Dealing with a “Full and Final” Settlement Offer When You Still Need More Treatment

Disclaimer: This is general information about Maine insurance and settlement practices. It is not legal advice. For advice about your specific situation, consult a qualified attorney in Maine.

Detailed answer — what a “full and final” settlement means and what can happen in Maine

When an insurance adjuster offers a “full and final” settlement, they are asking you to accept a single payment in exchange for signing a release that closes the claim. If you sign a full-and-final release, you generally give up the right to demand more money later for the same injury, including payment for additional medical treatment, lost wages, or future pain and suffering related to the claim.

Because signing a release usually ends the insurer’s responsibility for future treatment and costs tied to that event, the most important consequence is this: if you need more treatment after signing, you will likely have to cover those costs yourself unless the release specifically preserves (reserves) future treatment. In practice, insurers will not voluntarily reopen a claim after a full release unless the release contains language that allows it or a court orders otherwise.

Key practical points under Maine practice:

• Do not sign a full-and-final release if you still have ongoing medical care, unresolved symptoms, or uncertain future needs. The release typically cuts off any future claims related to the injury.
• If an insurer insists on a full release but you need more treatment, ask the insurer to:
• Delay any release until your treating doctor has “cleared” you medically, or
• Limit the release to past medical bills and wage loss while excluding future medical care (a partial or limited release), or
• Set up a structured settlement that preserves funds for future treatment or future payments tied to ongoing care.
• If the insurer refuses those accommodations, you can refuse the offer and continue negotiating or file a civil claim before signing anything.

Common scenarios and the likely results

• Scenario: You sign a full-and-final release now but need additional surgeries later. Result: The insurer will typically not pay for the new surgeries because you released all future claims related to the accident.
• Scenario: You and insurer agree to reserve future medical expenses for a stated period or condition. Result: The release specifies what is reserved; the insurer remains responsible only for those reserved items as written.
• Scenario: You refuse the offer and demand more money to cover future care. Result: The insurer may increase the offer, keep negotiating, or you may sue. Lawsuits involve costs, time, and risk, but preserve your right to seek full compensation.

How to protect your medical care and rights before signing

Follow these steps to protect yourself in Maine:

1. Get a clear medical prognosis in writing. Ask your treating physician to describe current injuries, recommended treatment, estimated future care, and expected recovery. Insurers give much more weight to written medical statements.
2. Ask the adjuster for a written explanation of how they calculated the settlement. Compare that total to your medical bills, out-of-pocket costs, and a realistic estimate for future treatment.
3. Request a limited release or a reservation of rights. For example, agree to release past bills but specifically reserve future medical claims for X months or until your doctor says you have reached maximum medical improvement (MMI).
4. Consider using a qualified attorney to review any release. Attorneys can spot broad release language that eliminates important rights and can negotiate more protective terms.
5. Keep documentation. Save medical records, bills, wage statements, and any written offers from the insurer. Those records matter if dispute arises.

Questions to ask the adjuster before you consider signing

• Is the settlement intended to be a full and final release for all claims related to the incident?
• Does this offer cover past medical bills only, or also future medical care and lost wages?
• Can we add a reserved clause for future medical treatment or a time-limited exception?
• Will the insurer pay medical bills directly, or will they offset payments against my settlement?
• Are there liens or third-party subrogation interests (like health insurers or Medicare) that will reduce my net recovery?

When to call a lawyer in Maine

Talk to a lawyer before signing if any of the following apply:

• You have ongoing or uncertain medical treatment needs.
• You received a low settlement offer that does not account for future care or lost earnings.
• You are unsure whether the release language is too broad.
• An insurer pressures you to sign quickly or refuses to provide written details of the offer.
• You suspect bad faith or unfair claim practices by the insurer.

Practical options if you already signed and now need more treatment

• Review the release carefully. Some releases include carve-outs for new, unrelated injuries or expressly reserve certain medical claims. If the release is narrow, you may still have a path to compensation.
• Speak with an attorney right away. If you were pressured, misled, or the insurer failed to disclose key facts, an attorney can evaluate whether you have grounds to challenge the release (for example, fraud, duress, or mutual mistake).
• Check for administrative remedies. In limited contexts (workers’ compensation, for example), different rules apply to settlement and reopening claims; consult the relevant Maine agency or an attorney familiar with that area.

Maine consumer resources

• Maine Legislature — statutes index: https://legislature.maine.gov/statutes/
• Maine Department of Professional and Financial Regulation, Bureau of Insurance (consumer help and file a complaint): https://www.maine.gov/pfr/insurance/
• Maine State Bar Association — lawyer referral and resources: https://www.mainebar.org/

Bottom line

A full-and-final settlement will usually end the insurer’s duty to pay for future treatment for the same injury. If you still need care, do not sign a full release until you confirm, preferably in writing and with legal review, that the settlement protects you or reserves the future treatment you expect. When in doubt, get written medical estimates and consult a Maine attorney before signing anything that limits your rights.