New Mexico — What Happens When an Adjuster Offers a Full and Final Settlement and You Still Need Treatment

The information on this site is for general informational purposes only, may be outdated, and is not legal advice; do not rely on it without consulting your own attorney. See full disclaimer.

Understanding a “Full and Final” Insurance Settlement When You Still Need Medical Care

This FAQ explains what a proposed “full and final” settlement from an insurance adjuster can mean for someone in New Mexico who still needs medical treatment. It uses plain language and practical steps you can take right away. This is educational information only — not legal advice.

Detailed Answer

What “full and final” usually means

An insurer’s offer described as a “full and final” settlement almost always asks you to sign a release or general release. A release typically says that in return for the payment, you give up all present and future claims related to the accident or incident covered by the claim. In practical terms, if you sign that release, you will generally lose the right to make any further claim against the insurer (or the at-fault party) for medical costs, lost wages, pain and suffering, or other harms from the same event.

Why this matters when you still need treatment

If you accept a full-and-final offer before finishing medical treatment, you risk paying for later care yourself. Medical needs can change: new diagnoses, follow-up procedures, rehabilitation, or complications sometimes arise weeks or months after the initial treatment. A settlement that releases future care removes your leverage to get the insurer to pay for those later costs.

Typical insurer goals and common settlement structures

Adjusters try to close claims and limit insurer exposure. Common ways insurers propose to resolve claims include:

  • One-time lump-sum payment with a full release (most common).
  • Structured settlement or series of payments (occasionally used to allocate funds over time).
  • Limited release—settlement that resolves only specific claims or certain categories of damages (less common but sometimes negotiable).

Options available to you in New Mexico

If you need more treatment, you generally have these choices:

  1. Decline the offer and continue treatment while preserving your current claim. This keeps your right to seek future compensation if needed.
  2. Negotiate for a higher amount that reasonably covers anticipated future care. Ask the insurer to base payment on documented medical bills, estimates from your provider, and a reasonable projection for future treatment.
  3. Request a limited release that specifically excludes future medical care or assigns only specific bills as resolved. Insurers may resist, but you can try to contract around future medicals or reserve a claim for future care.
  4. Use a structured settlement to receive ongoing payments timed to match expected future medical costs. (Structured settlements require insurer agreement and sometimes court or tax counsel.)
  5. Accept the offer with conditions (for example, a holdback for unresolved medical expenses). A holdback is an amount of money the insurer keeps until treatments are completed or bills are resolved.
  6. Consult an attorney before signing — especially if the offer is large or you are uncertain about future needs.

Practical legal consequences in New Mexico

Once you sign a general release in New Mexico, courts typically treat it as binding if the release was knowingly entered. You will likely be barred from reopening the same claim against the insurer or the released parties for the same accident. That means later medical bills related to the accident may be your responsibility.

Special considerations

  • Health-care liens and third-party payers: If you have claims by health insurers, Medicaid, Medicare, or medical providers for payments they made on your behalf, you must consider those liens when settling. Federal rules govern Medicare’s interests; state or private payers may assert liens. Resolving liens often requires coordination and sometimes negotiation to allocate settlement proceeds.
  • Minors and legally incompetent persons: Settlements on behalf of minors or incapacitated people frequently require court approval in New Mexico before a release is effective. That protection can allow review of whether future care is covered by the settlement.
  • Workers’ compensation: If the claim involves a workers’ compensation carrier rather than a liability insurer, different statutes and procedures apply. Talk to an attorney familiar with that area before signing anything.
  • Statute of limitations: If you reject a settlement, be aware of timing rules for filing a lawsuit. New Mexico has time limits for different claims — if you delay too long you may lose legal rights to sue. For statute information and the exact deadlines that apply to your case, consult official New Mexico statute sources or an attorney. For general access to New Mexico statutes and code, see the New Mexico Legislature website: https://www.nmlegis.gov/.

Hypothetical example

Anna is injured in a New Mexico car crash. The insurer offers $8,000 as a “full and final” payment. Anna still needs physical therapy and a possible MRI scheduled in two months. If Anna accepts and signs a general release, the insurer will likely pay the $8,000 and Anna will not be able to ask for more money later—even if the MRI shows a serious injury that requires expensive surgery. If Anna declines and negotiates a $25,000 settlement or a holdback for future care, she preserves funds to cover later treatment.

When to talk to a lawyer

You should consult an attorney before signing a full-and-final release if any of the following apply:

  • You still need medical treatment or an important diagnostic test.
  • The insurer’s offer does not reasonably cover known bills plus a realistic estimate of future care.
  • You think a third party (health insurer, Medicaid/Medicare, medical provider) may have a claim against settlement proceeds.
  • The circumstances are complex (multiple vehicles, serious injury, potential permanent impairment, or disputed fault).

Finding a lawyer can help you estimate future medical needs, calculate appropriate compensation for non-medical damages, negotiate lien reductions, and draft a release that protects your interests.

Where to find New Mexico legal information and resources

  • New Mexico Legislature — statutes and how to look up state law: https://www.nmlegis.gov/
  • New Mexico Courts — general court information and forms: https://www.nmcourts.gov/
  • New Mexico Human Services Department (Medicaid) — information about Medicaid liens and subrogation: https://www.hsd.state.nm.us/
  • CMS (federal) — Medicare Secondary Payer and lien guidance: https://www.cms.gov/

Helpful Hints

  • Do not sign anything the adjuster gives you without reading it and getting independent advice if you still need treatment.
  • Ask the adjuster to put the offer in writing and to state whether the release is limited or general. Keep a copy of all documents and correspondence.
  • Get a clear medical prognosis and a written cost estimate for anticipated future treatment from your treating providers.
  • Ask for time to consider the offer. Insurers often give a deadline; use it to gather information or consult an attorney.
  • Consider a holdback, limited release, or structured settlement if you and the insurer can agree on a method to protect future medical needs.
  • Check whether any medical providers, insurers, or government programs have lien or subrogation rights that must be satisfied from the settlement.
  • If you are unsure, consult a New Mexico personal injury attorney to review the release language and help negotiate terms that preserve coverage for future treatment.

Disclaimer: This article is for general information only and does not constitute legal advice. It does not create an attorney-client relationship. Laws vary by situation and change over time. For advice tailored to your situation, consult a licensed attorney in New Mexico.

The information on this site is for general informational purposes only, may be outdated, and is not legal advice; do not rely on it without consulting your own attorney. See full disclaimer.