If you’ve ever been in a personal injury (PI) case, you might have heard the term “pre-existing condition.” This is a common strategy used by insurance adjusters to reduce or deny claims.
But why do they love this defense so much?
Let’s break it down in simple words. If you’re dealing with such a case, the top personal injury lawyers in your area can help you navigate these challenges and fight for your rightful compensation.
What Is the Pre-Existing Condition Defense?
A pre-existing condition is any injury, illness, or medical issue that a person had before the accident. For example, if someone had back pain before a car crash, the insurance company might argue that the crash didn’t cause the pain—it was already there.
The pre-existing condition defense is when an insurance adjuster uses this argument to minimize the compensation they have to pay.
Why Do Insurance Adjusters Use This Defense?
1. It Helps Them Reduce Payouts
Insurance companies are businesses, and they aim to pay as little as possible in claims. If they can prove that your injuries existed before the accident, they can argue that they shouldn’t be responsible for paying your medical bills or pain and suffering.
2. It Creates Doubt About the Claim
When an adjuster brings up a pre-existing condition, it makes the case more complicated. They can question whether the accident really made things worse or if you are just trying to get money for an old injury. This doubt can sometimes lead to lower settlements.
3. It Delays the Settlement Process
By using this defense, insurance adjusters can slow down the claim process. They may request old medical records, hire medical experts, and demand extra proof. The longer the case drags on, the more pressure the injured person feels to accept a lower offer.
4. It Shifts the Burden of Proof
In a personal injury case, the injured person must prove that the accident caused their injuries. If an insurance adjuster uses the pre-existing condition defense, they shift the focus. Now, the injured person has to prove that the accident worsened their condition, which can be harder to do.
How to Fight Back Against This Defense
Even if you have a pre-existing condition, you still have rights. Here’s how you can protect your claim:
1. Be Honest About Your Medical History
It’s important to be upfront about any past injuries or conditions. If you hide them, the insurance company can use that against you later.
2. Get Medical Records and Expert Opinions
A doctor can help prove that your condition got worse because of the accident. Medical records that show a clear difference before and after the accident can strengthen your case.
3. Use the “Eggshell Plaintiff” Rule
In many states, there is a legal rule called the “Eggshell Plaintiff” doctrine. This means that if someone has a weak or vulnerable condition and an accident makes it worse, the at-fault party is still responsible for the damage.
4. Hire a Personal Injury Lawyer
A lawyer who understands PI cases can help you fight against the insurance company’s tactics. They know how to gather evidence, negotiate with adjusters, and take legal action if necessary.
Conclusion
Insurance adjusters love the pre-existing condition defense because it helps them pay less and makes it harder for victims to get fair compensation. However, with the right proof and legal support, injured people can still win their claims. If you’re facing this defense, don’t give up—know your rights and fight for the compensation you deserve.
Be First to Comment