In personal injury cases, victims often seek compensation for injuries caused by someone else’s negligence.
Whether it’s a car accident or a slip and fall, the goal is to secure financial support for medical expenses, lost wages, and pain and suffering.
However, the claims process isn’t always straightforward, especially when the injured party has a pre-existing condition.
Insurance companies frequently examine an injured person’s medical history to determine if the claimed injuries are entirely new or if they existed before the accident. If they find evidence of a pre-existing condition, they may argue that the injury wasn’t caused by the accident or was made worse due to prior issues. This tactic can complicate the process of securing fair compensation.
Personal injury lawyers play a critical role in navigating these challenges. They help clients present clear evidence showing how the accident worsened their condition or caused new injuries. Understanding what constitutes a pre-existing condition and why it’s used as a defense can make the claims process easier to manage.
What is a Pre-Existing Condition?
A pre-existing condition refers to any health issue or injury that a person had before the incident in question. These conditions can range from minor injuries to chronic illnesses.
In personal injury claims, insurance companies often investigate whether a victim’s current complaints are related to a prior condition.
Examples of pre-existing conditions include:
- Back pain or injuries from a previous accident
- Chronic conditions such as arthritis
- Neck or shoulder injuries
- Prior surgeries or medical treatments
It’s important to note that having a pre-existing condition doesn’t disqualify someone from pursuing a personal injury claim. Instead, it requires demonstrating how the accident worsened the existing condition or caused additional harm.
Why Pre-Existing Conditions Might Be Used as a Defense
Insurance companies are always looking for ways to minimize payouts. One common strategy is using a pre-existing condition as a defense to reduce or deny a claim. By arguing that the injuries were not caused by the accident, they attempt to shift responsibility away from their insured party.
Reasons this defense is used:
- Causation Issues: They argue the injury was not caused by the accident but was a pre-existing problem.
- Severity Disputes: They claim the accident did not worsen the condition significantly.
- Medical History Evidence: They use prior medical records to show the victim was already dealing with the same issue.
For example, if someone with a history of back pain is injured in a car accident and claims compensation for back-related injuries, the insurance company may argue the pain existed long before the accident.
Some Common Pre-Existing Conditions Used by Insurance Adjusters
Insurance adjusters often focus on specific conditions that are easier to link to prior medical history. These conditions are commonly cited in defense strategies because they’re difficult to attribute entirely to the accident.
Common pre-existing conditions include:
- Back Injuries: Chronic back pain or previous herniated discs are often scrutinized.
- Neck Issues: Whiplash-related injuries may be dismissed as recurring problems.
- Arthritis: Joint pain and stiffness are frequently attributed to degenerative conditions.
- Knee and Shoulder Problems: Previous surgeries or injuries in these areas may be used to deny claims.
- Mental Health Conditions: Pre-existing anxiety or depression may be cited to downplay emotional distress claims.
Victims should be prepared to provide clear evidence, such as recent medical evaluations, to show how the accident aggravated their pre-existing condition.
Conclusion
A pre-existing condition can complicate a personal injury claim, but it doesn’t mean the victim cannot recover compensation. Understanding what qualifies as a pre-existing condition and how it may be used as a defense can help injured individuals prepare for potential challenges.
With the guidance of a top personal injury lawyer, victims can present a strong case that demonstrates how the accident caused new injuries or worsened an existing condition. These professionals ensure that insurance companies don’t unfairly dismiss valid claims, allowing injured individuals to focus on recovery and move forward with their lives.
