Pre-Existing Conditions: Insurance Adjuster Tactics

Pre-Existing Conditions: Insurance Adjuster Tactics

At RedStone Law, our attorneys — Mike, Morgan & Mark — regularly handle personal injury and wrongful death cases in Kentucky and Tennessee. One of the most frequent defense tactics we see is the insurance adjuster pointing to a pre­existing condition as the cause of your injury instead of the crash or incident that triggered it.

What Is a Pre-Existing Condition?

A pre-existing condition is a symptom, diagnosis, or treatment that:

1. Began before the date of the accident, and
2. Is similar in nature to the injury you are now claiming.
   For example: many people have some form of back pain before a crash. The key question becomes: What new injury or exacerbation arose from the accident’s mechanism of injury?

Why It Matters in a Claim

In Kentucky and Tennessee, to hold someone liable in a personal injury action, you must prove that the negligent act caused your injury — this is referred to as medical causation.
If the defense can show your symptoms are entirely from a pre-existing condition, they may argue there is no new compensable injury — which can drastically reduce or eliminate the value of your claim.

Common Tactics Insurance Adjusters Use

• Over-generalization: They see a prior back problem or arthritis in your medical files, then claim all your pain stems from that condition, not the accident.
• “Playing doctor”: The adjuster acts like a medical expert, speculating that your current issues are due to the old condition — despite lacking the credentials.

How We Protect Your Case

At RedStone Law, we take specific steps to counter these tactics:

• We review your full medical history to identify what was truly pre-existing, the extent of it, and how the accident changed things.
• We document how the accident’s mechanism of injury caused new harm or aggravated a pre-existing condition — and how the “eggshell plaintiff” doctrine (you take the person as you find them) may apply.
• We communicate clearly with your medical providers to link treatment directly to the accident, not just the prior condition.

What You Should Do

• Be open with your doctor and attorney about your full history — honesty helps strengthen causation.
• Follow your medical treatment plan closely. Gaps or inconsistent treatment make it easier for adjusters to argue no new injury exists.
• Keep records of your symptoms, treatment, and any changes after the accident.
• Don’t accept an insurer’s claim that “it was just your prior condition” without a thorough review.

Ready To Talk?

If you’ve been injured in Kentucky or Tennessee and your insurer or the at-fault party is raising prior medical issues, contact RedStone Law for a free consultation. Attorneys Mike, Morgan & Mark will review your history, evaluate causation, and protect your rights from being undermined by pre-existing condition tactics.

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