.
• Consider reserving funds for future medicals or using a structured settlement.
• Have an attorney review the release language and negotiate any needed exceptions.
• Confirm in writing how third-party liens (TennCare, Medicare, etc.) will be handled.

Disclaimer

This information is for education only and is not legal advice. It does not create an attorney-client relationship. Laws vary by case and change over time. If you need legal advice about your situation, consult a licensed Tennessee attorney.

Helpful Hints

• Don’t sign a release on the spot. Ask for the document, read it, and get legal review.
• Get all promises in writing. Verbal promises from an adjuster are hard to enforce.
• Keep thorough records: medical notes, bills, estimates for future care, and all correspondence with the insurer.
• Ask the insurer whether the offer is “gross” or “net” of liens and who will pay outstanding medical bills.
• If unsure, ask the insurer to pay outstanding medical providers directly from the settlement proceeds so you do not face surprise bills.
• If you have TennCare or Medicare involvement, contact TennCare and Medicare’s recovery unit early to understand potential liens: https://www.tn.gov/tenncare.html