If you ever experience a car accident, it’s vital to know the various ways to work with the insurance company with which you must deal. While you want to believe that their sole purpose is to protect you during this time, they’re not always willing to pay out compensation.
As with any business, insurance companies have a strong priority on profits. The more they have to pay out in claims, the less money they make. As such, they’re quick to find ways to minimize compensation or deny claims if it means they can protect their bottom line. One method they may try to use against you is any pre-existing conditions you may have. Here’s how.
Questioning the Validity of Your Claim
If you claim that you suffered injuries in a crash resulting of someone else’s negligence, the insurance company may dig into your medical history. Your medical records will show what injuries or conditions you have endured in the past and compare them with your current claim.
A pre-existing injury doesn’t disqualify you from pursuing compensation as the current damages you endure may be from the negligence of the other driver in your claim. However, it may become more difficult, prompting you to get a lawyer who can help utilize medical records to show that these injuries are current and stem from the crash.
The Importance of Medical Records
We highly recommend individuals involved in car accidents to seek medical help whenever they can. You can benefit greatly when you have medical records from a qualified professional showing that your injuries are current, severe, and were caused by a specific action.
The more information you have regarding your injuries, the less likely it is for an insurance company to use pre-existing conditions against you. In any case, working with an attorney can help combat the tactics the insurance company may try to use to deny or diminish your claim.
When you suffer because of negligence, know that our Salem car accident lawyers at The Gatti Law Firm are here to protect your rights. We’ll help you pursue the compensation you need to move forward. Trust in us to advocate on your behalf, using all evidence available to build a strong case to seek the most favorable outcome possible.
Call our firm today for a free consultation: (503) 543-1114.
FAQs
How are pre-existing conditions determined? A pre-existing condition is typically when you have received treatment or diagnosis before you enrolled in a new health plan.
How do pet insurance companies know about pre-existing conditions? ›
How do pet insurers know about pre-existing conditions? Depending on your insurer, when you submit a pet insurance claim, they will typically request your pet's medical records to evaluate the claim and determine if the issue predates your waiting period.
Can insurance companies deny coverage for preexisting conditions? ›
Under the Affordable Care Act, health insurance companies can't refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. They also can't charge women more than men.
What is the exclusion period for pre-existing conditions? ›
The time period during which a health plan won't pay for care relating to a pre-existing condition. Under a job-based plan, this cannot exceed 12 months for a regular enrollee or 18 months for a late-enrollee.
What if pre-existing conditions are not declared? ›
Failure to disclose pre-existing conditions not only jeopardizes the chances of successful claims but may also lead to the cancellation of the policy in extreme cases.
Does a pre-existing condition have to be diagnosed? ›
How are pre-existing conditions determined? A pre-existing condition is a health issue that required diagnosis or treatment prior to an applicants' enrollment in a health plan.
What counts as a pre-existing medical condition? ›
A pre-existing medical condition (PEMC) is an illness or injury you had before your policy began or was renewed. Examples of pre-existing medical conditions include, diabetes, asthma, high cholesterol or a long-term back condition.
When were pre-existing conditions eliminated? ›
The Affordable Care Act (ACA or “Obamacare”) prohibited pre-existing condition exclusions for all plans beginning January 2014, which was great news for all insurance beneficiaries with pre-existing conditions.
Is high blood pressure a pre-existing condition? ›
In the health insurance world, a pre-existing condition is any injury, sickness or condition that exists before the date an insurance policy takes effect. Examples include asthma, diabetes, anxiety, depression, high blood pressure, high cholesterol and so on.
How far back is a pre-existing condition? ›
A pre-existing medical condition is a disease, illness or injury for which you have received medication, advice or treatment or had any symptoms (whether the condition has been diagnosed or not) in the five years before your joining date. Health insurance doesn't usually cover 'pre-existing conditions'.
A pre-existing condition waiver means a travel insurance company can't examine your recent medical records when it's reviewing a medical claim.
What is the waiting period for pre-existing disease? ›
Pre-Existing Diseases (PED) Waiting Period
Examples of some pre-existing diseases are thyroid, hypertension, and diabetes. Generally, the waiting period for pre-existing disease in health insurance plans is 1-4 years.
Can Covered California deny for pre-existing conditions? ›
You cannot be denied based on a pre-existing condition.
Is a broken bone a pre-existing condition? ›
So what do health insurance companies mean by “pre-existing condition”? A pre-existing condition can refer to the following: A past injury or illness that you have already recovered from (such as a broken ankle from your youth)
