How a Preexisting Condition Can Impact Your Accident Claim

By Aghabegian & Associates on June 23, 2021

One of insurance adjusters’ favorite ways to devalue or deny personal injury claims is to state that your injuries were caused by a preexisting condition. They may argue that you were injured at work or while playing a sport, or that your injuries are due to age. Their goal is to convince you to accept a small settlement or to avoid fighting back altogether, but this is a mistake.

Having a preexisting condition does not automatically prevent you from recovering compensation in an accident claim. In fact, with the help of a skilled attorney, you may be able to prove that the at-fault party worsened your condition and owes you full compensation for your trauma.

How Insurance Companies View Preexisting Conditions

In this country, you’ll most often hear about “preexisting conditions” during health insurance debates, but all insurance companies, including auto, homeowners, and commercial liability, can use preexisting conditions to deny a claim.

For example, let’s say that you suffered a slipped disc in a car accident caused by a drunk driver. After seeing a doctor and getting treatment, you initiate a claim with the drunk driver’s insurance company. You assume that the insurance adjuster will offer a fair deal, and you’re surprised that they bring up your work history. Since you worked in a physical industry (let’s say construction), the insurance adjuster tells you that any back pain you have after your crash is due to your job, not the crash. Based on this argument, they try to convince you to accept a smaller offer, arguing that your back pain is unrelated to the collision and you shouldn’t be given money for long-term treatment.

Even if your medical history shows that the collision directly caused your injury, the insurance adjuster will still try to connect it to another preexisting injury. They can bring up your job history, sports, age, prior surgeries, or other unrelated events as the cause of your trauma. This tactic is especially common with older plaintiffs, but there are ways for you to fight back and get full compensation for your injuries.

Is an Insurance Adjuster Asking for Your Medical Records? Talk to a Lawyer First

Insurance adjusters usually learn about preexisting conditions by accessing a claimant’s medical records. Legally speaking, insurance companies can only access these records with the claimant’s consent. However, they may refuse to provide compensation or consider a claim until the claimant signs a document that says the adjuster can access his or her medical records.

This is a major mistake. Do not give consent. If an insurance adjuster asks for your medical records, you should talk to a lawyer about your rights. When you sign away your privacy rights, an insurance adjuster may be able to access older records that show you have a preexisting condition or prior injury. When it comes time to negotiate your payout, they may use these old medical records to say your injury was unrelated to the accident.

For most personal injury claims, you will have to share your medical records with the insurance adjuster, but your attorney can go through your records, decided which ones are relevant for your case, and only send over the necessary copies to the adjuster. If the adjuster asks for older records, your attorney can stand up for you and fight to maintain your privacy.

Let’s Talk About the Egg-Skull Rule

It may have surprised you to learn that a preexisting condition will not prevent you from recovering compensation in a personal injury claim. This is because of a legal doctrine called the Egg-Skull Rule. Under the Egg-Skull Rule, the at-fault party is liable for all injuries suffered by a victim who files a personal injury claim, including injuries that were exasperated by the accident.

Let’s go back to the slipped-disc scenario. Say you did have a prior injury due to your job. If the car accident worsened your back pain, then the other driver is responsible for making your injury worse. Defendants in personal injury claims do not get to pick and choose how their negligent actions affected the plaintiffs. Instead, defendants must “take them as they are,” including any preexisting conditions.

How to Get Full Compensation for an Accident

If another person did something to aggravate a prior injury of yours, you should carefully document how the accident has made your condition worse. Medical records and doctors’ notes may show that you lost mobility as a result of this person’s actions, and you should also document how much pain you are dealing with in a journal. Family, friends, and coworkers can also testify as to how your injuries have affected your day-to-day life, such as your ability to enjoy your hobbies.

Throughout all of this, it is important to have an experienced Glendale personal injury attorney at your side. At Aghabegian & Associates, PC, our legal team has more than 40 years of combined experience and has recovered more than $125 million for clients throughout Los Angeles County. We work on a contingency-fee basis, meaning there is no upfront cost to hiring us. We only get paid when you do.

To discuss your injuries in a free consultation, call us at (818) 507-4311.