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Unrestrained Occupants: What Happens in a Car Crash

unrestrained occupant unrestrained child

Guest post Sean M. Cleary with edits and additions by Amie Durocher

You’ve probably seen families riding down the highway with small children who are not in a car seat and older children not wearing a seat belt. And you’ve probably wondered how do parents and caregivers get to a point where they compromise safety to this extent.

Maybe you remember when you were growing up, people were nowhere near as vigilant about car safety as today. Parents brought their babies home from the hospital in their arms, put babies in baskets on the floor of the car and kids even rode in the cargo area. (That was me.)

unrestrained occupant unrestrained child

What do laws require?

While seat belts were mandatory to be installed in cars in 1968, it wasn’t until 1984 that states started adopting laws that required using seat belts. Seat belt use first became mandatory in the state of New York. Over the next 11 years all other states, except for New Hampshire, adopted seat belt laws. However, only 31 states require all passengers to properly buckle in all seats. 18 states do not include adult passengers in the rear seat in the state’s seat belt law.

In 2013 Think Road Safety in United Kingdom put out some PSA videos showing what happens when a rear passenger doesn’t wear the seat belt. If you want a visual of what it looks like, watch this video entitled, “Like most victims, Julie knew her killer“. When this aired in the UK, the seat belt usage rate for back seat passengers increased astronomically as people finally considered the risk of an unrestrained passenger.

Meanwhile not using a proper child restraint is unsafe not to mention illegal in all 50 states. Even though all states have child restraint laws, they vary from state to state. It should be noted that car seat laws in some states are not nearly as stringent as best practice recommendations issued by the National Highway Traffic Safety Administration (NHTSA) and the American Academy of Pediatrics. Parent should consider the state laws as the very minimum in safety standards and follow best practice as closely as possible.

What Do the Statistics Say?

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Motor vehicle crash-related injuries are the number one cause of death for children in the U.S. In 2018, 636 child occupants under age 13 died in traffic crashes. Of those 191 were unrestrained and many others were inadequately restrained at the time of the crash.

In 2017, 675 children 12 years old and younger died in car crashes. Of the children 12 years old and younger who died in a crash in 2017 (for which restraint use was known), an average of 35% were not buckled up. Specifically, 49% of 8-12 year olds, 36% of 4-7 year olds and 22% of children less than 4 years old were not buckled up. The percentage is higher when you include improperly restrained children or children who were improperly sitting in the front seat.

While many people understand the life saving value of the seat belt, there are still about 10% who do not use one. In 2019 NHTSA found the national rate of use to be 90.7%. And according to a National Occupant Protection Use Survey, 90.4% of children age 8 and younger use a restraint. Restraint use is typically higher in states that have primary seat belts laws. (This means police can pull you over just for not wearing a seat belt.)

And adults in the back seat?

A 2016 IIHS survey shows of the 1,172 respondents only 72% said they always use a belt in the back seat. Whereas 91% said they always use one when they sit in the front seat. There are a few reasons why adults choose not to buckle up in the back seat. Among them are: they believe the back seat is safer so they don’t need to or they are taking a short ride in a taxi or ride share. Four out of 5 adults surveyed said short trips or traveling by taxi or ride share service are times they don’t bother to use a belt.

However, the laws of physics do not change for ride share services and taxis. They too can and do crash.

Although taxis are often exempt from car seat laws, ride share services, such as Uber and Lyft, are subject to the car seat laws in most states. Uber drivers can refuse or cancel a trip if children don’t have the proper restraints or the driver is not comfortable with you putting a car seat in their car.

Since you are most often legally required and it is safer, you should always buckle up and have your child properly restrained when using ride share services.

Seat belts and child restraints are the most effective tools available for decreasing injury and death in crashes. Seat belts reduce the chance of fatal injury by half for adults. NHTSA estimates that car seats reduce the risk of fatal injury by 71% for infants (younger than 1 year old) and by 54% for toddlers (1 to 4 years old) in passenger cars. (For infants and toddlers in light trucks, the corresponding reductions are 58% and 59%, respectively.)

Why Wouldn’t Parents Keep their Child Restrained?

“The answer could be a lack of awareness about the consequences of children riding unrestrained or the benefits of appropriate and correctly used restraints,” says Sean M. Cleary, a Miami car accident lawyer. And maybe even overconfidence that they have their child seated correctly while misusing a car seat or a booster seat. Overconfidence is a concern since parents might not seek out information on how to correctly restrain their child while driving in the car or have their car seat checked by a certified child passenger safety technician.

Download our report: Common Car Seat Mistakes and How to Fix Them

In addition, appropriate child restraint use may be, unfortunately, limited due to accessibility and cost, or could simply be impractical because of large family size.

Perhaps parents would be more likely to always properly buckle their children and themselves if they were more aware not only of legal requirements but more importantly what kinds of injuries can occur.

Unrestrained Occupants/Incorrectly Restrained Children: What Are the Risks?

Remember in any collision there are actually three collisions:

  • Collision 1: the vehicle. The vehicle hits an object, such as a tree or another vehicle.
  • Collision 2: the human and the interior. The people in the vehicle hit each other and the interior of the vehicle. Wearing a seat belt will reduce this as engineers designed the seat belt to keep the person in their seat.
  • And collision 3: the internal. Organs inside a person’s body may hit other organs, bones, or even the inside of the skull. The person may look fine but the liver, heart, or other organs may be torn, bruised, or bleeding inside. This is the most serious of the three types of collisions.

Never really thought about that did you?

Common Unrestrained Injuries by Type of Crash

The most common type of crash is a frontal crash. This means your car hits something head on.

Frontal Crash

In a frontal crash an unrestrained occupant tends to move in one of two ways while being thrown toward the point of impact, either up-and-over or down-and-under. What does this mean?

  • Down-and-under. The occupant continues to move downward into the seat and sliding toward the dashboard and steering column. The majority of the injuries will be to the lower extremities. For example dislocated knees and hips or fractures to the femur and tibia caused by the knee striking the underside of the dashboard. (This motion also happens while wearing a seat belt but with less movement. When you move down into the seat and slide somewhat under the lap portion of the seat belt is called submarining. This can be potentially harmful to a pregnancy.)
  • Up-and-over. The body’s forward motion carries it up and over the steering wheel. The head colliding with the windshield is often the first point of contact causing face and neck injuries. Unrestrained drivers also suffer chest and abdominal injuries from impacting with the steering wheel. And air bag injuries occur to the face, neck and chest.
Side Impact Crash

In side impact crashes, the crash energy throws unrestrained occupants toward the point of the impact first. So it depends on which side the occupant is sitting and which side is impacted. If the occupant is on the side closest to the impact, the unrestrained occupant collides with the side of the car and door before being thrown to the other side and potentially colliding with another passenger or door of the other side.

unrestrained occupant rollover injuries
Rollver Crash

In rollover, unrestrained occupants impact with the vehicle’s interior repeatedly, making them more likely to suffer injury. They are 14 times more likely to receive cervical spine injuries. They also are much more likely to be ejected from the vehicle than restrained occupants. Ejected occupants are four times more likely to die as those who remain inside. The seat belt’s number one job is to keep an occupant from being ejected. 75% of passengers who are totally ejected from the vehicle in a crash are killed.

In addition, unrestrained occupants inside a motor vehicle place the driver and other passengers, even belted passengers, at increased risk of injury. Studies show a 40% increased risk of injury to belted occupants from unrestrained occupants. Another passenger could be killed if struck by an unrestrained occupant who was catapulted forward, backward or sideways during a crash.(1) Unrestrained rear-seat passengers place themselves as well as their driver at great risk of serious injury when involved in a head-on crash. A good reason for ride share drivers to insist on passengers wearing their seat belts. (2)


Again unrestrained occupants are more likely to be injured as they collide with the vehicle repeatedly. Unrestrained occupants can also be thrown from the vehicle during a spin.

Child specific injuries

In the event of sudden braking or collision, an unrestrained child can be thrown against the car interior or ejected from the vehicle. Moreover, small children are susceptible to injuries even in low-impact accidents.

At birth, an infant’s skull is very flexible, so a relatively small impact can result in significant deformation of the skull and brain. The infant rib cage is also very soft and flexible. Therefore, even a minor impact to the chest can result in an injury where the chest wall is compressed onto the heart, lungs and some of the abdominal organs.

Because the bone-forming process is not complete until the age of 6 or 7 years old, a child’s skull remains less strong than that of an adult and more susceptible to injury.

On the other hand, the use of improper restraints, such as an adult restraint system, may itself injure the child during a car accident. An infant’s joint hasn’t formed properly and the pelvis has not become stable and cannot withstand the forces from an adult restraint system. For a child between 4-6 years of age, if the adult belt is too high across the stomach, a serious internal injury could result in a crash, or the child could slide under the seat-belt.

most common car seat mistakes

Some Common Car Seat Misuses that Lead to Dangerously Incorrectly Restrained Children

The actual percentage can vary by the year, location and study, but car seat misuse is roughly 75%. Now this could be something minor that may not make much of a difference in a crash. Or it could be something more serious that will dramatically change the results of a crash.

  • Loose car seat installation. The danger is that a child in a loose seat could crash into the back of the front seat, seriously injuring their head or face. Or if rear facing the seat can over rotate down. In this case the child’s neck could elongate as it’s no longer being cradled by the seat. Rebound actions on the seat will also change, creating more opportunity for injury.
  • Loose harness or having thick materials between child and harness straps (like a winter coat). A child who’s loose in their harness can potentially come out of the seat in a crash. Then the child would be an unrestrained occupant which can lead to being ejected from the vehicle altogether.

Liability for Unrestrained Child Injuries

Breaking the seat belt law can result in fines of $10 to $200 dollars. Breaking a state’s car seat law, on the other hand, can result in fines of $10 up to $500.

Parents’ legal duty is to comply with state car seat laws and properly restrain child passengers on every drive. In the event of an injurious car accident, the failure to comply with seat belt and car seat laws could result in traffic citations and lead to financial responsibility for damages.

Normally the at-fault party’s insurance will pay your insurance claim when you are injured in a crash. However, if you or your child were injured in a car crash while you or your child were not properly buckled, the insurance company — or court if it goes to that — will likely interpret it as negligent on your part. The insurance company can reduce the amount they pay for your injuries by a percentage that reflects your degree of fault for failing to wear a seat belt.

If you were at fault for the crash and you did not properly wear your seat belt or restrain your child, the insurance company could refuse the claim or the courts may not reward damages.

Because it breaks the law, not properly restraining a child may qualify as negligence or negligence per se. Negligence per se means there is no other proof of negligence necessary. The negligent parent may also face criminal charges if the state deems their actions as criminal.

As the driver, make sure all adults and teens buckle up. And as the parent, always buckle your children in age- and size-appropriate child restraints and seat belts for their safety and your peace of mind.

We want to hear from you. Do you ever not wear a seat belt or let your child go without a proper restraint? (1 in 5 parents admit to “bending the rules” during carpools.)

Sean M. Cleary is the principal attorney and founder of The Law Offices of Sean M. Cleary, a personal injury law firm based in Miami, Florida. Sean represents the families of children severely injured in car accidents, product liability and medical malpractice cases.

Edited by Amie Durocher, Creative Director at Safe Ride 4 Kids and certified CPS Tech since 2004

Copyright 2020 Safe Ride 4 Kids. All rights reserved. You may not publish, broadcast, rewrite or redistribute this material without permission. You are welcome to link to Safe Ride 4 Kids or share on social media.

© dima_sidelnikov | depositphotos
© poringdown | depositphotos


  1. My 11-year-old grandson was in a car accident I don’t believe he had a seatbelt on but I’m not sure he is in ICU That’s why I don’t believe he didn’t have a seatbelt on he has broken bones in his face he has a bruise on his brain and we’re not sure about him internal injuries yet. Will this driver, which is not his parent or legal guardian, be charged with child endangerment?

    1. Hi Linda, Oh no. I do hope your grandson will be OK. We are certified child passenger safety technicians and not lawyers so we cannot give legal advice. I’m sure it will depend on the specific details of the crash if any driver will be charged with anything. This is an article on our site written by an attorney which may give you some more information: If Your Child Is Injured Riding in Someone Else’s Car? But I would suggest contacting the parent’s insurance company and/or a lawyer.

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