How Do Pre-Existing Conditions Affect Your Insurance Coverage?

If you've been hurt in an accident, you'll make a claim against either your insurance or - if the accident was someone else's fault - against the at-fault party's insurance. Here, we discuss how a pre-existing medical condition might affect your ability to recover money for medical bills in a claim. 

It's Your Job to Prove Negligence

For the purpose of this article, let's say you were rear-ended by another driver named Bill and you hurt your back in the accident. In order to recover compensation for your medical bills, you're going to have to make a claim through Bill's insurance. 

Unfortunately, making a claim isn't as easy as pointing fingers. In order to successfully convince Bill's insurance company to pay you anything, you'll need to prove that a) Bill caused the accident and b) the accident caused your injuries. That's why a lot of people hire attorneys to handle their personal injury cases - proving negligence can get tricky. 

Where Pre-Existing Medical Conditions Come Into Play

So you were able to prove Bill rear-ended you (maybe through photos and a police report, or eye witnesses). Great. But there's a problem - you had back surgery ten years ago and the insurance company knows about it. 

Suddenly, they're denying your claim. Bill's insurance company will try to use your previous back injury against you by saying things like "Bill didn't hurt you in the accident - you were hurt all along!" YOU know that you've been feeling fine for years and this wreck clearly caused a new back injury, but how can you prove it? 

What About the Affordable Care Act? 

The Affordable Care Act only affect people who are buying insurance. It prohibits insurance companies from denying coverage to anyone with a pre-existing condition. It doesn't, however, make any changes to the claims process. 

Insurance companies can still use a pre-existing condition to deny you coverage after an accident, and they will. 

This does not mean you can't make a claim or recover compensation if you have pre-existing injuries. It just means that you will have to fight especially hard to prove that the accident directly caused your current condition. 

The Bottom Line

Depending on the medical records and the medical testimony, there's a chance your claim's value will be diminished due to the pre-existing medical condition. 

If you've been seriously hurt and the insurance company is denying or undervaluing your claim, you have the option of consulting an attorney. An accident lawyer will know how to gather evidence and construct your case to ensure you're given the full and fair compensation you deserve after an accident. 

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Contact the Anderson Law Firm online, or by calling 817-294-1900 for a free consultation on your rights.

Mark A. Anderson
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Board Certified Personal Injury Lawyer in Fort Worth, Texas