$95,000 Settlement After Severe Car Accident in Manchester, NH, With Significant Treatment Gap
- Keith Diaz
- Apr 20
- 8 min read
Updated: Apr 25
Past results disclaimer: Every New Hampshire personal injury case turns on its specific facts, injuries, and legal issues. The $95,000 settlement described here is a past result, not a prediction of what any other case is worth. This article is for general information only and does not create an attorney–client relationship.
A gap in your medical treatment does not end your New Hampshire car accident case. Under NH law, you still have a claim if you can prove — by reasonable medical probability — that the crash was a substantial factor in causing your injuries. Apis Law used that rule, supported by independent medical expert testimony, to defeat the insurance company’s "treatment gap" defense and recover $95,000 for a Manchester car accident client who had gone more than 1.5 years without documented care during the COVID-19 pandemic.
This post explains the treatment-gap defense, how the NH eggshell-plaintiff and substantial-factor causation law neutralize it, and what you should do if an adjuster is already using a gap in your records to devalue your claim.
The Rule: Causation in One Paragraph
In New Hampshire, a personal injury plaintiff must prove that the defendant’s negligence was a substantial factor in bringing about the injury. NH Civil Jury Instruction 9.12 states the rule directly: conduct is a legal cause of an injury if it was a substantial factor in producing the harm. A plaintiff does not have to show the defendant’s negligence was the only cause, only that it materially contributed. This is the doctrine that defeats the treatment-gap defense because a gap in the record does not, by itself, break the causal chain if competent medical opinion links ongoing symptoms to the original trauma.
"The defendant’s conduct is a legal cause of the plaintiff’s harm if it was a substantial factor in bringing about the harm." — NH Civil Jury Instruction 9.12 (Substantial Factor Causation)
Worked Example: The Manchester $95,000 Settlement
Apis Law was retained three days before the statute of limitations expired under RSA 508:4 (a two-year deadline for personal injury actions). The police report at the scene placed liability unambiguously on the other driver, who ran a stop sign, a violent T-bone impact, and an emergency-room trip that documented torn spinal tissue, fractured ribs, and a concussion. Then the pandemic hit. Elective appointments were canceled, providers moved to telehealth, and the client, like many chronic-pain patients in 2020-2021, simply could not get sustained follow-up care. The result was a 1.5-year gap in the medical record. The insurance carrier refused to meaningfully value the claim and pointed to the gap as proof that the injuries had resolved.
Apis Law filed suit in Hillsborough County Superior Court South (Manchester) inside the 72-hour window, then reconstructed the medical timeline, retained a qualified expert to reestablish causation by reasonable medical probability, and signaled trial-readiness. The insurer, which had been pricing the case on the assumption that the gap would produce a quick discount, reassessed its trial risk and paid $95,000 to settle, a result that illustrates what NH's substantial-factor and eggshell-plaintiff law actually allows, even when the record looks compromised on its face.
If the insurance adjuster is already pointing to a gap in your records, do not give a recorded statement and do not accept their number. Call Apis Law at (603) 785-1013 for a free consultation before you say anything else.
How the Insurance Company Uses the Treatment Gap Against You
Every major NH auto carrier runs the same playbook on a gap case. Four moves show up again and again:
1. Early recorded statement. Within days of the crash, the adjuster calls, asks "how are you feeling today," and locks in a statement that can later be read back as evidence that the injuries had resolved. You are not legally required to give this statement.
2. Reframing the gap as recovery. The defense argues that no treatment equals no pain — if the injuries had been serious, the reasoning goes, the plaintiff would have been in a provider’s office every week. Medical reality in 2020-2021 (and true for many self-pay patients today) is the opposite.
3. Asserting a degenerative alternative cause. The carrier retains a records-review physician to opine that any post-gap symptoms are "age-related," "pre-existing," or caused by an unrelated intervening event. Under the NH eggshell-plaintiff doctrine, a pre-existing condition does not defeat a claim and may, in fact, increase damages if the crash aggravated it.
4. Anchoring a low-ball offer to the gap. Because the gap is presented as "proof" that the injuries have been resolved, the first offer is discounted — often by 20 to 40 cents on the dollar relative to actual damages. The offer is a negotiating position, not a medical finding, and it is routinely beaten when the plaintiff credibly threatens to go to trial.
NH Case Law That Defeats the Treatment-Gap Defense
These are the NH Supreme Court decisions most directly relevant to a gap-in-treatment case.
Peterson v. Gray, 137 N.H. 374 (1993)
The NH Supreme Court reversed a defense verdict where the trial court failed to properly instruct the jury on aggravation of a pre-existing condition. Peterson holds that a plaintiff may recover the full extent to which a pre-existing condition was made worse by the defendant’s negligence, which is exactly the mechanism that converts a patient who was "mostly okay" before the crash into a full-value plaintiff after it, even if records between the crash and trial are thin.
Rawson v. Bradshaw, 125 N.H. 94 (1984)
The Court affirmed that a tortfeasor takes the plaintiff as he finds her, the classic eggshell plaintiff rule. An insurance carrier cannot discount a claim by arguing that a more robust person would have recovered faster or without a treatment gap.
Valliere v. Filfalt, 110 N.H. 331 (1970)
Early NH authority establishing that a defendant whose negligence aggravates a pre-existing injury is liable for the entire aggravation, even where some of the plaintiff’s symptoms would have developed anyway. Critical when the defense tries to allocate symptoms to an intervening cause.
Pridham v. Cash & Carry Building Center, 116 N.H. 292 (1976)
Articulates the substantial-factor causation standard that appears in NH Civil Jury Instruction 9.12. Pridham confirms that the plaintiff needs only to prove the defendant’s negligence was one substantial factor, not the sole cause, in producing the harm.
Szewczyk v. Continental Paving, 176 N.H. 148 (2023)
Recent authority from the NH Supreme Court reaffirms that medical causation must be established by expert testimony to a reasonable degree of medical probability. This is the standard the gap-case expert must meet and, once met, it answers the carrier’s "missing records" argument as a matter of law.
How the Issue Is Actually Decided in a NH Courtroom
A gap-in-treatment case is decided by a Hillsborough County jury (for a Manchester crash) using the NH special verdict form. The jury receives instruction 9.12 (Substantial Factor), instruction 9.13 (Aggravation of Pre-Existing Condition), and, where applicable, instruction 9.15 (Pre-Existing Condition — Eggshell Plaintiff). The jury does not need to find continuous documented treatment; it needs to find that the collision was a substantial factor.
Expert testimony from a qualified physician, reviewing the mechanism of injury, the initial imaging, and the post-gap symptom record, is generally what carries the day. The judge then applies RSA 507:7-d comparative fault arithmetic to whatever the jury allocates. See NH Civil Jury Instructions 6.1 (general negligence) and NS9.111 (aggravation damages).
Four Practical Takeaways
1. A gap does not end your case. NH’s substantial-factor rule does not require unbroken treatment. It requires a competent medical opinion linking the crash to the current condition. The gap is a fact to be explained, not a bar to recovery.
2. Do not give a recorded statement. You are not legally required to speak to the other driver’s insurance company. Almost nothing helpful can come of it, and almost everything harmful can.
3. Get the expert before you negotiate. A gap-case settlement offer is usually pegged to the carrier’s internal assumption that you cannot produce expert testimony. Producing a qualified expert opinion before the first meaningful negotiation resets the carrier’s number.
4. Mind the RSA 508:4 deadline. New Hampshire gives you two years from the date of injury. If you are inside the last 60 days, retain counsel immediately. With or without a gap, a late-filed case cannot be resurrected.
Frequently Asked Questions
Does a gap in my medical treatment ruin my NH car accident case?
No. Under NH Civil Jury Instruction 9.12 and Pridham v. Cash & Carry Building Center, you only need to prove the crash was a substantial factor in causing your current injury. A gap is a fact the jury can weigh. It is not a bar to recovery. Qualified medical expert testimony that reviews the mechanism of injury and the post-gap symptoms typically resolves the issue.
What if I had a pre-existing condition before the crash?
New Hampshire follows the eggshell plaintiff doctrine — a defendant takes the plaintiff as he finds her. Under Peterson v. Gray, 137 N.H. 374 (1993), and Valliere v. Filfalt, 110 N.H. 331 (1970), the defendant is liable for the full extent to which the crash aggravated the pre-existing condition. A history of back or neck problems can actually increase, not decrease, the value of the claim.
How long do I have to file a NH car accident lawsuit?
Two years from the date of injury under RSA 508:4. That deadline is strict. If you are close to it, retain counsel immediately. A gap in treatment can be overcome, but a blown statute of limitations generally cannot.
Do I have to give the other driver’s insurance company a recorded statement?
No. You have no legal obligation to provide a recorded statement to the opposing carrier. Early recorded statements are a standard defense tool used to lock in "I feel fine" quotes that will later be used to argue that your injuries have resolved. Most injury lawyers strongly advise against giving one.
How much is a treatment-gap car accident case worth in New Hampshire?
There is no formula. The value depends on liability, injury severity, medical specials, wage loss, and non-economic damages (pain, suffering, loss of enjoyment of life) under NH Civil Jury Instruction NS9.111. The Manchester case described here resolved at $95,000 after litigation, expert disclosure, and a credible trial posture — but each case is different, and past results do not predict future outcomes.
External Legal Resources
NH RSA 508:4 (two-year statute of limitations for personal actions) — full statute text at Justia
NH RSA 507:7-d (modified comparative negligence rule) — full statute text at Justia
New Hampshire Judicial Branch — Supreme Court orders and opinions: courts.nh.gov
Related Pages on apislaw.com
Practice-area hub
Location pages
Related posts
Speak With an Experienced NH Car Accident Attorney
If an insurance company is pointing to a gap in your medical records to devalue your New Hampshire car accident claim, do not accept their number. Apis Law offers a free consultation to New Hampshire injury victims. Attorney Keith F. Diaz has 22 years of trial experience and handles car accident, spinal injury, and catastrophic injury cases across Manchester, Goffstown, Bedford, Concord, Nashua, and throughout Hillsborough County.
Call (603) 785-1013 or visit apislaw.com to schedule a free consultation.
About the Author
Keith F. Diaz, Esq. is the founder of Apis Law, PLLC, a New Hampshire personal injury and employment law firm. Attorney Diaz has 22 years of legal experience and is admitted to practice in the State of New Hampshire (Bar No. 15831), the U.S. District Court for the District of New Hampshire, and the First Circuit Court of Appeals. He founded Apis Law in 2022 to provide dedicated, client-focused representation to individuals and families throughout New Hampshire.
This article is for general informational purposes only and does not constitute legal advice or create an attorney–client relationship. Past results do not guarantee future outcomes. Consult a licensed New Hampshire attorney for advice on your specific situation.
Comments