The “Kiss of Death” takes a lot of forms.  Here’s how it’s delivered by Michael to Fredo in The Godfather Part II.

In personal injury cases the delivery is a little bit different.  But the result is the same.

Doctors recommend treatment.  Clients decline.  It can be the kiss of death for their cases.

Here are some variations on the theme:


Sometimes clients don’t schedule treatment because of cost.  Here’s what we tell them:

If the treatment isn’t worth the insurance co-pay (or even the entire amount of the treatment expense) to you, then it puts a price on your pain (or what you’ve lost because of your pain). What you’re telling the jury is that improvement or recovery isn’t worth $X per week to you.     

If it’s not worth $X to you, it won’t be worth $X to the insurance carrier or a jury.  Whether it’s fair or not, treatment expenses play a big role in case value.  They’re often equated to the magnitude of the injury.  Saving $X on a co-pay is going to result in a $10X reduction in case value.

(There’s always a way to pay for medical treatment.  Many providers will treat on a lien basis.  Lots of companies offer non-recourse loans.)


It’s not always the money.  Sometimes clients don’t get the treatment recommended by their own providers because they’re busy, scared or think it’s not going to help.

One of the worst things a client can do is to deviate from the treatment plan outlined by providers.  It signals to adjusters, opposing counsel, judges and jurors that getting better must not be a priority.  If getting better isn’t a priority, the natural conclusion is that the injuries must not be that bad.

And not only does it suggest injuries aren’t serious, it also gives the defendant a basis to argue that if the injured person had followed the treatment plan there wouldn’t be any residual effects from the accident.

Failing to schedule and/or missing appointments bleeds value out of the case.

Backsliding to the Chiropractor

Clients love their chiropractors.  There’s something different about chiropractors than other providers.  They establish a much deeper connection with their patients.

And it’s because of this connection that a lot of clients—despite receiving a detailed plan that includes other types of treatment (usually because they’ve plateaued with chiropractic)—end up going straight back to their chiropractors and eschewing other types of treatment.

Experts and Credibility

We frequently send clients to see different kinds of doctors.  Mainly it’s physical medicine and rehabilitation, psychiatrists and neuropsychologists.  They recommend treatment and usually testify about how much it’s going to cost.

We send clients to these doctors so that the doctors can outline treatment plans and help us prove the cost of future treatment.  All of this is undone when the client doesn’t follow the doctor’s recommendations.  That’s another way of telling the jury not to award future treatment costs.

We can’t have a serious conversation with an adjuster or stand up in front of a jury and say that my client is entitled to $X for future treatment if they haven’t pursued the treatment that’s been recommended.  That would put a serious dent in our credibility and drag down the value of the case.


Even if you’re concerned about cost, busy, scared or skeptical set up appointments with the recommended (types) of providers.  Find out what the treatment entails.  Remain open to treatment options (even if not may not be the ideal time to get them).  That at least gives us the attitude to argue that you should be awarded the cost of future treatment so you can get it when the time is right.

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