Obtained a policy limits liability plus substantial underinsured motorist (UIM) settlement for the driver of an SUV whose vehicle was rear-ended by a tractor-trailer. The impact fractured and dislocated his shoulder. The ER doctor missed the dislocation, and when the worker’s compensation doctors were slow to recognize the severity of the condition, we referred him to an orthopedic surgeon who performed surgery to repair shoulder and affix with 15 screws. Two screws migrated, requiring surgical removal. Shoulder has deteriorated further, and evidence is that client will eventually require total shoulder replacement.