Possibly. Moreover, they may even do so before your personal injury attorney has to sue. However, you will likely need to for a few things to happen for the car insurance company to voluntarily pay the $1 million BIL limit without a lawsuit. First, you will likely need moderate to significant damage to the car(s) involved in the accident. Second, it will help your chances if the total medical billed charges are high. Also, your chances of getting the $1 million limits are higher if the BIL insurer is an: Out of state insurer that doesn't sell insurance in Florida; or Excellent paying insurance company like Nationwide, Hartford and a few others. But don't get too excited. As you'll see below, Nationwide has taken fusion cases to trial. So get an attorney immediately. In one claim, an out of state car insurance company paid $1 million to settle a Florida car accident claim where the injured person had a back fusion surgery. That wasn't my case. Additionally, I've heard of Nationwide Insurance Company paying close to the $1 million BIL limits in a back fusion surgery claim. Nationwide Companies operate under the following names: Colonial County Mutual Insurance Company Freedom Specialty Insurance Company National Casualty Company Scottsdale Indemnity Company Scottsdale Surplus Lines Insurance Company Western Heritage Insurance Company Scottsdale Insurance Company You can breathe a sigh of relief if your need for a fusion surgery was caused by someone insured with one of the above Nationwide Insurance companies. That said, you will still likely need an personal injury attorney to get fair settlement value for your case.