Yes, a pre-existing condition will impact your personal injury settlement, but not in the way insurance companies may want you to believe. It does not automatically disqualify your claim or reduce what you recover.
The core issue is not if you had a prior condition, but proving how the recent accident made that condition worse—a concept known as “aggravation.”
Insurance companies use a pre-existing condition as leverage to argue that your pain isn’t from the accident, aiming to pay you less. However, Indiana law protects injured people in this exact situation through a legal principle called the “Eggshell Plaintiff Rule.”
If you are concerned about how your medical history might affect your injury claim, call Yosha Law for a free consultation at (317) 648-7319.
Key Takeaways for Pre-Existing Conditions in Indiana Injury Claims
- Insurance companies use your medical history to reduce your payout. They often argue that your pain is from an old injury, not the accident. But that doesn’t mean they’re right.
- Indiana’s “Eggshell Plaintiff” rule protects you. The law holds the at-fault party fully responsible, even if you were more vulnerable due to a prior condition.
- Proving change is key. Clear before-and-after medical records, expert opinions, and personal testimony help show how the accident worsened your condition and justify full compensation.
The Insurance Company’s Playbook: Why Your Medical History Is Suddenly Under a Microscope
The insurance adjuster’s questions about your past are part of a calculated strategy to minimize their payout.
Why Are They Asking for Years of My Medical Records?
Adjusters are looking for any mention of a similar condition. A sore back reported five years ago will be used to argue your current herniated disc isn’t from the car crash.
Their goal is to create doubt and connect your current pain to your past, not to the recent accident. They want to build a narrative that suggests your injuries are not as severe as you claim or were not caused by their insured’s negligence.
Common Arguments You Might Hear
Adjusters use specific phrasing designed to devalue your claim.
- “This is just a flare-up of your old arthritis.” They will suggest the accident didn’t cause a new injury but simply triggered a temporary worsening of an existing problem. This argument attempts to minimize the long-term impact of the accident.
- “Your medical records show a history of back pain.” They use broad statements to imply your condition was already severe, even if it was minor and manageable before. This tactic ignores the difference between manageable, chronic pain and acute, debilitating pain.
- “You would have needed this surgery eventually anyway.” This is an attempt to devalue claims for necessary medical procedures. They argue the accident didn’t create the need for it, but merely sped up the timeline for an inevitable surgery.
The Financial Motivation
Insurance companies are for-profit businesses. They have a duty to their shareholders to limit payouts while still fulfilling their contractual obligations. This means they conduct a thorough investigation, looking for any evidence to argue you were at fault or that your injuries are not related to the accident.
Indiana’s “Eggshell Plaintiff” Rule: A Shield for the Vulnerable
Indiana law has a powerful, long-standing rule that holds a negligent party responsible for all the harm they cause, even if the victim was more susceptible to injury than the average person. This principle levels the playing field for those with prior medical conditions.
What is the “Eggshell Plaintiff” Rule?
The law requires a defendant to “take their victim as they find them.”
Analogy: If you lightly tap a normal teacup and it doesn’t break, you’ve caused no harm. But if you lightly tap a teacup with a hidden, hairline crack (the pre-existing condition) and it shatters, you are responsible for the shattered cup. The fact that it was more fragile doesn’t excuse your action.
This legal doctrine is a cornerstone of personal injury law in Indiana and across the U.S. It ensures that a person’s vulnerability does not become a windfall for the person who caused them harm.
How Does This Rule Apply to My Case?
It means the at-fault party cannot use your age, frailty, or a pre-existing medical condition as an excuse to pay less. Their responsibility is measured by the damage they caused, not the damage they intended to cause or what might have happened to a healthier individual.
- Example 1 (Degenerative Disc Disease): You had manageable back stiffness before a rear-end collision. After the crash, you have radiating leg pain and need a spinal fusion. The defendant is responsible for the cost of the surgery and your increased pain because their negligence turned a manageable condition into a debilitating one.
- Example 2 (Prior Knee Injury): You had a stable knee after an ACL repair years ago. A slip and fall at a grocery store tears the meniscus in that same knee. The store is responsible for the new tear and the resulting instability, even if your knee was not “perfect” to begin with.
The Bottom Line
You are not penalized for having a medical history. The focus of a personal injury claim is on what changed after the accident. The defendant is liable for any aggravation or new injury their negligence caused in personal injury case.
Aggravation vs. A New Injury: How We Prove the Accident Caused New Harm
The key to a successful claim is building a clear, evidence-based story that draws a bright line between your “before” and “after.” We do this by meticulously documenting the change in your condition, leaving no room for the insurance company to argue that your pain is unrelated to the accident.
Drawing the Line: What’s the Difference?
- Aggravation: A pre-existing condition is made measurably worse. For example, your manageable arthritis becomes severely painful, limiting your ability to walk. Compensation covers the increase in pain, medical bills, and limitations.
- New Injury: An injury that is entirely new or affects a different part of the body. This is more straightforward but less common when a prior condition exists in the same area.
- Activation of a Dormant Condition: You may have had an asymptomatic condition (like a bulging disc you didn’t know about) that was made painful by the trauma of the accident. In the eyes of the law, this is typically treated as a new injury, since it was not causing you any problems before the incident.
Building the “Before-and-After” Narrative
Courts and insurers rely heavily on “before-and-after” medical records. Our job is to tell this story with undeniable evidence, showing a clear progression from your baseline health to the condition you suffer from today.
- Medical Records Analysis: We don’t just submit your records; we analyze them. We look for your doctor’s notes describing your condition as “stable,” “chronic but managed,” or “asymptomatic” before the accident. Then we contrast those with the “acute,” “severe,” and “debilitating” descriptions found after the accident.
- Your Personal Testimony: Your own account is powerful. Could you work a full day before, but now you manage only a few hours? Could you lift your grandchildren, but now you can’t? We help you document these specific, tangible changes in your daily life.
- Expert Medical Opinions: In many cases, we work with medical professionals. Your treating physician or an independent medical expert writes a report or testifies, stating with a reasonable degree of medical certainty that the accident directly caused the aggravation of your condition. This expert testimony is typically the deciding factor in convincing an insurer or a jury.
The Evidence That Makes the Difference
The burden of proof is on you, the injured party. This means you must present evidence to support your personal injury claim. Our role as your legal partner is to help you gather, organize, and present that evidence in the most compelling way possible.
A strong claim is built on a foundation of clear, organized, and credible evidence. Here’s what we gather to prove your case:
- Complete Medical History: We need all records related to your pre-existing condition, even from years ago. Full transparency prevents the insurance company from claiming you were hiding something and strengthens your credibility.
- Post-Accident Medical Treatment Records: This includes everything from the initial emergency room visit to ongoing physical therapy. Consistent treatment demonstrates the severity of the injury and your commitment to recovery.
- Diagnostic Imaging: We will compare new MRIs, X-rays, or CT scans to any older ones. A new scan showing a herniated disc where an old one only showed mild degeneration is powerful proof of a change in your condition.
- Statements from Your Doctors: A letter from your long-term family doctor or specialist explaining your baseline health before the accident is invaluable. This provides a professional, third-party account of your “before” state.
- Pharmacy Records: Prescription histories show you were taking minimal medication before, but now require significant pain management. This is a simple but effective way to illustrate the increased severity of your condition.
- Witness Testimony from Friends, Family, and Co-workers: These individuals speak to the changes they’ve observed in your physical abilities and quality of life since the accident, providing a human element to your claim.
Frequently Asked Questions About Pre-Existing Conditions and Indiana Injury Claims
Do I have to disclose my pre-existing condition to the insurance company?
Yes. Honesty is non-negotiable. Hiding a condition will damage your credibility and is used to deny your personal injury claim entirely if discovered later. The strategy is not to hide your medical history, but to confront it head-on with clear evidence of aggravation caused by the accident.
Can my own health insurance refuse to pay for treatment because of the accident?
Your health insurance should cover your initial medical bills. However, they may seek reimbursement from the final personal injury settlement through a process called subrogation. This means they have a right to be paid back for the costs they covered that were caused by someone else’s negligence. Our personal injury attorneys will handle these negotiations for you to maximize the amount you keep.
What if I don’t have a family doctor or a long medical history?
This is not uncommon. In these situations, the medical records created immediately after the accident become even more important. The diagnosis from the emergency room or an urgent care clinic establishes a baseline of your injury from the incident itself, creating the starting point for your “after” narrative.
Is there a specific law in the Indiana Code that covers the “Eggshell Plaintiff” rule?
The “Eggshell Plaintiff” doctrine is a common law principle. This means it has been established and upheld by Indiana courts over many years through case decisions rather than being written into a single statute.
Could my pre-existing condition actually *increase* my settlement?
In some situations, yes. If the accident took a minor, manageable condition and turned it into a permanent, life-altering disability, the compensation required to account for that drastic reduction in your quality of life may be substantially higher than if you had no prior condition at all. The settlement is based on the extent of the harm, and making a vulnerable person’s condition worse causes a great deal of harm.
Your Past Doesn’t Define Your Recovery
You are not to blame for having a medical history, and you shouldn’t have to pay out of pocket for expenses when someone else’s carelessness makes it worse.
One phone call is enough to get started. If you’re ready to discuss your situation, call Yosha Law at (317) 648-7319.
