Insurance companies have gained a reputation for denying claims or severely reducing payouts for a wide range of reasons. Notably, an insurance adjuster may seek to minimize an injury claim by citing a pre-existing condition. However, a pre-existing injury may benefit a car accident case in other circumstances.
How Do Insurance Companies Look at Pre-Existing Injuries in Tulsa?
Insurance companies are for-profit. It is important to understand how they operate as a business to understand how they will handle a car accident claim with a pre-existing injury.
Like any business, an insurance company will operate within the bounds of the law to minimize claim payouts and maximize profits. Staying solvent and profitable are the chief concerns of most business entities.
When considering pre-existing injuries, an insurance company may try to use the condition in its favor.
What is a Pre-Existing Injury?
A pre-existing injury is any physical condition or ailment the claimant had prior to the car accident. Examples of pre-existing injuries can include anything from a sprained ankle to cancer.
When a car accident causes injuries to the same part of the body as the pre-existing condition, it can make recovering compensation particularly challenging.
How Can a Pre-Existing Injury Work in Favor of an Insurance Company?
Personal injury cases can be medically complex. In many car accident claims, an insurance company may seek to reduce a payout or deny a claim based on pre-existing injuries.
If an insurance adjuster can link the medical damages the claimant suffered during the accident to a pre-existing injury, they may argue that the car crash is not directly responsible for the injuries and therefore is covered by the insurance policy.
An insurance company may also evaluate the circumstances of the accident against a pre-existing condition, citing that the car crash could not have caused the injuries listed in the claim.
Is a Claimant Required to Tell the Insurance Company of a Pre-Existing Condition?
When filing a personal injury claim, claimants are required to disclose any pre-existing conditions or injuries to the insurance company. Failing to do so can irreparably harm a car accident injury claim.
An insurance company may view the withholding of important and pertinent information as fraud or use it to deny the claim permanently.
What if the Car Accident Aggravated My Pre-Existing Injury?
Pre-existing injuries are complicated. However, if an old injury or condition was made worse in a car accident, a claimant may be able to recover damages.
The aggravation of a pre-existing injury refers to the degree an old injury or condition is made worse. For example, suppose a woman sustained head trauma in a skiing accident that left her with permanent damage to her memory. A few years later, a car accident caused a traumatic brain injury that now leaves her with permanent cognitive impairment.
Her prior head injury and resulting memory loss would be considered a pre-existing injury that was aggravated by the car accident. The woman can claim damages for the degree her brain injury was worsened from memory loss to permanent cognitive impairment.
What Evidence Will Support My Claim?
Car accident claims with pre-existing injuries are medically complex. Your personal injury attorney will need to gather detailed records and documentation to support your claim for compensation.
Some evidence that will help establish how your pre-existing injury has become worse may include the following:
- Witness testimony for your pre-existing injuries and new physical trauma
- Documented hobbies and activities that can no longer be enjoyed
- Employment records that reflect a change in work status
- Extensive medical records before the aggravated injury and after
Medical records can be used to establish your quality of life prior to the car accident and compared to how your life has changed. In some cases, an MRI or X-ray can prove a pre-injury has been aggravated. In other cases, the frequency of visits or extensive treatment can be used to establish how a car crash aggravated an old injury.
What is the Eggshell Skull Doctrine?
The Eggshell Skull Doctrine is a long-established legal doctrine used in many negligent personal injury claims. Under the rule, defendants are responsible for damage resulting from negligence even if the injuries are unusually high, given a pre-existing condition.
When a person suffers harm in a car accident, the Eggshell Skull Doctrine can protect a claimant from having their payout diminished or rejected. It holds that a claimant:
- Cannot be discriminated against for having a pre-existing injury or condition
- That the defendant is liable for the full consequences of their negligent actions
While a claimant cannot recover losses suffered from the pre-existing injury, it protects their right to compensation for the extent to which the old injury was aggravated or exacerbated.
How Are Personal Injury Damages Affected by a Pre-Existing Injury?
It can be difficult to properly place a value on a personal injury claim. While economic losses are more easily calculable, the proper evaluation is more subjective in cases of pre-existing injuries.
For example, suppose a person who suffered an old back injury is currently taking pain medication and attending physical therapy. If the person is then involved in a car accident, their personal injury claim will need to show how the injury was made worse:
- Did the new car accident cause the claimant’s medication to change or increase?
- Does the claimant have to undergo surgery or any additional medical treatments?
- Did the traffic collision cause additional injuries that affected the old injuries? (i.e., damaging additional disks in the spine)
Non-economic damages are even more subjective. Assessing the amount of additional pain and suffering experienced by the claimant is challenging to calculate.
Is My Right to Compensation for a Car Accident Protected in Oklahoma?
Every person has the right to compensation for a negligent car accident in Oklahoma. Under the state’s tort law, anyone who has been injured by the intentional or careless acts of another has the right to recover financial compensation for damages.
At Graves McLain, our car accident lawyers can properly evaluate your personal injury claim. Schedule a free consultation today or call at 918-359-6600 to discuss the details of your case.