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Iowa appeals court upholds no recovery after surgery replaces therapy
The ruling said the injured driver’s cut short conservative care, leaving her with more than $56,000 in medical bills but no payout under Iowa’s mitigation rule.
An Iowa Court of Appeals ruling upheld a jury verdict that left an injured motorist with zero recovery after she chose surgery over recommended physical therapy and injection treatment, even though the other driver admitted fault in a 2019 crash near Des Moines, according to Insurance Business.
The appeals court, dated August 19, 2026, found the key issue was failure to mitigate. The injured driver had long-term right hip problems with multiple surgeries dating to 2010, went about six years without hip treatment before the November 2019 collision, and doctors had urged starting with a corticosteroid injection and then eight weeks of physical therapy twice a week.
Insurance Business reports the injection reduced her pain by about 60%, but she stopped therapy after three weeks and pushed for surgery despite surgeons warning she had only a 50% to 60% chance of improvement given her prior procedures. Her surgery lasted four hours, involving cutting and rotating the femur and securing it with a custom metal plate and eight screws.
The medical bills for the operation and related care totaled more than $56,000, which was more than 90% of her total medical claim, while barely $3,200 went to the conservative treatment she discontinued. The jury attributed 75% of the fault to her for failing to mitigate, and the court rejected her arguments on appeal, including that the mitigation defense lacked evidence and that jurors should have been instructed that patients can choose among reasonable treatments.