V44.5XXA: Car-vs-Truck Crash in Tennessee Settlement Value

ICD-10-CM external-cause codes (the V chapter, V00 through V99) describe how a person was injured during transport. They are not diagnoses; they are circumstance codes attached to the actual injury codes. Reading V44.5XXA character by character:

• V44: car occupant injured in collision with heavy transport vehicle or bus (the category).
• .5: the injured person is the car driver, and the crash occurred in traffic (not a parking lot, driveway, or other non-traffic location).
• XX: two placeholder characters so the seventh character (the encounter character) lands in position 7.
• A: initial encounter. The patient is being seen for active treatment. Follow-up becomes D; long-term sequelae become S.

Closely related codes a Tennessee coder may use on the same chart: V44.6XXA (passenger rather than driver), V44.7XXA (person on the outside of the car), and V44.9XXA (unspecified occupant). The non-traffic (parking lot, driveway) variants live at V44.0 through V44.3.

V44.5XXA covers the full range of car-driver-versus-heavy-vehicle traffic collisions. The five patterns we see most often in Tennessee cases:

V44.5XXA never appears alone on a complete record. The dollar value of the claim flows almost entirely from the paired S-codes describing the actual injuries. Common Tennessee pairings and the SetCalc guides that go deeper:

• Cervical sprain (S13.4): the most common pairing in non-catastrophic V44.5XXA cases. See the whiplash settlement guide.
• Herniated disc (M51.16 cervical / M51.26 lumbar): high-energy lateral impact. See the Tennessee back injury settlement guide.
• Traumatic brain injury (S06.0X through S06.9X): the single most value-driving pairing. See the TBI settlement guide.
• Fractures (S22, S32, S72, S82): ribs, lumbar, femur, and tibia from underride and crush mechanisms. See the broken bone settlement guide.
• Spinal cord injury (S24 cervical / S34 lumbar): the highest-value pairing; lifetime care costs alone routinely exceed $5 million in uncapped economic damages.

The pairing matters far more than the V-code itself. Two TN V44.5XXA cases can settle for $50,000 and $25 million respectively depending entirely on the paired S-codes.

Tennessee sits at the geographic crossroads of the U.S. freight network. Memphis hosts one of the largest freight hubs in the country (FedEx Express superhub, UPS regional, BNSF and CSX intermodal). Knoxville is a major I-40 east-west exchange. Nashville is a national distribution node. The high-volume truck corridors:

• I-40: cross-state east-west; Memphis to Nashville to Knoxville to the NC line. National freight artery. Includes the Pigeon River Gorge stretch in East TN, a documented fatal-truck-crash zone.
• I-65: north-south through Nashville (Louisville to Birmingham corridor). Heavy automotive supply-chain traffic.
• I-75: Chattanooga to Knoxville, continuing into Kentucky. Steep grades near Caryville and Jellico produce brake-failure and run-off-road truck crashes.
• I-24: Nashville to Chattanooga. The Monteagle Mountain grade is a 6-percent, 4-mile descent and a notorious runaway-truck zone with a dedicated escape ramp.
• I-81: Northeast TN (Bristol and Kingsport) to Virginia and Pennsylvania. Primary corridor for Northeast-to-Southeast freight.
• I-26: connects I-81 in Northeast TN to Asheville and the Carolinas. Mountain grades; documented serious truck-crash incidents.

Venue strategy in a TN V44.5XXA case often comes down to which county a corridor crosses: Davidson (Nashville), Shelby (Memphis), Knox (Knoxville), Hamilton (Chattanooga), Sumner, Williamson, and Rutherford counties for the Nashville suburbs.

The single largest difference between a TN V44.5XXA case and the otherwise identical V43.5XXA car-versus-car case is the size of the policy on the other side. Federal Motor Carrier Safety Administration rules at 49 CFR Section 387.9 require:

• $750,000 per occurrence for general freight in interstate commerce (vehicles over 10,001 lbs)
• $1,000,000 per occurrence for non-bulk hazmat (gasoline tankers under 3,500 gallons, certain corrosives)
• $5,000,000 per occurrence for bulk hazmat, Class A and B explosives, certain radioactive materials, and bulk tanks over 3,500 gallons

These minimums were set by the Motor Carrier Act of 1980 and have not been adjusted for inflation; $750,000 in 1980 is roughly $2.8 million in today's dollars. Many national fleets carry $1 million primary plus $5 million to $25 million in excess layers as a practical matter. Compare with Tennessee's passenger-auto minimum of $25,000 per person under TCA Section 55-12-102. A moderate-severity case that would “cap out” at a $50,000 auto policy in a car-versus-car crash can recover 10 to 20 times that amount when V44.5XXA is on the chart.

For intrastate-only TN carriers, TCA Section 65-15-111 adopts the FMCSR by reference, so the same insurance, hours-of-service, ELD, and driver- qualification framework applies. The MCS-90 endorsement on the carrier's policy is a federal financial-responsibility filing that obligates the insurer to pay regardless of policy exclusions when liability falls within the federal scheme.

Settlement ranges reflect SetCalc analysis of Tennessee court records and confirmed settlements involving car-versus-heavy-truck traffic collisions, 2025 to 2026. The bands track injury severity rather than the V-code itself.

Source: SetCalc analysis of Tennessee verdicts and confirmed settlements, 2025 to 2026. The $750,000 / $1,000,000 non-economic cap at TCA Section 29-39-102 constrains pain-and-suffering recovery; the catastrophic-band totals are driven by uncapped economic damages (medical, future care, life-care plan, lost earning capacity) and properly-pled punitive damages under TCA Section 29-39-104. See the verdict and settlement database for case-by-case comparables.

Three representative Tennessee case profiles that would carry a V44.5XXA code on the medical chart. Two are drawn from public Tennessee verdicts and filings; the third is a composite that reflects ranges seen for similar fact patterns.

• Statute of limitations: one year from the crash date under TCA Section 28-3-104(a)(1)(A). Extended to two years under Section 28-3-104(a)(2) if criminal charges are brought against the truck driver. GTLA deadlines apply if a public-entity bus or TDOT vehicle is involved.
• Comparative fault: 49% bar modified comparative under McIntyre v. Balentine. See the Tennessee comparative negligence page.
• Non-economic damages cap: $750,000 standard, $1,000,000 catastrophic, TCA Section 29-39-102. Economic damages (medical, future care, life-care plan, lost earnings) uncapped.
• Punitive cap: TCA Section 29-39-104. The cap was struck on federal-law grounds in Lindenberg v. Jackson National (6th Cir. 2018) and remains the subject of ongoing constitutional litigation; current TN practice still pleads within the cap framework.
• Several liability only: TCA Section 29-11-107.
• FMCSA federal minimum: 49 CFR Section 387.9 ($750K / $1M / $5M).
• TN intrastate carriers: TCA Section 65-15-111 adopts FMCSR by reference. Same federal HOS, ELD, and insurance framework applies.
• Negligence-per-se for FMCSR violations: TN follows the standard four-element framework. ELD log violations, HOS breaches, and maintenance lapses routinely support negligence-per-se and may open punitive-damages exposure.
• Dead-man's statute: TCA Section 24-1-203. Plaintiff cannot testify to statements by a deceased trucker against the trucker's estate absent waiver; work around via ELD, dash-cam, bystander witnesses.

Carrier severity-evaluation systems (Colossus, Liability Navigator, Claim IQ) ingest diagnosis and external-cause codes from the medical records as scoring inputs. V44.5XXA specifically flags the case as a higher-severity transport crash. Three things to know:

• V44 (heavy transport) scores higher than V43 (car-on-car) or V47 (fixed object) at the same injury level. The kinematic energy involved in an 80,000-pound impact is fundamentally different from passenger-car collisions; adjuster severity software is well-calibrated to this.
• Commercial carriers, not personal-line carriers, control TN truck cases. Tennessee Farmers Mutual, State Farm, and Allstate may handle the car driver's UM/UIM, but the at-fault side is typically Sentry, Great West, Old Republic, National Indemnity, or a captive commercial layer. These carriers have dedicated trucking adjusters and house counsel familiar with TN venue patterns.
• The 7th-character A tells the system treatment is still ongoing. Cases with only A codes and no follow-up D codes after 30 days are flagged as “treatment-gap” cases and discounted. V-codes alone do not generate a settlement number; they modulate severity scoring for the paired S-codes. Defense lowball tactics typically attack the S-codes (downgrading S06.0X “concussion” to “post-concussive symptoms”) rather than the V-code, which is rarely disputed.

Read more about how severity scoring works in our Colossus settlement-software guide. For deeper coverage of TN trucking practice, see our Tennessee trucking accident settlement guide.