Missouri attorney James Roswold has spent more than three decades observing how the state’s crash-response systems work — from insurance practices to medical billing processes to the challenges that everyday Missourians face when navigating life after a collision. His interest in injury cases began early in life, after witnessing the long-term impact a medical malpractice injury had on his older brother and on his family. That experience shaped his perspective on how ordinary people interact with complex systems during some of the most difficult moments of their lives.
After graduating magna cum laude from the University of Minnesota’s Carlson School of Management and earning his law degree with distinction from the University of Iowa College of Law, Roswold began his career at a defense firm, gaining insight into how insurance claims are evaluated and managed. He later shifted his career toward understanding the broader challenges injury victims face in both Kansas and Missouri, with a particular focus on how institutional and administrative processes affect outcomes.
Today, Roswold studies the patterns he sees in Missouri crash cases — not from a commercial lens, but from the standpoint of someone who has watched thousands of families interact with medical providers, insurers, and state-level systems. In this interview, he discusses the most persistent issues he observes and why these challenges continue to affect Missourians long after a collision occurs.
Q: From your experience watching Missouri cases unfold over several decades, what is one of the earliest challenges people encounter after a crash?
James Roswold: One of the first challenges is the speed at which insurance companies request information. People are still trying to make sense of what happened, but insurers often reach out very quickly. That timing can catch people off guard. They’re processing a stressful event, yet they’re suddenly in an administrative conversation they didn’t expect to be in so soon.
Q: You’ve talked before about delayed injuries. Why is that a recurring issue in Missouri?
Roswold: Many injuries from crashes don’t appear right away, and that’s something people are often surprised by. Adrenaline, shock, and the way soft-tissue and neurological injuries behave can delay symptoms. In Missouri, like everywhere, people often try to return to work or normal routines quickly, which can mask things that might need attention.
Q: How does Missouri’s comparative fault system add complexity?
Roswold: Missouri uses a comparative fault model, which means responsibility can be divided between the drivers based on percentages. Even when someone believes they played no role in the crash, they may still find themselves navigating conversations about partial responsibility. It can be confusing because people tend to think of fault as an all-or-nothing concept.
Q: You’ve mentioned that medical billing and payment systems can be overwhelming for crash victims. What makes it so complicated?
Roswold: Missouri has multiple layers involved in post-crash medical billing — private health insurance, hospital billing departments, potential liens, and reimbursement processes. People expect a straightforward path, but the reality is that these systems weren’t built to communicate seamlessly with each other. So individuals end up acting as intermediaries without having any background in the process.
Q: Financial stress seems to appear early for many people after a collision. Why does it escalate so quickly?
Roswold: A crash often disrupts someone’s normal life immediately. If their job requires physical activity, even a mild injury can force them to take time off. Household costs continue, medical expenses begin, and people are trying to manage all of that while still recovering physically and mentally. It’s a demanding combination of pressures.
Q: How does social media complicate crash-related issues today?
Roswold: Social media has introduced a new layer to how incidents are perceived. Posts and photos can be taken out of context, and people sometimes underestimate how public content may be interpreted by others involved in the claims or investigative process. It’s a modern complication that didn’t exist a generation ago.
Q: What long-term issues do people tend to overlook?
Roswold: People often think only about the immediate aftermath of a crash. But physical symptoms, financial strain, or emotional stressors can show up much later. One of the most consistent patterns I’ve seen is that the long-term effects are harder to predict than the short-term ones.
Q: After decades of observing these cases, what stands out most about how Missourians handle the aftermath of a crash?
Roswold: What stands out most is how resilient people are, even in the face of complex systems and unexpected obstacles. The challenges are real, but so is the determination people bring to navigating them. Missouri has a strong culture of looking out for one another, and I see that reflected in how families support each other after a crash.
