What to do if I was in an auto accident and a condition that I’ve had since birth was made worse so the insurer is not paying all bills since it was a pre-existing injury?

I was in a auto accident; it was a minor accident. I suffered soft tissue damage. I have a injury that i have had since birth that would only hurt from time to time. After the accident the pain was more frequent. the insurance company is refusing to pay for any treatment to the “old injury”. And are discounting some of my bills for the pain in my back due to my weight.

Asked on October 28, 2014 under Personal Injury, South Carolina


S.L,. Member, California Bar / FreeAdvice Contributing Attorney

Answered 6 years ago | Contributor

There is a maxim in the law that the defendant takes the plaintiff as is.

In other words, the at-fault party in your case is liable for the exacerbation (worsening) of your pre-existing injury.  The at-fault party is not liable for your pre-existing injury, only the exacerbation of that injury.  Therefore, the at-fault party is liable for your increased pain.

Applying the legal maxim again that the defendant takes the plaintiff as is, the at-fault party is liable for your back injury / back pain regardless of your weight.

When you complete your medical treatment and are released by the doctor or are declared by the doctor to be permanent and stationary, which means having reached a point in your medical treatment where no further improvement is anticipated, obtain your medical bills, medical reports, and documentation of any wage loss.  Your personal injury claim filed with the at-fault party's insurance carrier should include these items.

Compensation for the medical bills is straight reimbursement.  The medical reports document the nature and extent of your injuries and will be used to determine compensation for pain and suffering which is an amount in addition to the medical bills.  Compensation for wage loss is straight reimbursement.

If the case is settled with the at-fault party's insurance carrier, NO lawsuit is filed.

If you are dissatisfied with settlement offers from the at-fault party's insurance carrier (which will probably occur since the insurance company is discounting your bills, etc.), reject the settlement offers and file a lawsuit for negligence against the at-fault party (registered owner of the vehicle).

If the case is NOT settled with the at-fault party's insurance carrier, your lawsuit for negligence must be filed prior to the expiration of the applicable statute of limitations or you will lose your rights forever in the matter.


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