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Insurance Claims and Pre-existing Conditions

Seth Harris

Last modified on September 21, 2023

Insurance Claims and Pre-existing Conditions

Dealing with an injury is challenging on its own. But when a pre-existing condition enters the equation, the path to a successful insurance claim becomes much less certain. Insurers frequently use pre-existing conditions to deny claims or reduce their value, hurting injured people when they most need help.

If an insurer refuses to pay your claim because of a pre-existing condition, a knowledgeable attorney can assist you in recovering the money you need. The New York personal injury lawyers at Harris Keenan & Goldfarb have spent nearly 30 years representing the injured and know how to fight pushy insurance companies.

What Is a Pre-existing Condition?

A “pre-existing condition” is any health issue, ailment, or injury you had before the incident that led to your current insurance claim. For instance, if you had a back problem from years ago and got into a car accident this week, your old back issue would be a pre-existing condition. Pre-existing conditions can complicate insurance claims because insurers often argue that your new injury or illness that affects the same area as your earlier condition is unrelated to the recent incident. Instead, they argue your current health problems are related to or were caused by the pre-existing condition.

Common Examples of Pre-existing Conditions

By definition, pre-existing conditions are any injury or health issue you had before filing your recent claim. However, some injuries or illnesses are more likely to cause insurers to object to a claim. These conditions include:

  • Arthritis: Chronic inflammation of the joints can create problems for claims involving joint injuries or similar health problems.
  • Degenerative Disc Disease: This condition causes the discs in your back to gradually break down, potentially complicating back or neck injury claims.
  • Hypertension (High Blood Pressure): If you had high blood pressure before an injury to or developing a health condition related to your heart, insurers are more likely to scrutinize your claim closely.
  • Diabetes: A metabolic disorder that an insurer might bring up in claims involving poor wound healing or circulatory concerns.
  • Previous Fractures: An insurer might bring up bone fractures you sustained in the past if your current claim involves a similar injury.
  • Asthma: If you have asthma and file a claim involving lung or breathing issues, an insurer might use your asthma diagnosis to deny or devalue your claim.
  • Migraines: Recurring, severe headaches can complicate claims involving head trauma or injuries.

Can Insurance Companies Deny Claims for Pre-existing Conditions?

Insurance companies examine every detail when evaluating claims, and pre-existing conditions often draw scrutiny. It’s common for insurers to point to these conditions as a reason to deny a claim or to offer a reduced settlement. However, it’s vital to understand that having one does not automatically invalidate your claim.

Just because you had a health concern in the past doesn’t mean you aren’t entitled to compensation for new injuries or worsened conditions due to a recent incident. A pre-existing condition might make the claim process more challenging. Still, with the right approach and evidence, it’s possible to counter the insurance company’s arguments and recover the compensation you deserve.

How We Can Help if You Have a Pre-existing Condition

Insurance Claims and Pre-existing Conditions 2Our New York personal injury attorneys have seen how insurers leave people in the lurch when they need help. If an insurance company is refusing to pay fair compensation due to a pre-existing condition, we can help by:

  • Thoroughly Evaluating Your Claim: Our experienced attorneys can meticulously review the details of your injury and the history of your pre-existing condition, ensuring the distinction between the two is clear and well-documented.
  • Consulting Medical Experts: Our team works closely with medical professionals to highlight the difference between your recent injuries and any effects of pre-existing conditions.
  • Negotiating on Your Behalf: Armed with a deep understanding of insurance tactics, our lawyers can effectively counter any attempts by the insurance company to undervalue or deny your claim based on a pre-existing condition.
  • Gathering Evidence: Our personal injury lawyers know the importance of quality evidence. They’ll gather all the necessary documentation to build a robust case in your favor.
  • Representing You in Court: If negotiations fail, we can represent you in court to protect your rights and give you the best chance of receiving the compensation you deserve.

No matter what an insurance company says, a pre-existing condition does not negate your right to compensation for more recent injuries. Harris Keenan & Goldfarb has extensive experience with these matters and can safeguard your interests throughout the claims process. Call [phone-number linked=true] or complete our contact form for a free consultation.

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Our track record showcases over $500 million won for our clients. Each victory underlines our commitment to justice and client care. Explore our impact, case by case.

VERDICT

$17,500,000

A Brooklyn jury awarded Mr. Vargas $17.5 million for the City of New York’s violation of his civil rights for failing to provide him medical care while in custody. The jury found that the police officers involved failed to provide the necessary medical treatment and awarded $17.5 million to Mr. Vargas.

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$4,730,398

Harris Keenan & Goldfarb partners Seth Harris and Sheri Holland obtained a $4,730,398.00 jury verdict on behalf of our client who tripped and fell at a private apartment building in the Bronx, suffering a broken foot that developed a very painful, permanent neurological condition called Reflex Sympathetic Dystrophy (“RSD”).

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$12,561,772

A Bronx jury awarded John Doe over $12 million for an accident on a construction site. John Doe was working when a piece of scaffold weighing 35 pounds fell, striking John Doe in the lower back. John Doe suffered a herniated disc requiring surgical removal of a portion of the disc and permanent nerve damage.

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$10,500,000

A Bronx jury awarded $10.5 million to the mother of Malcolm Ferguson, who was wrongfully shot and killed by the New York City Police Department. The police officer, Louis Rivera, also a defendant in the case, was found to have used excessive force in violation of Malcolm Ferguson’s civil rights as protected under the United States Constitution.

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$4,000,000

A Bronx jury awarded plaintiff William Cardoza $4 million for injuries caused by the use of excessive force during an arrest. During the arrest, Mr. Cardoza was pepper-sprayed and repeatedly hit with a police nightstick. As a result, Mr. Cardoza sustained injuries to his hand and finger.

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$3,470,670

The firm’s client, a 33-year-old teacher’s assistant, was scalded by an espresso machine that exploded while the defendant’s employee was demonstrating how the machine worked. The client was a customer at the defendant’s coffee shop on the date of the accident and suffered first-degree burns to her right (dominant) hand.

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$4,000,000

The firm represented the mother- decedent and her infant son. During the decedent’s admission to the defendant hospital, the defendant dispensed anesthesia during an epidural to the decedent in an inadequate manner. The mother-decedent suffered personal injuries and wrongful death due to the defendant’s failure to properly administer epidural anesthesia.

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$3,823,000

Mr.Brennan fell from approximately 25 feet while working on a construction project. He suffered a shattered bone in his right leg requiring surgery and hardware placement. Mr. Brennan also suffered two fractures in his facial bones, and a dislocated finger requiring surgical repair.

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$2,750,000

The firm’s client was a child with cerebral palsy who was injured as a result of medical malpractice. The firm’s clients claimed improper management of pregnancy, labor, and delivery resulting in brain damage, and received a Brooklyn personal injury settlement.

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$1,677,835

The firm’s client, a 63-year-old mentally incompetent man, slipped and fell in his own urine while attempting to walk to the bathroom at the defendant’s senior citizen home. The client fractured his hip and as a result is confined to a wheelchair for the rest of his life. The client claimed that the staff of the home failed to properly care for him, and the jury awarded $1,677,835.

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$2,995,000

The firm’s client, a 47-year-old male, slipped and fell on a public sidewalk in the Bronx. It had snowed four to five days prior to the date of the accident, and the sidewalk was covered with ice. The client suffered a lumbar fracture and a herniated disc. The jury found the city liable and awarded the client a $2,995,000 personal injury settlement in the Bronx.

VERDICT

$2,610,000

A Bronx jury awarded plaintiff Luis Molina $2.61 million for injuries sustained when he fell down a subway station stairway. Mr. Molina was caused to slip and fall as a result of a plastic bag that had blown onto the steps from a street opening. As a result of the fall, Mr. Molina suffered a herniated disc and a tear of his right shoulder’s rotator cuff. The jury found that the NYC Transit Authority was liable for the accident.

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$2,253,714

A Bronx jury awarded Ms. Colon $2.25 million for a trip and fall accident. Ms. Colon was caused to fall when she moved to the right to allow another pedestrian to pass, and her foot rolled to the outside due to the sidewalk being unlevel with the adjoining grass. The jury found the defendant liable and awarded Ms. Colon $2,253,714.00 for her pain and suffering.

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$1,900,000

A Brooklyn jury awarded Arvella Floyd $1.9 million for a fractured wrist which required multiple surgeries, including an open-reduction internal fixation and a carpal tunnel release. Ms. Floyd was injured when the hot water knob of the shower fell off after numerous complaints to the superintendent, and scalding water spewed toward her, causing her to
fall and break her wrist.

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$1,350,000

A Bronx jury awarded plaintiff Juanita Young $1,350,000 for injuries caused by the use of excessive force during an arrest. During the arrest, Ms. Young, who is legally blind, was handcuffed from behind, with her children watching, and taken to the top of the stairs to exit the building. The officer proceeded to push her down the stairs multiple times.

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I am completely satisfied, and recommend Harris Keenan & Goldfarb as Attorneys to represent anyone. Their care for me physically, and overall helped me stay strong in spite of my injuries. Always available to answer questions, and inform.They got me Justice, and achieved a substantial outcome for my case.I am very impressed, and thankful for their outstanding performance on my behalf.I am very pleased, and significantly satisfied with their representation.‐-Sherylon Wilkins
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Gene Matos (fanboye)Gene Matos (fanboye)
18:48 15 Jan 24
I first crossed paths with Seth Harris when serving jury duty many years ago. He was so professional and personable, that when my mom was seeking legal counsel for medical malpractice, I told her she had to reach out to his firm. We had meetings with a few different firms, but Harris Keenan & Goldfarb was the only firm that did not try to get us to sign paperwork before even meeting. They took the time to listen and understand our situation before we signed anything, and they were transparent and responsive the whole time. I would like to give special thanks to Samantha Walton, Marla Stein, Val Wallace and Seth Harris for helping my mom through this tough time. They were honest and upfront, and even though Seth Harris wasn't personally on the case, he took the time to meet with us and give us his thoughts on it.
Solange IsaacSolange Isaac
17:52 08 Jan 24
I am pleased with the services provided by Ms Sheri on my case. The team at Harris, Keenan, & Goldfarb were very nice and explained everything to me. Everything that I had questions on they answered without frustration and were prompt and knowledgeable.6 years ago I had a slip and fall accident at my employers place of business. I reached out to them because I knew that I was being wrongfully treated. They took care of the case, restored my self confidence, and brought so much peace to my problem riddled life.I can recommend without a shadow of a doubt the services of Harris, Keenan & Goldfarb to anyone who is in need of someone who will have your back!
Brittany DempseyBrittany Dempsey
16:02 08 Jan 24
My mother had an accident with her ankle back in 2019. I immediately contacted Harris, Keenan & Goldfarb on the day of the accident. They were extremely prompt and helpful. They attended to my mother's case beautifully and she's been recovering well. I'd like to thank you for being so diligent, kind and above all professional. I'd recommend this law firm to anyone who are injured and in need of legal assistance. My mother, Andrea, and I thank you for everything.
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