How a Pre-existing Condition Affects Your Personal Injury Claim

UPDATED: Jul 17, 2023Fact Checked

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Jeffrey Johnson

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Jul 17, 2023

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UPDATED: Jul 17, 2023Fact Checked

If you suffer an injury in a car accident, the insurance company for the party at fault will process your injury claim. In doing so, the insurance company can argue that any injury incurred during the accident was the result of a pre-existing medical condition. If they suspect the nature or severity of your injury is due to a pre-existing condition, the insurance company may legally demand your medical history with a subpoena and identify any previous injuries similar to the one suffered in the car accident. If the insurance company can prove that you had a pre-existing condition that contributed to your current injury, then your recoverable damages may be reduced.

If you have injuries similar to the one you suffer in a car accident that you’ve incurred in the past, it does not mean that the driver at-fault can escape liability by pointing to a pre-existing condition. However, you may end up having to defend your current injury as being caused by the car accident. This can be done through a thorough review of your medical records, and possibly via testimony provided by a doctor or other expert witness. If your medical records show that the injury or condition was completely healed, you will usually have no difficulty demonstrating that the injury was not pre-existing.

Even if you have a pre-existing condition similar to the one suffered in the car accident, the defense still has the burden of showing that the pre-existing condition had a causal relationship to the current injury. This is also done through doctor’s testimony. Sometimes, during the treatment for an injury incurred by a car accident, a doctor will discover a degenerative condition, like arthritis, that was not on your record before. In this context, the arthritis would most likely be considered an incidental finding, and would probably not limit your recoverable damages. You will need to be prepared to defend your medical history and demonstrate that the current injury you suffer was primarily due to the car accident, and not a pre-existing medical condition.

Insurance companies will do the best they can to limit the amount they pay out for your damages after a car accident, and you should not try to challenge them alone. If you are in a car accident, you should contact an auto accident attorney right away, so that you can ensure the best recovery for your injuries.

Case Studies: How Pre-existing Conditions Affect Personal Injury Claims

Case Study 1: The Impact of a Pre-existing Condition

Sarah had a pre-existing back injury from a sports accident several years ago. Recently, she was involved in a car accident where she suffered additional back injuries.

The insurance company representing the at-fault driver argues that her current injuries are not solely caused by the accident but are a result of her pre-existing condition. They subpoena Sarah’s medical history to identify any previous similar injuries and attempt to reduce her recoverable damages based on the pre-existing condition.

Case Study 2: Defending Against a Pre-existing Condition Defense

Mark had a previous knee injury from a workplace accident. Mark was driving when another driver ran a red light and collided with his vehicle, causing him to sustain a new knee injury.

The driver’s insurance company argues that Mark’s current knee injury is related to his pre-existing condition. To prove that the accident caused the new injury, Mark must provide a thorough review of his medical records, possibly including testimony from a doctor or expert witness.

Case Study 3: Establishing Causal Relationship and Overcoming Incidental Findings

Emily had a history of neck pain due to a previous car accident. She is involved in another car accident and suffers a severe neck injury. During her treatment, the doctor discovers that Emily has developed arthritis in her neck, which was not present in her previous medical records.

The defense argues that the arthritis is the primary cause of her current injury, not the recent accident. Emily needs to defend her medical history and demonstrate that the accident significantly contributed to her current injury, despite the incidental finding of arthritis.

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Jeffrey Johnson

Insurance Lawyer

Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

Insurance Lawyer

Editorial Guidelines: We are a free online resource for anyone interested in learning more about legal topics and insurance. Our goal is to be an objective, third-party resource for everything legal and insurance related. We update our site regularly, and all content is reviewed by experts.

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