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Insurance Games: The “Pre-Existing Condition” Argument

The personal injury attorneys at Schultz & Myers Law Firm recently helped our client obtain an offer from the insurance company which was 400% of the initial offer.

We were representing a client who was injured when a vehicle tried to cross her lane of traffic on US 61 North. Our client struck the driver’s side of the crossing vehicle, and both cars were totaled.

Our client was injured in the crash, but the insurance company for the at-fault driver initially offered to cover less than half of her medical expenses. The insurance company for the at-fault driver saw our client’s medical history as an opportunity to save themselves a few dollars. The attorneys at Schultz & Myers didn’t fall for their games.

When the Accident Exacerbates a Pre-Existing Medical Condition

If you are injured in an accident and make a claim, the insurance company will always make a big deal out of your prior medical history and any pre-existing medical conditions. This leads many people who are injured in accidents to believe that they aren’t entitled to compensation for those injuries. This is simply not true. While it can complicate matters, having a pre-existing medical condition won’t keep you from getting your bills paid.

That is–as long as you don’t fall for the insurance company tricks.

pre existing condition

If the insurance company can get you to give a recorded statement, (We can’t say it enough; NEVER GIVE A RECORDED STATEMENT.)  they will always, always, ask about your prior medical history. They will ask you about any back pain you’ve had before the accident, or if you have been diagnosed with arthritis.

At this point, they have you between a rock and a hard place. If you say that you have had back pain or a pre-existing condition, then, they may say that your symptoms would have happened regardless of whether or not you were in a crash, so they won’t agree to pay. If, in answering the questions you are not completely forthcoming about your prior medical history, when it is found out – and it will be – the insurance company will use this to argue that you are being untruthful. At that point, they can say “if the client lied about this, they’re probably lying about their pain too,” so they won’t agree to pay.

This is exactly the type of game insurance companies love to play. The truth is, most people haven’t made a personal injury claim before. They’re new to the process, and they just want it done quickly. Unfortunately, insurance companies count on that fact.

The bottom line: if you didn’t have symptoms before the accident, and you’re having them afterwards, they were caused by the accident!

Recovering Physically and Financially 

Degenerative changes, arthritis, disc disease, or other “wear and tear” style conditions are typical in active individuals as they reach certain ages. If you were diagnosed with one of these “wear and tear” diseases, but didn’t feel any pain from it before the crash, your records will show this. Maybe you never took any pain medication, or treatment at all. A pre-existing condition that does not cause any pain or symptoms is not at the front of a person’s mind. It’s the pain and soreness that matter, and in some cases, that doesn’t happen until a physical trauma such as a car accident.

Other times, a claimant’s pre-existing condition does cause symptoms from before the accident. This is often when a doctor’s opinion will become especially important. The doctor’s focus is ultimately to make you feel better. They have records to show your progress and how the car accident may have contributed.

It’s important to explain your symptoms in as much detail as possible to your doctor. Include new pain, and any activities that you’ve had to stop doing since the accident occurred. (for example, you may have had to use a pad when kneeling on the ground for gardening, but after the crash, you were unable to kneel at all.)

Call an Attorney

As for our client’s claim, we sent the insurance company for the at-fault driver a letter stating that their offer was far too low, and that we would have no choice but to file a lawsuit against the at-fault driver. With our track record of success, the insurance company was afraid to engage our firm in litigation. Just two days after sending the letter, we received an offer for $100,000. The insurance company ultimately paid the policy limits on the insurance policy.

Insurance company strategies may vary for every individual and every accident, but if you were injured in a crash, and you have a pre-existing condition, the insurance company will try to put all kinds of obstacles in your way. Your best bet is to call us at 314.444.4444.

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