When you’re injured in a car accident, the insurance adjuster will make an assessment of the damages and likely make you a low-ball settlement offer quickly—sometimes before you’re even out of the hospital. Usually, it’s not enough to cover your medical bills, and you may wonder how they get away with offering you far less than your claim is worth. One tactic they use is their assertion that they found a “pre-existing condition” in your medical history. They’ll maintain that your injuries weren’t caused by the accident; rather, the accident simply exacerbated a previous injury.
The skilled attorneys at Peterson Law Firm understand the shady tactics used by insurance companies, especially their attempt to point at a pre-existing condition for your injuries. Insurance adjusters are trained to use your medical history against you, and we know how to fight against their strategies. Here, we discuss how insurance companies learn about your past health conditions and what we do to help protect your legal rights.
How an Insurance Company Learns About Your Pre-Existing Conditions
Insurance companies have strategies they use to try and gain access to your medical history. This is one reason why it’s so important to seek legal counsel after you’re involved in an accident. Personal injury lawyers know how to advise you to avoid making mistakes that could negatively affect the outcome of your claim.
Medical Authorization Forms
Asking injury victims to sign medical release forms is one way insurance companies use to get into your medical records. These forms give adjusters access to your entire medical history. Once they obtain those records, they can search through all of your doctor visits, rehab appointments, and anything they think points to a similar symptom or complaint you had in the past. When you hire a Missouri personal injury lawyer, they’ll tell you to not sign this type of document and/or limit the release of specific pieces of information. Getting that advise sooner than later can help ensure the adjuster isn’t using irrelevant information to try and deny your claim.
Your Social Media Posts
Most people have some type of social media platform they use to communicate with friends, coworkers, and family. However, insurance companies use social media to investigate a victim’s injury claims. Searching Facebook, X (Twitter), Instagram, and other platforms, adjusters look for photos or posts they can use to dispute your injury claims. Old pictures of yourself with friends or during certain events might be used as evidence against you—even though they’re outdated.
Many insurance companies have a special investigation unit that will comb through your tweets, posts, and photos to find information that contradicts your claim. For example, you might still take a planned vacation after the accident. If you post selfies of you and your friends smiling or in a pool, it may appear that you’re not as injured as you claimed. The insurance adjuster will take any photo or any statement out of context if it means they can offer you less money or deny your claim.
Independent Medical Exam: Your Rights
After you file a personal injury claim in Missouri, you may be asked by the defendant’s insurance company to undergo an independent medical exam (IME). This usually happens if:
- You’ve filed a claim under your own insurance
- You’ve filed a lawsuit against the other driver responsible for the crash
The insurance company typically asks for an IME to help their case, and the chosen doctor works for the insurance company to help them deny your claim. Never believe that the “independent” examiner is independent or will be objective. The doctor will likely downplay your injuries and create a medical report that portrays you in a bad light. In most cases, the IME will be used to help prove you weren’t injured, prove your injuries were not a result of the accident, and discredit you. Remember that the doctors who are hired to perform these exams are often paid big money by the insurance companies.
Your Prior Claims
Insurance adjusters might use industry-wide databases that may have claims you’ve made in the past. They can learn if you filed claims with any other insurance companies. These databases contain information about any prior accident injuries, claims, and settlements. Adjusters will use this information to show a pattern of behavior on your part or to identify similar injuries from prior accidents.
Pre-Existing Conditions: What Insurance Companies Look for
Insurance companies target certain medical conditions over others when building their defense against your personal injury claim. These conditions are often used against injured victims in car accident claims more often than others. Here are some of those conditions:
Prior neck and back injuries. If your personal injury claim includes neck/back injuries, the defendant’s insurance company will try to find evidence in your medical history that shows you had prior back pain or neck issues. They want to know if you’ve received treatment for this type of injury in the past, and they’ll try to argue that your current pain is a continuation of that prior condition. If your medical records show that you had a muscle strain, saw a chiropractor, or had a disc or spine problem, the insurance company will use this information to reduce your settlement offer.
Mental health issues. If you’ve had bouts with depression, anxiety, or post-traumatic stress disorder (PTSD), insurance companies may use this information if your claim includes emotional distress or pain and suffering damages. They may suggest that because you had psychological symptoms in the past, you’re predisposed to emotional reactions that aren’t typical after a car accident.
Degenerative conditions. Insurance companies often use conditions such as arthritis or disc degeneration in their defenses. They will claim that these types of age-related conditions, not the accident, are responsible for the pain you’re feeling since the accident.
Chronic pain conditions. Because pain conditions such as chronic fatigue syndrome and fibromyalgia have symptoms that can’t usually be measured with standard medical testing, they get targeted by insurance companies. An adjuster will try to make the claim that your accident-related pain is part of your chronic condition.
What to Know About the Eggshell Plaintiff Rule
The insurance companies aren’t playing fair when they dig into your medical history and try to reduce your settlement based on a pre-existing condition. Their tactics are intrusive and based on background information that doesn’t factor into the legitimacy of your claim. However, there are some legal principles that help protect your right to fair compensation, even when you have conditions that existed before the accident. Our attorneys may use any of these principles as defenses in your case. One of these principles is the eggshell plaintiff rule.
How it Works
The eggshell plaintiff rule is a legal principle that says the defendant must “take their victims as they find them.” This means if you had a pre-existing condition that made you vulnerable to injury, the at-fault driver is still responsible for the harm suffered by the victim. For example, if you had an old neck injury from a dune buggy wreck, and you suffered a herniated neck disk in the accident that wouldn’t have slipped out of place had you not been in the crash, you’re still entitled to full compensation for your losses.
When you aggravate a pre-existing condition, it’s still compensable under the law. In fact, every state recognizes that when an existing problem is exacerbated, the victim still has a legitimate claim for injury from the accident. When you hire our Kansas City personal injury attorneys, we will help establish the actual harm caused by the accident by separating your pre-accident condition from your post-accident symptoms.
Under this rule, the defendant can’t argue they’re only liable for basic injuries that the victim suffers without a pre-existing condition. The rule recognizes that the at-fault party shouldn’t benefit from a victim who was already in a vulnerable condition.
Properly Document Your Pre-Existing Condition and New Injury
Medical evidence is key to establishing that your current symptoms are a result of the accident rather than a pre-existing condition. Certain types of documentation carry more weight than others in proving this crucial distinction.
Comparative medical records. Records that show your condition before and after the accident provide some of the strongest evidence. These records enable medical experts to identify new injuries and highlight specific changes in your health status. Pre-accident records showing you were asymptomatic or had different symptoms are particularly valuable.
Expert interpretation of diagnostic imaging. Experts who analyze your imaging tests can provide an objective opinion about new injuries. For example, an MRI might show a new disc herniation that wasn't present on previous scans, or X-rays might reveal new fractures. These objective findings make it difficult for the insurance company to target a pre-existing condition.
Your physician’s opinion. When your doctor examines you, their opinion on causation is very important. A detailed medical narrative from your doctor that discusses how the accident caused new injuries provides validation of your claim from a skilled professional. Your doctor’s report should specifically address how your current condition differs from any pre-existing issues.
Friend and family testimony. Accounts from people familiar with your physical capabilities can provide additional medical evidence. Statements from family members, coworkers, or friends describing how your abilities have changed since the accident help show the real-world impact of your injuries. Witnesses who can explain the types of activities you enjoyed before but now struggle with can be especially beneficial to your case.
