When the case is settled and the defendant is released, it's all over. You will not be asked to refund any of the money if you make a sudden miraculous recovery. And the case can not be reopened no matter how much worse your condition later becomes. Unlike workers compensation, future medical is not left open. After settlement or trial the defendant and his or her insurer will have no obligation to pay for your continuing medical expenses, so it's important that your settlement is adequate. In some six figure and higher recoveries you may prefer for tax reasons to accept a structured settlement of periodic payments over a number of years, but you will not be forced to do so.