If you’re above a certain age, you likely have at least one or two previous injuries or pre-existing conditions in your medical history. Maybe you saw a doctor for neck pain a few years ago or have a history of anxiety and depression.
Unfortunately, past symptoms and treatments can become roadblocks when you’re trying to get a fair settlement after being injured in a car wreck. The auto insurance company only must pay for medical treatment resulting from the crash. If they can show, for example, that you probably needed back surgery anyway, they could get out of covering it.
Insurance companies will look for any excuse to get out of paying claims. They often find them in victims’ medical records, but that doesn’t necessarily mean the insurance company’s decision is right or fair. You may need an experienced car accident attorney on your side to set the record straight and get the compensation you deserve.
Background: What is a pre-existing condition?
In the context of a Texas auto accident claim, a pre-existing condition could include any condition you’ve been diagnosed with, or any previous injury or symptoms that caused you to seek medical treatment in the past.
Examples of relatively common pre-existing conditions that can affect car accident claims include:
- Previous injuries, including those you have recovered from or are successfully managing
- Previous surgeries
- Previous mental health issues or diagnoses
- Chronic diseases (asthma, heart disease, etc.)
If I have a pre-existing condition, will the car insurance company pay for my treatment?
It depends on the circumstances.
The basic rule in Texas is that, if you’ve been hurt in a crash that wasn’t your fault, the insurance company must pay for any medical treatment you wouldn’t have otherwise needed if the crash never occurred.
This means that, if the crash aggravated a previous injury or made your symptoms worse, the insurance company must pay for the difference.
For example, say you have chronic back pain due to a previous injury that you are currently managing with occasional injections and physical therapy. While things aren’t perfect, your symptoms are mostly under control and not expected to get worse anytime soon.
Then, you get into a car accident. Your back pain gets significantly worse. You now need more frequent injections and additional therapy sessions. You might even need surgery.
In this situation, the auto insurance company would not be required to pay the level of care you were already receiving. But they would be on the hook for any new or more frequent treatments caused by the crash.
That may seem straightforward in theory. The problem, however, is that insurance companies often disagree with crash victims about their current and pre-crash medical needs.
Case study: How insurance companies try to use medical history against crash victims
A couple of years ago, we represented a young mom named Melissa. She was riding in a hotel shuttle when her van was rear-ended by a distracted driver.
Melissa hit her head and suffered a severe concussion. Symptoms included post-traumatic headaches, chronic neck and shoulder pain, dizziness, ringing in the ears, and issues with memory and concentration. While these symptoms gradually improved to some degree with regular treatment, they were still severe enough to interfere with her work, hobbies, and family time.
Unfortunately, her case was complicated by her medical history. A few years before this crash, she had been in a different motor vehicle crash and suffered neck and back injuries. She also had a previously existing history of migraine headaches.
Predictably, the insurance company refused to pay a fair settlement. They tried to argue that any symptoms Melissa experienced were either a result of the previous crash or all in her head.
This is a very common tactic, so we were prepared for it. And in the end, after two years of hard work and intense medical investigation, we were able to secure a $500,000 settlement for Melissa.
RELATED: Winning for a Young Mom With a Complex Medical History: Melissa’s Story | Crosley Law
The “eggshell skull” rule: Your susceptibility to injury shouldn’t matter in a personal injury case
Some people are more susceptible to injury than others. If you’re young and healthy, you might be able to escape a minor crash with only some temporary bumps and bruises.
But if you have brittle bone syndrome, those same impact forces might cause multiple fractures. If you’ve already had a few concussions in the past, you’re more likely to suffer another, more severe one. If you have a history of depression or anxiety, you may be more likely to experience PTSD or other mental health issues after the crash.
The eggshell skull rule prevents insurance companies from avoiding responsibility simply because the victim is more susceptible to injury than a typical person. The rule says you must “take the victim as you find them,” rather than speculating about what might have happened if the victim did not have a pre-existing injury.
However, the insurance company might still try to claim that your crash-related symptoms were pre-existing. An experienced attorney can protect you against this unfair tactic.
RELATED: What Is the Eggshell Skull Rule? | Crosley Law
Tips for car accident victims with pre-existing conditions
Now that you understand the eggshell skull rule—and how insurance companies try to get around it—here’s some additional advice that can help protect you after a crash:
Seek immediate medical attention
The longer you wait to get checked out by a doctor, the harder it is to prove the crash caused your symptoms or is directly responsible for worsening your condition.
Remember these words of wisdom: If it’s not in the medical records, it didn’t happen. You need clear documentation of your condition and symptoms immediately before and after the wreck.
Contact a car accident lawyer as soon as possible
Evidence starts to disappear very soon after any crash. Meanwhile, the insurance company starts digging around for any evidence it can use against you. Mistakes and incorrect statements you make, even in the first few days after a crash, can make it much harder to get a fair settlement later.
The sooner you hire a good lawyer to represent you and deal with the insurance company, the better protected you will be.
Don’t lie about your pre-existing conditions
The worst thing you can do in any personal injury case is lose your credibility. Hiding a pre-existing condition from the insurance company almost always backfires. They will find out eventually, and you will look like a liar to them and any potential jury that would decide your case if it goes to trial.
Any experienced car accident lawyer will have represented crash victims with pre-existing conditions many, many times. It’s your attorney’s job to put your conditions and symptoms in context and fight for the fair compensation you deserve. The best thing you can do to help is to be completely honest with them.
Don’t agree to give a recorded statement to the insurance company
Recorded statements are never required to file a claim, and they can almost never help you. The insurance company is hoping you’ll say something they can later use to claim you’re exaggerating your symptoms or lying about your medical history.
For example, say you’re experiencing shoulder pain after a crash, but when asked about your symptoms you forget about a previous shoulder injury from several years ago. Innocent mistakes like this happen all the time, especially when you’re stressed and in pain. But now, the insurance company can twist your words and make you look like you’re intentionally hiding something.
Don’t give the insurance company access to your complete medical history
The insurance company may ask for a “blanket release” to fully review all your medical records. You should be very wary of this request.
It might seem like it would be a convenient time saver. But in our experience, insurance companies will dig through years of records that are irrelevant and completely unrelated to the case, looking for absolutely anything they could use against you. It’s an unnecessary invasion of privacy and increases the risk that you’ll face bogus pre-existing injury accusations.
You only need to release medical records and history relevant to your crash injuries. An experienced attorney is the best person to help you curate and provide the necessary records to the insurance company.
Car Crash? Call Crosley
As soon as you tell the insurance company you intend to file a claim, they will begin looking for any excuse to deny it.
Don’t let them hold an old unrelated injury against you. The best way to protect yourself is to discuss your case (and previous medical history) with an experienced car accident attorney as soon as possible.
To schedule your free case review with Crosley Law, give us a call at (210) 529-3000 today.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.
