Personal Injury Pre-Existing Condition

Personal Injury Pre-Existing Condition, Honesty Pays Off

One of the reasons many personal injury claims face unfair denial is because insurance companies try to pass off an accident-caused personal injury as a pre-existing condition. This could have been the case for our client, who was pursuing her slip and fall case with another law firm, but running into problems getting full compensation due to pre-existing back problems.

The claimant had slipped and fallen on the walkway of the shopping center where she worked. The accident resulted in a serious back injury that required spine surgery to correct. However, she had medical records of a previous injury in the same area and a chronic “bad back,” which made the insurance company dig its heels in and refuse to pay for a “pre-existing condition”.

Old Injuries Complicate Legal Matters

The insurance company refused to pay for an already-existing injury that it had proof of on MRI films. The lawyer that the claimant was working with prior to coming to Buttafuoco & Associates was treating her case like any normal slip and fall. We estimated the insurance company would not even come close to offering $50,000 for this injury that was worth much more than that amount.

Not only did the claimant require surgery, but she would also be out of work for quite some time. She worked at a family-run food store and served as the owner’s “right hand” employee, doing many tasks for which she was the sole person in charge. The accident put her out of work and in deep medical debt; she was in dire need of a substantial settlement. That is when she called Buttafuoco & Associates.

We were able to assess her old medical records against her current MRIs and worked with orthopedic and spinal experts to testify that this new injury was “the straw that broke the camel’s back”. Her slip and fall injury caused her existing back problems to become so severe that surgery was a necessity to find relief.

The Insurance Company Agrees to Solid Evidence

With expert testimony in hand and proof that our client would not have needed surgery but for the slip and fall accident caused by unsafe sidewalks, we were able to enter mediation with the shopping center’s insurance company. An eight-hour session ended with a $1,150,000 verdict in our client’s favor. She was able to get her spinal surgery and return to her job, both at the store and as a single mother.

This scenario is all too common for accident victims with pre-existing conditions or old injuries. Unfortunately, many claimants give up once the insurance company points out their past medical history. What many people do not know is that, even if you have an existing condition, if your accident aggravates or causes new damage in that area, the negligent party is still liable for causing new pain and suffering.

Honesty Pays Off

This case underscores the utter importance of clients being honest with their lawyers and being truthful about prior injuries before the other side finds out. Because our client did the right thing in this situation, we were able to create a defense against the insurance company rather than being blindsided by evidence later.

It is better to truthfully disclose your related medical history upfront rather than letting the insurance company uncover it later on and make the claimant appear to have deceived the insurance company.