You got hurt. You filed a claim. Then the insurance company called. They’re blaming pre-existing conditions for new injuries. Classic injury claim denial.
Maybe it’s an old back injury. Maybe it’s arthritis you’ve had for years. Whatever it is, they’re saying your current pain isn’t from the accident.
Can a lawyer help? Yes, we can definitely challenge this.
Learn about why you’re not disqualified from getting compensation just because you weren’t in perfect health when someone else’s negligence hurt you.
A pre-existing condition is any health issue or medical condition you had before your accident.
This could be chronic pain, prior injuries from an old accident, arthritis, a bad back—the list goes on. Basically, anything that shows up in your medical history from before the collision.
Insurance companies hunt through your medical records looking for anything they can use against you. They’re trained to find old injuries and blame your current pain on them.
Their goal is to pay you less or pay you nothing.
The insurer’s job is to save money. One of the most common reasons insurance companies deny claims is by pointing to your medical history and saying your injuries existed before their client hit you.
They’ll say one of three things: your injuries were already there before the crash, the accident didn’t cause any new damage, or you were already susceptible to injury because of your condition.
It’s a tactic designed to reduce or reject claims. Insurance companies often try this because they know most people don’t understand their legal rights.
They’re banking on you accepting their denial and walking away.
California has a legal principle that changes everything. It’s sometimes called the “eggshell plaintiff” rule or the aggravation rule.
What it means in plain language: if someone negligently hurts you, they’re responsible for ALL the harm they cause—even if you were more vulnerable because of a pre-existing condition.
California law provides that defendants must take victims as they find them. You can recover compensation for:
New harm from the accident:
Aggravation of existing issues:
This means the at-fault party’s insurer must pay for the actual harm their client caused.
The impact of pre-existing conditions on your claim doesn’t eliminate your right to fair compensation. It just makes the insurance company work harder to avoid paying what they owe.
This is where things get challenging, but not impossible: Your lawyer needs to show the difference between your old injuries and the new harm caused by the accident.
Information that injury attorneys use to strengthen your case:
Medical documentation:
Professional medical opinions:
Your daily activities:
Seeing a doctor right away matters. Gaps in treatment hurt your claim because insurers use them to argue you weren’t really injured.
When you explain how the accident affected your condition through medical records and doctor testimony, you build a strong claim that the insurance company can’t easily dismiss.
A denial doesn’t mean your case is over. First, don’t panic. Second, don’t sign anything or accept a lowball offer just to make this go away.
Here’s what you should do:
Consider all your options. This may include filing a complaint with the California Department of Insurance or filing a lawsuit against the at-fault party.
Time matters here. California’s statute of limitations gives you two years from the date of your injury to file a personal injury claim in California.
The limitations for personal injury claims are strict. Don’t waste time hoping the insurance company will suddenly change its mind.
At DP Injury Attorneys, we’ve handled plenty of claims involving pre-existing conditions. We know exactly what the insurance companies use to deny claims, and we know how to respond.
Our approach includes:
We’ve seen how insurance companies often try to twist old injuries into excuses to deny claims. We’ve also won cases where insurers initially said no.
Our goal is to get you the compensation you deserve for your actual injuries, not what the adjuster thinks you should accept.
The party’s insurance company may try to use your prior injuries against you. That doesn’t make it right, and it doesn’t mean you have to accept it.
We take on the insurance bullies who think they can deny your claim in California just because you weren’t in perfect health before the accident.
We’ve got your back.
California’s statute of limitations keeps ticking. Contact DP Injury Attorneys now to discuss your case and learn how we can help you get fair compensation for your injuries.
Arthur Paul D’Egidio is the Managing Partner of DP Injury Attorneys, a San Diego personal injury law firm. With more than 12 years of experience in California injury law, he has dedicated his practice to representing clients in a wide range of personal injury matters, including car accidents, workers’ compensation, slip and falls, catastrophic injury, and wrongful death cases.
Arthur received his Juris Doctor from the Thomas Jefferson School of Law and is a member of the State Bar of California as well as the San Diego County Bar Association. He has received numerous accolades for his work, including being named a Super Lawyer for seven straight years by Thomson Reuters and a “Top 40 Under 40” by the National Trial Lawyers.
