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Written by: J. Todd Tenge

How Do Colorado Insurance Companies Determine a Pre-Existing Condition?

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how does insurance determine pre-existing condition

If you were in a serious car accident, you likely sustained injuries.

But what happens if you have a pre-existing condition that is made worse by a car accident?

The other driver’s insurance company might tell you that they will not cover your pre-existing injuries. But that is not necessarily true, at least not in Colorado.

So, how do insurance companies determine a pre-existing condition, and when are they financially responsible?

When a car accident results in new injuries or exacerbates an earlier injury, the defendant should be responsible for compensating you.

However, pursuing a pre-existing conditions lawsuit can be complicated. You need a skilled Colorado car accident lawyer on your side.

Contact the Tenge Law Firm, LLC to learn how we can assist you.

Examples of Common Pre-Existing Injuries From a Colorado Injury

how do insurance companies determine pre-existing conditions

Pre-existing injuries aren’t limited to older adults either.

Younger people can suffer injuries in prior accidents, have debilitating health conditions, and more.

Some of the more common pre-existing injuries or illnesses that can be impacted by a car accident include:

  • Prior surgery;
  • Scoliosis;
  • Nerve damage;
  • Neck and back pain;
  • Vertebral fracture or disc herniation;
  • Temporomandibular joint (TMJ);
  • Broken bones; and
  • On-the-job injuries involving bending, lifting, repetitive motion, etc.

Some chronic illnesses can cause significant pain or reduce someone’s ability to heal.

These include conditions such as diabetes, fibromyalgia, degenerative disc disease, neuromuscular disorders, rheumatoid arthritis, and multiple sclerosis.

Some victims assume it might be better to keep a pre-existing condition from the defendant’s insurance company or their own attorney.

However, this is not wise as the insurance company might use that against you.

Even if you don’t think your pre-existing condition is relevant to your injuries now, it’s crucial to disclose everything to your attorney right away. 

Eggshell Plaintiff or “Thin Skull” Rule

There is something called the eggshell plaintiff, also known as the “thin skull” rule.

This rule means that the defendant cannot argue that you are a frail victim and more prone to injuries as a means of escaping liability for the extent of your injuries.

Whether you are older or very young, it doesn’t make the at-fault driver any less liable for the worsening or aggravation of a pre-existing condition.

Exacerbation vs. Aggravation

There’s a difference between exacerbation and aggravation of a pre-existing condition.

Exacerbation means that your injuries worsened after the accident, but they will return to baseline condition after some healing time.

Aggravation means that your condition is now permanently worse than it was prior to the accident.

Consider someone with degenerative disc disease in their back. Before the accident, the victim had occasional back pain but could still work and participate in light physical activities.

After the accident, their condition worsened. The victim cannot work in their regular job and struggles to do day-to-day tasks.

If the increased pain is only temporary and they eventually return to occasional discomfort, it’s an exacerbation.

If the victim needs to go on permanent disability or needs back surgery, it may mean the pre-existing back injury is aggravated.  

When Is a Defendant Not Liable for Pre-Existing Conditions?

It’s important to clarify that there are situations where a defendant is not liable in a personal injury claim with a pre-existing condition.

A defendant won’t be responsible for injuries they did not cause—they are only responsible if the accident they caused made your existing injury or pain worse.

If your back injury was not affected by the accident, then the defendant doesn’t owe you any compensation.

If the accident caused new injuries or made existing injuries worse, the at-fault party would be responsible for those.

What Does Apportionment Mean?

If your case goes to trial, the jury could apportion your damages. If this happens, the defendant would not be responsible for your entire injury.

They will designate a certain amount of damages to the pre-existing condition and the remainder to your other injuries.

If the jury doesn’t include an apportionment, it means the defendant will be liable for all damages.

A jury only issues an apportionment if they don’t believe your prior injuries were affected by the car accident.

Contact a Colorado Car Accident Lawyer

If you have a pre-existing condition and suffered worsening of your injuries in a car accident, you need a skilled legal advocate on your side.

Negotiating an aggravated injury settlement is not easy. However, you don’t have to go through the legal process alone.

The experienced team at the Tenge Law Firm, LLC is here to help. We have years of experience assisting injured victims like you get the compensation they deserve.

We know how to gather evidence and build a strong case proving the at-fault party should be responsible for aggravating your pre-existing condition.

To learn how one of our Colorado car accident lawyers can help you fight for the maximum compensation possible, contact the Tenge Law Firm today to schedule an initial consultation.

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