$100,000 Policy-Limits Settlement for Traumatic Cardiac Contusion After Head-On Collision in New Boston, NH

A catastrophic head-on collision in New Boston, New Hampshire, resulted in life-threatening cardiac trauma to a 71-year-old husband returning home from grocery shopping with his wife. This New Hampshire personal injury case involved complex causation issues, massive medical expenses, and limited insurance coverage. Despite more than $170,000 in medical specials, the bodily injury carrier paid its full $100,000 policy limits after facing overwhelming evidence of cardiac injury and post-traumatic arrhythmia.

This case illustrates how cardiac contusions—even when initially misunderstood as “just chest pain”—can evolve into dangerous electrical disturbances requiring invasive cardiac ablation. It also demonstrates the impact of New Hampshire’s underinsured motorist (UM) stacking rules and how insufficient coverage can cap recovery despite significant medical harm.

Case Overview

The client was a 71-year-old New Hampshire resident, married for more than 50 years, known for living a quiet, peaceful retirement with his spouse. On the day of the crash, he was the front-seat passenger in a 2020 Acura MDX—an SUV that quite literally saved his life.

He came to the firm after experiencing a severe and sudden cardiac event immediately after the impact. Although he survived the collision, the physiological trauma triggered dangerous arrhythmias and ultimately a nonsustained ventricular tachycardia requiring ablation. His medical bills exceeded $170,000, almost twice the available liability limits.

The firm undertook a rapid evaluation of the cardiac component of the injury, consulted specialists, and presented clear evidence of causation to the carrier. The result was a full policy-limits settlement.

Key Facts and Background

The Collision in New Boston, NH

The crash occurred in New Boston. The insured driver of a 2013 Nissan crossed the double yellow line on a curve at approximately 35 mph, striking the clients’ Acura head-on. The police report attributed full fault to the at-fault driver, noting the absence of brake marks and the driver’s inability to recall why she crossed the center line. Liability was never in dispute.

Immediate Post-Crash Cardiac Event

Although the couple initially declined ambulance transport, EMS strongly urged evaluation due to the severity of the impact. En route to the hospital, the client began experiencing alarming cardiac symptoms:

• Rapid heartbeat

• Electrical irregularities

• Lightheadedness

• Chest pain along the seatbelt path

At one point, EMS stopped the ambulance entirely to address the cardiac emergency. This episode was documented clearly in the run sheet and confirmed later by hospital cardiac assessments.

Emergency Room Findings

At the emergency room, he underwent trauma-level cardiac assessment including:

• Elevated troponins, indicating cardiac muscle injury

• ECG irregularities

• Evidence of pericardial effusion

• Observed bigeminy (heartbeat skipping)

• Left-sided chest pain consistent with seatbelt/airbag trauma

He was admitted for observation for two nights due to suspected cardiac contusion, a potentially dangerous condition following blunt force impact.

Progressive Arrhythmia and 2,500 VT Runs

After discharge, symptoms continued. Follow-up cardiac testing revealed:

• 2,500 episodes of nonsustained ventricular tachycardia (VT)

• Recurrent lightheadedness

• Electrical instability

• Persistent arrhythmia unresponsive to conservative management

Cardiology recommended catheter ablation.

Cardiac Ablation

The client underwent invasive cardiac ablation, performed under general anesthesia, where a catheter was threaded through the groin into the heart and multiple ablation burns were applied to disrupt the faulty electrical pathways. Total cardiac-related costs exceeded $145,000.

Total Medical Specials

Hospitalization, cardiology, and ablation-related care totaled:

• $172,577.33 in medical billing

This amount far exceeded available liability insurance.

Legal Issues and Challenges

Establishing Causation Between the Collision and the Arrhythmia

Cardiac contusions are complex injuries. Insurers often argue:

• Arrhythmias could be age-related

• Troponin elevation may be unrelated

• Irregular heartbeats may be idiopathic

• Ablation may have been “elective” or pre-existing

To counter this, the firm relied on:

• Hospital records explicitly linking the troponin elevation and VT runs to traumatic cardiac contusion

• EMS documentation of an immediate cardiac crisis just minutes after impact

• Absence of any pre-accident cardiac history

This created a tightly controlled causation narrative that the insurer could not break.

Coverage Limits and UM Stacking Issues

New Hampshire does not permit stacking of identical underinsured motorist (UM) coverage. Because:

• The at-fault driver carried $100,000

• The clients’ UM also carried $100,000

No additional UIM coverage was available.

Had the clients carried:

• $250,000 UM → Additional $150,000 available

• $500,000 UM → Additional $400,000 available

This case could easily have exceeded $200,000–$300,000, given the extent of cardiac injuries.

Medical Bills Exceeding Policy Limits

With more than $170,000 in specials, damages were indisputable. The carrier’s only argument was coverage.

Strategy and Litigation Approach

The firm pursued a focused, evidence-driven approach:

Immediate Specialist Consultation

A cardiac specialist confirmed that:

• The arrhythmia pattern

• Troponin spike

• Pericardial effusion

• VT runs

• Need for ablation

were entirely consistent with traumatic impact from a head-on collision.

Heavy Reliance on Medical Documentation

The demand letter incorporated:

• EMS run sheet showing the cardiac stop

• Hospital findings of VT and troponin elevation

• CT and ECG records

• ZIO patch report documenting 2,500 VT episodes

• Ablation operative report

  All of which clearly established trauma-induced electrical instability.

Policy-Limits Demand and Causation Confrontation

The carrier was confronted with:

• Overwhelming medical evidence

• Catastrophic risk at trial

• A sympathetic 71-year-old retiree

• The undeniable sequence of cardiac symptoms beginning within minutes of impact

Faced with a clean causation line and significant exposure, the insurer capitulated.

Outcome and Resolution

The case resolved for the full $100,000 policy limits.

Although the client’s medical expenses far exceeded available coverage, the firm forced the carrier to recognize the elevated litigation risk surrounding a traumatic cardiac injury with documented arrhythmia and required surgical intervention.

Past outcomes do not guarantee future results.

What This Case Means for New Hampshire Clients

This case underscores several important lessons for those injured in New Hampshire:

Cardiac Injuries After a Crash Are Often Misunderstood

Chest pain after a collision is usually attributed to seatbelts or airbag contact. But cardiac contusions can produce:

• Troponin elevation

• Electrical instability

• Life-threatening arrhythmias

Early evaluation is critical.

UM Coverage Matters

Had higher underinsured motorist limits been in place, the client could have accessed coverage in the six-figure range.

Documentation Wins Cases

The carrier folded because the medical records were ironclad. EMT notes, ECG readings, troponins, and specialist reports drive settlement value.

Experienced Litigation Counsel Changes Outcomes

The insurer resisted paying full value until confronted with a cohesive, specialist-supported causation theory. Thorough case development is essential.

Apis Law approaches catastrophic New Hampshire car accident cases with a disciplined, evidence-driven strategy. The firm conducts thorough investigations, secures specialist support, and prepares every case as though it may proceed to trial. In serious injury matters—particularly those involving cardiac complications—precise documentation and aggressive advocacy are essential.

The firm regularly represents clients throughout New Hampshire, including New Boston, Goffstown, Manchester, Bedford, and Hillsborough County. If you or a loved one suffered a serious injury in a motor vehicle collision, our team is prepared to evaluate your case and guide you through the process with clarity and experience.