Preexisting Injuries and Accident Insurance Claims

by Craig Aronow, Esq.

How Preexisting Injuries Are Handled in Car Accident Claims

Motor vehicle accidents on U.S. roadways result in 4.4 million injuries annually that require medical attention. This statistic does not encompass preexisting injuries, which can be exacerbated and accelerated and, according to some studies, increase overall accident recovery costs by as much as 24%. Trucking accident lawyers in particular warn that insurance companies and their lawyers will often seek to use your preexisting medical conditions to limit the amount of compensation that you receive.

What Is a Preexisting Medical Condition?

The term “preexisting medical condition” refers to an objective standard for injuries, illnesses and other health conditions that existed prior to an event. In the health insurance domain, the term is specified further to indicate injuries, illnesses and other health conditions for which a patient received treatment, was aware or should have sought treatment if prudent prior to a health insurance policy going into effect. In the domain of accident claims, the language is more general and refers to any health condition that existed prior to the accident occurring. Common examples of preexisting medical conditions that may be considered in regard to an accident claim include:

• Anxiety
• Arthritis
• Migraines
• Fibromyalgia
• Back or neck pain

Can You Make an Accident Claim for a Preexisting Medical Condition?

The general rule is that you cannot seek damages in a personal injury claim for a preexisting medical condition. The application of this rule is nuanced and varies from state to state. In New Jersey, for instance, the rules differ depending on whether or not the preexisting condition was causing you pain. As an example, a past herniated disc that was not causing pain prior to an accident would have different laws applied to it than a herniated disc that was actively causing pain that a person was managing through treatment and medication.

The Eggshell Skull Rule

Many states follow what is called the eggshell skull rule. Other variations of the name include “the eggshell doctrine,” “eggshell skull doctrine” and “eggshell plaintiff rule.” These all refer to a concept used to teach the principle in law school. It involves a theoretical man who has a skull that is as thin and delicate as an eggshell. If that man were involved in an automobile accident, he would be predisposed to serious brain injuries that most people would not. The person who causes the accident would still be liable.

In other words, if you have a preexisting medical condition that makes you predisposed to other injuries that occur as a result of your accident, then you can seek damages for them. In addition, if your accident activated, accelerated or exacerbated your preexisting condition, then you can also seek damages related to that new harm. In our earlier example of a herniated disc that had been treated and no longer causing pain, the person could seek damages for any future treatment to be required.

How the Eggshell Skull Rule Is Applied to Personal Injury Claims

Be mindful that the eggshell skull rule does vary from state to state and that there are often nuanced differences, such as how individual state laws factor in negligence. From a broad perspective, the eggshell skull rule exists to protect against discrimination. The theoretical man in the law school example would be discriminated against by the insurance companies if the rule did not exist.

Another perspective is that the rule exists to hold negligent defendants liable for the full consequences of their actions—even if those consequences were exacerbated by circumstances over which the defendant had no control. While the doctrine does make a victim eligible for financial compensation, it does limit the extent of that compensation. To appreciate these limits, there are three core damage types to consider: general, special and punitive.

Compensatory Damages

Compensatory damages are awarded to make a victim whole. These damages are further broken into two categories: noneconomic, or general, damages and economic, or special, damages. Examples of general damages include:

• Mental anguish
• Pain and suffering
• Lack of consortium
• Diminished quality of life
• Disfigurement or dismemberment

Examples of special damages include:

• Lost income
• Medical expenses
• Transportation costs
• Diminished ability to earn
• Future medical care and rehabilitation

Can You Seek Noneconomic Damages for a Preexisting Condition?

Yes, you can seek general damages within the context of how the preexisting medical condition was activated, accelerated or exacerbated. But it is important to note that the eggshell skull rule is generally limited to physical damages and not emotional damages. As an example, if a preexisting back injury were exacerbated to the point that it diminished your quality of life, then you likely could seek general damages based on that but likely could not seek it for any mental anguish that arose from it.

Can You Seek Economic Damages for a Preexisting Condition?

Yes. The economic damages must be related to the activation, acceleration or exacerbation of the preexisting medical condition, however. Within that context, you have the right to seek all of the economic damages that you could seek if the injury were directly caused by the accident.

As you may suspect, these distinctions make accident cases complex. Attributing damages to the injury prior to the accident and after the accident would be difficult in a cooperative environment. This is not the case with accident claims, however. The insurance companies will seek to attribute as much of the economic damages as possible to the preexisting condition itself in order to minimize their losses, so it is a good idea to have a lawyer represent you and protect your rights.

Can You Seek Punitive Damages If You Have a Preexisting Condition?

Punitive damages exist to punish defendants that acted in a grossly negligent or even intentional manner, but these are rare in accident cases. A truck driver operating his or her vehicle under the influence of alcohol or narcotics or a driver involved in a high-speed pursuit with police are examples of accident cases where you may be able to seek punitive damages.

In cases where such criteria are present, then yes, you can seek punitive damages. However, punitive damages are typically not awarded via an insurance claim. They are awarded by the court and require a lawsuit. Whether or not your preexisting medical condition was a factor would be up to the discretion of the jury or judge.

Protect Your Rights by Contacting a Professional

If you or a loved one has been involved in an accident with a commercial truck, the responsible insurance companies are likely to work very hard to limit the compensation that you receive. RAM Law has substantial litigation and trial experience with accident claims involving preexisting medical conditions. Our law firm has offices in New Brunswick and Somerville, New Jersey, and you can schedule a free consultation with one of our trucking accident lawyers by calling (732) 394-1549 or by contacting us online using our secure form.