Posted on Saturday, March 8th, 2025 at 9:00 am
You’ve been hurt in an accident. You’re in pain, especially because the accident worsened the arthritis in your hip from an old sports injury. Now, the insurance company is telling you that it won’t cover some of your medical bills because you have a pre-existing condition. What does this mean, and what can you do to fight back?
What Is an Aggravated Pre-Existing Condition?
In the context of a car accident case, a pre-existing condition refers to any medical issue or injury that a person had before the accident occurred. These conditions can range from chronic illnesses like arthritis to previous injuries such as a herniated disc or a past concussion.
When a person with a pre-existing condition is involved in a car accident, one of the key legal and medical questions is whether the accident worsened or aggravated that condition. Insurance companies and defense attorneys often scrutinize pre-existing conditions to argue that the plaintiff’s injuries were not directly caused by the accident but rather were a continuation of prior health problems.
The “Eggshell Skull Rule” Rule
However, the existence of a pre-existing condition does not automatically disqualify a plaintiff from receiving compensation for a worsened injury. Under the “eggshell skull” doctrine, a defendant is still liable if the accident exacerbates an existing condition. This means that even if the plaintiff’s medical history made them more susceptible to an injury, the at-fault driver cannot use that as a defense to avoid responsibility.
The oddly named rule derives from the common example of a theoretical plaintiff who had an especially thin skull, which caused them to suffer more severe injuries than what a person with normal skull thickness would suffer in the same circumstances. Essentially, the eggshell skull rule exists to allow plaintiffs to recover the true cost of their injuries, not an insufficient amount based on what a fictional average person would deserve under the circumstances.
Note that a plaintiff still cannot recover compensation for a prior injury that was unaffected by the accident in question. Only injuries directly worsened by the accident apply.
Proving aggravation of a pre-existing condition requires strong medical evidence, such as records showing a worsening of symptoms after the accident or expert testimony from doctors. Thus, while insurance companies may attempt to minimize payouts by citing pre-existing conditions, claimants can still recover damages if they can demonstrate that the accident directly worsened their health issues.
How Pre-Existing Conditions Impact Settlement Amounts
Pre-existing conditions can significantly impact settlement amounts in a car accident case, which is why they often become a point of contention between the injured party and the insurance company. When a claimant has a documented medical history of similar injuries or health issues, insurers may argue that the accident was not the primary cause of the claimant’s current pain or disability. This can lead to lower settlement offers as insurance adjusters attempt to minimize payouts by attributing the injuries to prior conditions rather than the accident itself. To that end, insurers may request extensive medical records to prove that the claimant was already dealing with the same or similar symptoms before the collision.
However, the claimant can still demand compensation if the accident aggravated or worsened their pre-existing condition. This is where medical evidence and expert testimony become especially important. The claimant will have a much stronger case for compensation if doctors can clearly establish a link between the accident and the increased severity of their injury. Additionally, the eggshell skull rule prevents defendants from escaping liability simply because the victim is more susceptible to injury. This means that a person with a pre-existing condition is entitled to damages for any additional harm caused by the accident.
The extent to which a pre-existing condition affects the settlement also depends on the strength of the plaintiff’s medical documentation and the skill of their attorney. A well-documented case with clear medical records showing a deterioration of health after the accident can lead to higher compensation. On the other hand, any ambiguity about whether the accident truly worsened the condition can reduce the settlement amount. In some cases, insurance companies may offer lower amounts upfront, anticipating that the claimant might accept less to avoid a lengthy legal battle.
How a Lawyer Can Help with Your Car Accident Claim
Do you suspect that a prior condition worsened the injuries you suffered in a recent car accident? If so, it’s crucial that you seek help from an experienced car accident lawyer. Here’s what they can do on your behalf:
Investigating the accident to determine what happened and who’s to blame for it
Working with medical experts to review your medical records and determine how any prior conditions worsened your current injuries
Protecting you from giving the insurance companies access to your medical records, which they could use as a “fishing expedition” to find pre-existing conditions
Negotiating with the insurance companies for a settlement that acknowledges the degree to which your pre-existing condition worsened your current injuries
Taking your case to trial if doing so becomes the best way to get you every cent you deserve
It’s also important to note that most car accident lawyers work on contingency. That term means that you only pay them if they win your case. The contingency fee arrangement means that you do not have to go out of pocket to secure experienced legal representation. Times are tough after an accident, and that’s especially true when you’re dealing with a worsened condition. You shouldn’t have to pay upfront to assert your rights to fair compensation.
Get Help from London Harker Injury Law
At London Harker Injury Law, we know all too well how insurance companies will try to get out of paying accident victims fairly. They might try to argue that your pre-existing condition worsened your injuries and that they shouldn’t have to pay you the fair value of your claim. We won’t let them pull those tricks. Instead, we’ll fight back and build a strong case showing the true cost of what you’ve suffered. Contact our law firm today at (772) 272-7274 or through our online form to discuss your case for free with a Utah car accident lawyer.
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