Many accident victims are not new to accidents and injuries. They have pre-existing injuries and health conditions they acquired prior to the accident. Unfortunately, insurance companies often try to use pre-existing conditions against claimants to avoid offering full payouts. If you are entering into a personal injury claim with a pre-existing condition, you may need an attorney to help you negotiate a fair outcome.
What Is the Connection Between a Pre-Existing Condition and a Personal Injury Claim?
Insurance companies process claims by analyzing a claimant’s injuries and losses for opportunities to limit payouts. An insurance company’s main goal is to save money on claims to profit its investors. Part of the insurance company’s investigative process is to verify the losses claimed by the victim using supporting evidence such as medical records.
Throughout the entire investigation, however, the insurance company looks for excuses to reduce your payout as a claimant. One of these excuses may be a pre-existing condition located in your medical records (or disclosed by you). The insurer may try to use the pre-existing condition as a reason to deny or reduce your benefits.
It is important to realize that an insurance company cannot deny your claim based solely on the fact that you have a pre-existing condition. Even if your pre-existing condition exacerbated the severity of your accident-related injury or vice versa, the insurance company cannot reject benefits based on this alone. A pre-existing injury does not bar you from financial recovery under the Eggshell Skull Rule.
What Is the Eggshell Skull Rule?
The Eggshell Skull Rule is a legal doctrine that states a defendant must take a plaintiff as-is. In a successful injury claim, it is a defendant’s legal obligation to pay to make a plaintiff whole again – even if the amount owed is higher due to a pre-existing condition. The plaintiff’s pre-existing condition does not limit the defendant’s financial liability for the full consequences of the accident.
In other words, even if you have a pre-existing condition, the law in New Mexico entitles you to a fair settlement for the actual damages suffered, regardless of whether or not your pre-existing condition exacerbated these damages. You may find it difficult, however, to obtain a fair settlement from an insurance company if it uses your pre-existing condition against you.
Common Pre-Existing Conditions
An insurance company will do everything it can to search for any prior injury or condition diagnosed before the accident in question. Common pre-existing conditions involved in insurance claims include:
- Muscle strains or sprains
- Herniated or slipped disks
- Healed bone fractures
- Prior concussions or head traumas
- Degenerative disk disease
- Diabetes
- Cancer
- Asthma
- High blood pressure
- Arthritis
- Anxiety or depression
If you have a pre-existing condition as an injury claimant, do not be discouraged. This does not automatically bar you from financial recovery. You can protect your rights and still receive fair compensation if you take the correct steps.
What to Do If You Have a Pre-Existing Condition
First, do not fail to disclose your pre-existing condition to the insurer. Hiding a pre-existing condition can make you seem suspicious to the insurance company and set you up for failure. Do not, however, sign a Medical Authorization Release Form given to you by the insurance company. This form is often extremely broad in its terms to give an insurance company full access to your medical records. This is a tactic insurance companies use to search for pre-existing injuries that may have nothing to do with your current claim.
Before you sign anything given to you by an insurance company, bring the paperwork to an attorney for review. Unlike an insurance company, a personal injury lawyer will have your best interests in mind. Your attorney can help you negotiate for fair and full financial compensation even with a pre-existing condition affecting your claim. Hire a lawyer right away for assistance with your case. Dedicated legal advocacy can help you obtain the award you deserve, with or without a pre-existing condition.