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Texas V43.5XXA cases turn on a trio of hard ceilings: Texas auto insurance minimum of 30/60/25 (the lowest per-person limit in the nation), the 51% comparative-fault bar (CPRC Chapter 33, which erases recovery at 51% fault), and UM/UIM stack availability (Insurance Code Section 1952.106 permits stacking across household vehicles, partly offsetting the uninsured-driver problem in Texas, which sits at ~14%).
V43.5XXA at a glance
V43.5XXA Settlement Value Snapshot (Texas, 2026)
Last updated
- Definition
- Car driver injured in collision with car, pick-up truck or van in traffic accident, initial encounter (ICD-10-CM, FY2026).
- Where it appears
- Most common code on Texas ER face sheets after a passenger-vehicle collision. Appears on hospital bills, EOBs, carrier claim files, and indirectly on the TxDOT CR-3 crash report.
- TX settlement
- Typical range $12,000 to $80,000. Surgical orthopedic $110,000 to $400,000; severe with permanent impairment $400,000 to $1,500,000; catastrophic and wrongful death $1,500,000 to $40,000,000+ (Currie v. Landry: $41M).
- TX auto minimum
- $30,000 per person, $60,000 per accident, $25,000 property damage (Texas Insurance Code Chapter 601 / TDI). ~14% of TX drivers uninsured; UM and UIM under Insurance Code Section 1952.106 is the most important coverage you can buy.
- Policy ceiling
- Texas minimum auto insurance is the lowest per-person limit nationally: $30,000 (most other states are $50K–$100K). Combined with ~14% uninsured-driver rate (highest in nation per IRC), roughly half of all V43.5XXA cases hit the policy-limits ceiling. UM/UIM stacking under Insurance Code Section 1952.106 is the critical gap-filler; household-resident and umbrella layers often define case value over primary policy limits.
- Rideshare wrinkle
- $1,000,000 TNC coverage layer (TX Insurance Code Chapter 1954) applies during Uber/Lyft Periods 2 and 3, plus $1M UM/UIM. Period 1 (app on, no ride) carries $50K/$100K/$25K plus $200K aggregate.
Source: SetCalc analysis of Texas court records, TxDOT crash data, and Insurance Research Council uninsured-motorist data, 2024 to 2026. Estimate your V43.5XXA settlement value →
This page is the ICD-10 lens on Texas car-vs-car cases
What V43.5XXA Actually Means
V43.5XXA reads character by character as: V43 (car occupant injured in collision with car, pickup, or van), .5 (car driver, traffic accident), XX (two placeholders), A (initial encounter, first visit for active treatment). The closely related codes you may see on the same chart are V43.6XXA (passenger), V43.7XXA (person on the outside of the car), and V43.9XXA (unspecified occupant). The non-traffic variants live at V43.0 through V43.3.
V-codes describe circumstance, not fault
How a V43.5XXA Crash Typically Happens in Texas
Texas car-versus-car crashes split into four dominant patterns. Each has characteristic injury pairings and characteristic comparative-fault arguments under the 51% bar.
Rear-end at a stop or slowdown
The most common V43.5XXA pattern in Texas, especially on I-610, I-45, the Beltway 8 tollway in Houston, I-35E and I-635 in DFW, and I-35 through Austin. Standard pairing: S13.4 cervical sprain. Liability usually clear; the dispute is over treatment duration and pre-existing degeneration.
Intersection T-bone
One driver runs a red light or stop sign and broadsides the other. Lateral forces produce higher-energy injuries: S06 TBI, S22 / S32 fractures, more frequent surgical intervention than rear-ends. High concentration at the I-35 / I-635 interchange, Houston Westheimer-area arterials, and San Antonio Loop 410 intersections.
Improper lane change
Lane-change side-swipes followed by secondary impact with a barrier or another vehicle. The 51% bar matters most here; defense routinely allocates 30 to 50 percent to the “cut off” driver for following too closely or staying in the blind spot. Pushing fault from 49 to 51 percent ends the case.
Head-on at low closing speed
Crossover collisions on undivided rural roads (US-77 through South Texas, FM roads off I-10). Less common but injury-severe; airbag deployment produces S06 concussion in nearly all cases. Often involves alcohol or drowsiness on long Texas rural runs.
The Injury Codes Paired With V43.5XXA
V43.5XXA is paired with one or more S-codes. The dollar value of the case is driven by these pairings far more than by the V-code itself:
- Cervical sprain (S13.4): whiplash. The dominant pairing for rear-end V43.5XXA cases. See the whiplash settlement guide.
- Herniated disc (M51.16 / M51.26): appears in roughly 15 to 25 percent of moderate Texas V43.5XXA cases. See the Texas back-injury settlement guide.
- Concussion / mild TBI (S06.0X): common with airbag deployment. See the TBI settlement guide.
- Rib and thoracic fractures (S22): seatbelt loading in higher-speed frontal and lateral impacts.
- Wrist and shoulder injuries (S52, S43): bracing on the steering wheel; common in higher-speed frontal V43.5XXA pairings.
Texas Settlement Ranges for V43.5XXA Cases
| Severity Band | Texas Range | Typical Paired S-Codes |
|---|---|---|
| Minor soft tissue (no injections) | $8,000 to $35,000 | S13.4 whiplash, conservative care only, under 4 months treatment |
| Moderate (injections, PT) | $35,000 to $110,000 | M51.16 / M51.26 disc, epidural injections, S06.0X concussion |
| Surgical orthopedic | $110,000 to $400,000 | Cervical ACDF, lumbar microdiscectomy, S52 / S82 fixation |
| Severe (permanent impairment) | $400,000 to $1,500,000 | Multi-level fusion, S06.2 moderate TBI, S22 rib flail |
| Catastrophic / wrongful death | $1,500,000 to $40,000,000+ | S24 / S34 spinal cord, severe S06 TBI, fatality with significant beneficiary class under CPRC Chapter 71 |
Source: SetCalc analysis of Texas court records and confirmed settlements, 2024 to 2026. The ceiling on most moderate cases is the at-fault driver's policy limit; catastrophic-tier verdicts include Currie v. Landry ($41M South Texas head-on DUI). See the verdict and settlement database.
Texas Car-vs-Car Case Examples
Example 1: Rear-end at red light, I-610 (Harris County)
Facts:
31-year-old driver stopped at a red light, rear-ended at approximately 18 mph at the I-610 access road near Westheimer. At-fault driver carried a $50,000 / $100,000 policy.
Injuries (paired codes):
V43.5XXA + S13.4 cervical sprain, 6 months chiropractic and PT, no imaging beyond normal cervical x-ray.
Settlement range: $16,000 to $30,000. Median outcome for a whiplash-dominant rear-end in Harris County. Adjuster opened at $7,500; case settled mid-band after demand package.
Example 2: Improper lane change, I-35E (Dallas County)
Facts:
43-year-old driver side-swiped during freeway lane change, secondary impact with concrete barrier. Defense argued 40 percent comparative fault for following too closely. Jury allocated 35 percent.
Injuries (paired codes):
V43.5XXA + M51.16 C5-C6 herniation, ACDF surgery; S06.0X concussion; S52.5 radius fracture from steering-wheel impact, ORIF.
Settlement range: $185,000 to $325,000. Gross value before comparative reduction approximately $285K to $500K; 35 percent fault reduction applied. At-fault carrier had $250K primary plus $1M umbrella. Defense pushed hard for 51 percent to invoke the bar.
Example 3: T-bone intersection crash, Bexar County (San Antonio)
Facts:
At-fault driver ran a red light at the Loop 410 / Bandera Road intersection, lateral impact at approximately 42 mph. At-fault driver carried Texas minimum $30,000 policy; plaintiff had $250,000 UIM on her own policy plus household stacking from a second vehicle.
Injuries (paired codes):
V43.5XXA + S06.2 moderate TBI with cognitive deficits, S32 pelvic ring fracture with surgical fixation, S22 multiple rib fractures.
Settlement: $530,000 (combined). $30,000 from at-fault driver's policy (tendered limits) + $500,000 from plaintiff's stacked UIM. True case value approximately $900,000+; collection ceiling was the available coverage.
The Policy-Limit Ceiling on V43.5XXA Cases
This is the structural difference between V43.5XXA and V44.5XXA cases. Truck cases sit on top of FMCSA-mandated $750,000-plus commercial policies; passenger-auto cases sit on top of Texas's $30,000-per-person minimum. The data on how this plays out in Texas:
- Roughly half of all moderate-to-severe V43.5XXA cases in Texas settle below their objectively calculated value because the policy limits are insufficient.
- About 14 percent of Texas drivers are entirely uninsured (Insurance Research Council estimates). This is one of the highest rates in the country.
- UM and UIM coverage is available under Texas Insurance Code Section 1952.106 and is generally stackable across multiple household vehicles, which is more permissive than many neighboring states.
- Where the at-fault driver has assets beyond the policy (real estate, business interests), a personal judgment can reach those. Where the at-fault driver is judgment-proof, your own UM and UIM is the only meaningful recovery source.
Stowers demand letters
Texas Legal Context for V43.5XXA Cases
- Statute of limitations: two years (CPRC Section 16.003). Six-month government tort claim notice if a public-entity vehicle is involved (Gov Code Section 101.101); TTCA caps $250,000 per person, $500,000 per occurrence (Section 101.023). See the Texas SOL page.
- Comparative fault (51% bar): modified comparative under CPRC Chapter 33. Recovery is reduced by your fault percentage if you are 50% or less at fault; recovery is zero if you are 51% or more at fault. See the Texas comparative-negligence page.
- Minimum auto policy: $30,000 per person, $60,000 per accident, $25,000 property damage (Texas Insurance Code Chapter 601 / TDI). UM and UIM available and stackable but not required.
- No pain-and-suffering cap: standard auto personal-injury cases have no statutory limit on non-economic damages. Caps apply only to medical malpractice (CPRC Section 74.301), exemplary damages (CPRC Section 41.008), and governmental defendants.
- No Texas equivalent to Proposition 213: uninsured Texas plaintiffs CAN recover non-economic damages. Texas Rule of Evidence 411 generally bars admission of liability-insurance status for the purpose of proving fault.
- No state income tax: lost-wage damages should be calculated on a gross basis without state-level after-tax adjustment, which typically increases lost-wage components by 5 to 9 percent compared to a state-income-tax jurisdiction.
CR-3 to ICD-10 Crosswalk (Texas-Specific)
Texas police use the TxDOT CR-3 crash report form to record crash circumstances, unit types, and manner-of-collision codes. Medical coders separately apply ICD-10-CM V-codes from the patient record. Two parallel code systems describing the same crash. The CR-3 unit-type codes for “passenger car” and “pickup truck” align with the V43 category, but CR-3 fault assignment by the responding officer is one input, not the final word; Texas juries apply CPRC Chapter 33 percentages independently.
Source: TxDOT crash reports and records, CR-3 form and instructions.
How a Texas Adjuster Reads V43.5XXA
V43.5XXA is the “baseline” transport code on a Texas auto-claim file. Severity-evaluation systems (Colossus, Liability Navigator, Claim IQ) use it as a low-severity baseline against which other codes are compared. Three adjuster behavior patterns specific to Texas V43.5XXA cases:
- Initial offers on V43.5XXA + S13.4 (whiplash) cases in Texas average 20 to 35 percent of eventual settlement value. The lowball pattern is consistent and documented; Texas Colossus profiles are calibrated tightly to the state's jury-verdict history and uninsured-driver rate.
- Treatment gaps over 30 days produce a sharp downward severity adjustment in Colossus. The system reads them as evidence the injury was minor or has resolved.
- Adjusters routinely attack the paired S-codes (downgrading S06.0X “concussion” to “post-concussive symptoms,” downgrading M51.16 “herniated disc” to “degenerative disc disease”) rather than the V-code itself. They also push comparative-fault percentages aggressively because of the 51% bar. See the Colossus settlement-software guide.
What to Do If V43.5XXA Is on Your Texas Bill
Confirm V43.5XXA matches what happened
Get the other driver's policy limit (and check for TNC)
Trigger your own UM and UIM if the limit is low
Treat without gaps
Decline recorded statements to the other carrier
Frequently Asked Questions
What does V43.5XXA mean on my Texas hospital bill?
V43.5XXA is the ICD-10-CM external-cause code for a car driver injured in a collision with another car, pickup truck, or van in a traffic accident, initial encounter. This is the single most common external-cause code on Texas auto claims because most crashes involve two passenger vehicles. It documents the crash type, not the injury and not who was at fault.
What is the average Texas car-vs-car settlement?
The typical Texas car-versus-car settlement falls in a $12,000 to $80,000 band for soft-tissue cases. Rear-end collisions usually settle between $8,000 and $50,000 (whiplash-dominant); T-bone collisions can range from a few thousand to $1.5 million depending on whether a TBI or spinal injury is paired with the V43.5XXA code. Severe cases with permanent injury reach $400,000 to $1,500,000+ and routinely tap the at-fault driver's policy limit, any available umbrella, and UM/UIM stacking. Catastrophic Texas car-vs-car verdicts have hit eight figures, including the $41M Currie v. Landry DUI head-on out of South Texas.
Why is V43.5XXA usually a lower-value code than V44.5XXA?
Two reasons. First, car-versus-car kinematic energy is lower than 80,000-pound heavy-truck collisions, so paired S-code severity tends to be lower. Second, and more importantly, the at-fault driver carries a passenger-auto policy, not an FMCSA commercial policy. Texas's minimum policy limit is just $30,000 per person, $60,000 per accident, $25,000 property damage under Texas Insurance Code Chapter 601 (the TDI 30/60/25 minimum); a serious V43.5XXA case can settle for the policy limit and still leave the plaintiff under-compensated.
What is the 51% bar and how does it apply to V43.5XXA cases?
Texas follows modified comparative negligence with a 51% bar under Chapter 33 of the Civil Practice and Remedies Code. If you are 50% or less at fault, your recovery is reduced by your fault percentage. If you are 51% or more at fault, you recover nothing. This matters more in V43.5XXA cases than in clearly-one-sided crashes because car-versus-car liability is often genuinely shared: lane changes, partial-fault rear-ends, intersection disputes. Defense counsel will fight hard over 40-percent and 50-percent fault allocations because pushing the plaintiff to 51 percent ends the case.
What if the other driver is uninsured?
Texas has one of the highest uninsured-driver rates in the nation (around 14 percent per Insurance Research Council). If you carry uninsured motorist (UM) coverage on your own policy, you file a UM claim against your own carrier under Texas Insurance Code Section 1952.106. UM and UIM stacking is generally permitted in Texas, so a household with multiple policies may have access to multiple coverage layers. Without UM or UIM, your direct recourse is a personal suit against the at-fault driver's individual assets, which is often a dry well.
What is Texas's statute of limitations on a V43.5XXA case?
Two years from the date of the crash under Texas Civil Practice and Remedies Code Section 16.003. If a Texas governmental entity is involved (a city car, a TxDOT vehicle, a school district vehicle), the Texas Tort Claims Act requires written notice within six months under Government Code Section 101.101, with caps of $250,000 per person and $500,000 per occurrence under Section 101.023. Missing either deadline ends the claim.
What if V43.5XXA was coded for a crash that happened while I was in an Uber or Lyft?
Rideshare crashes are coded as standard auto V-codes because ICD-10 does not have a separate transportation-network-company (TNC) code. The legal difference is the coverage stack. Under Texas Insurance Code Chapter 1954, an Uber or Lyft driver carries three coverage tiers: Period 1 (app on, no ride assigned) requires $50,000 per person, $100,000 per accident bodily injury and $25,000 property damage with $200,000 aggregate; Periods 2 and 3 (en route to pick up, or with rider in vehicle) require $1,000,000 in third-party liability plus $1,000,000 in UM/UIM. If V43.5XXA was coded during an active ride, you are typically dealing with a $1M layer, not a $30K one.
Does Texas have anything like California's Proposition 213?
No. California's Proposition 213 bars uninsured drivers from recovering non-economic damages in auto cases. Texas has no equivalent statute. An uninsured plaintiff in Texas may still recover both economic and non-economic damages, though defense counsel will sometimes try to use the absence of insurance for impeachment purposes; the trial court controls admission under Texas Rule of Evidence 411.
How long does a Texas V43.5XXA case take to settle?
Most V43.5XXA cases close in 4 to 18 months. Minor soft tissue cases (V43.5XXA paired with S13.4 whiplash, no surgery) often settle in 4 to 8 months. Moderate cases involving injections or extended physical therapy run 8 to 14 months. Severe cases requiring surgery, with paired M51.16 herniated disc or S06.0X concussion, generally take 12 to 24 months because settling before maximum medical improvement leaves significant value uncalculated and because the 51% bar puts a premium on fully developing the fault record.
Are V43.5XXA settlements taxable in Texas?
Compensatory damages for physical injuries and physical sickness are not taxable under federal law (26 USC Section 104(a)(2)). Texas has no state income tax, so there is no state-level layer at all on personal-injury compensatory damages. Punitive damages, interest on the settlement, and lost-wage components in certain structures may be federally taxable. IRS Publication 4345 is the controlling federal guidance.
Estimate your V43.5XXA settlement value
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