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Don’t Let The Insurance Company Take Advantage of You!  What Are Preexisting Conditions, And What Can You Do?

A: A preexisting condition is any health condition you have before the date of your car wreck.

Almost all of us have preexisting conditions. Some of us have such conditions from birth on while others develop over time. The sprained ankle you suffered in high school basketball is a preexisting condition. The time you fell off your bike and hit your head when you were six is a preexisting condition. If you were lifting a heavy object at work and suffered a hernia or pulled muscle in your back, those would be considered preexisting conditions. Repetitive motion can also cause preexisting conditions.

The key is that many of the symptoms go away and any preexisting condition is asymptomatic, which is to say that someone may have an underlying condition without symptoms. Even if the condition is symptomatic, for many the symptoms are minor and not regularly occurring.

In many car wreck cases, insurance companies claim that your symptoms are the result of preexisting conditions, not the car wreck. The insurance companies reason that they are only responsible for paying the damages their insured caused, not for paying your preexisting condition.

Indeed, under Wisconsin law, this is a legitimate claim for insurance companies to make in some cases. However, we have seen insurance companies raise the preexisting condition defense more often than necessary and sometimes for illegitimate purposes, namely to deny payment.

Whether a condition is preexisting or was caused by the wreck can be difficult to sort out. Here are steps that you can take to help.

  1. Work closely with your doctors. Tell the doctors all of your symptoms, including pain complaints. Documentation is important. Over time, a pattern often emerges that shows differences between your condition before and after the wreck.  
  2. Talk to friends and co-workers and ask them to document the differences between what you could do before and after the wreck.  
  3. Be careful about each insurance company document you sign. In particular, we recommend against signing any authorization that gives an insurance company unlimited access as to time and scope to our clients medical records. In other words, we don’t believe that in most cases it is appropriate for an insurance company to go back to your childhood and get your medical records. Similarly, we don’t believe that an insurance company should have access to sensitive medical records that have nothing to do with the claimed injuries.  
  4. Retain a qualified lawyer who understands the issues in your specific case. The problem is that often when an insurer raises the preexisting condition defense, you may be in for a long difficult fight. A lawyer can help you.

Again, sometimes the preexisting condition defense is used legitimately by insurance companies. Often it is not. We hope these simple steps help you if and when you face this defense in your car wreck case.

2810 Gilman Drive
Plover, WI 54467
phone: 715.343.2850
toll free: 855.343.2850
fax: 715.343.2803
email: jason@studinskilaw.com
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