One way in which an insurance company may try to avoid paying you during a personal injury lawsuit is by bringing up a pre-existing condition. Note, however, that a pre-existing condition alone will not bar you from financial recovery in an injury suit. If you have a pre-existing injury, it is important to prepare for hurdles during your injury claim. With the right strategy and legal assistance, you can successfully counter a pre-existing injury defense.
What Is a Pre-Existing Condition?
A pre-existing condition refers to any medical condition, injury or illness that you had prior to the accident for which you are currently pursuing financial compensation. Although any pre-existing medical condition can make it more difficult to recover fair financial compensation during an injury suit, some conditions are more likely to lead to challenges than others. These include:
- Back problems
- Herniated disks
- Degenerative disk disease or arthritis
- Neck stiffness or soft-tissue injuries
- Joint problems
- Prior broken bones
- Prior head or brain injuries
- High blood pressure
- Diabetes
- Fibromyalgia
- Cardiovascular problems
These are conditions that may get worse because of your accident or trigger more serious injuries and symptoms related to an accident injury. A pre-existing condition does not, however, bar you from financial recovery for a preventable accident in Albuquerque.
Can an Insurance Company Deny Your Claim Because of a Pre-Existing Condition?
Having a pre-existing condition does not disqualify you from filing a claim or receiving financial compensation. Although you cannot blame your pre-existing injury on the accident, if the accident exacerbated your pre-existing condition or vice versa, you could still recover financial compensation for your current health state from one or more defendants. The legal doctrine that applies to these situations is called the Eggshell Skull Rule.
The Eggshell Skull Rule states that a defendant must take a plaintiff as he or she is at the time of the accident. This means that even if the plaintiff had a pre-existing condition (such as a skull as thin as an eggshell) that will make the losses related to the accident more severe, the defendant will be liable for the full extent of the plaintiff’s injuries and damages. A defendant cannot use a plaintiff’s pre-existing injury to avoid liability for an accident.
How to Handle a Claim Involving a Pre-Existing Condition
It is critical to disclose any pre-existing conditions during an injury claim. Failing to do so could make you ineligible for insurance benefits. Unfortunately, many insurance companies try to use claimants’ pre-existing conditions against them to try to diminish or reject benefits. Be prepared for this issue during your claim.
You may face complications related to your pre-existing injury that you or your personal injury lawyer will have to overcome. For example, you may have to prove that the injury for which you are seeking financial compensation is not something that you had before the accident. One way you can avoid this particular issue is by refusing to sign any type of Medical Authorization Release Form given to you by the insurance company.
These release forms often give insurance companies full access to a claimant’s medical history, giving the insurer the opportunity to search for pre-existing conditions to try to find a reason to deny the claim. Instead of signing, work with an attorney to only give the insurance company copies of those medical records that are relevant to your current case.
If the insurance company offers a settlement that you believe is too low for your current and future estimated medical expenses (especially if you have new costs related to a pre-existing injury), take the offer to an attorney for review. The insurance company may be unfairly diminishing the value of your claim based on a pre-existing condition. A lawyer can help you negotiate with an insurance company for fair financial compensation, even with a pre-existing injury.