Pre-existing Injuries and No-Fault Coverage

no-fault coverage for pre-existing injuryAs we all know, car accidents can be life-altering. These collisions can cause new injuries or even make old injuries much worse. Michigan residents are fortunate because our auto no-fault insurance system is designed to cover situations where one might face such instances. In other words, medical treatment for both new injuries as well as pre-existing injuries aggravated by a car accident may be compensated under the Michigan No-Fault Act.

This principle was recently affirmed by the Michigan Court of Appeals in Brown v Allstate Insurance Company.  In that case, the Plaintiff was injured in a car accident and suffered “[s]erious and traumatic injuries to his back, shoulders, right foot, and right leg as well as other injuries not yet manifested . . .”; he sought treatment a couple of days afterward. However, in the year prior to the accident, Brown sought treatment for various ailments he experienced as a result of his injuries sustained while serving his country: “[d]ifficulty with range of motion to both ankles . . . evidence of trauma involving both lower extremities . . . spasms in [his] ‘lumbar, thoracic, and cervical regions . . . .’”

Allstate argued that Brown’s back problems were no different from what he suffered before the car accident. It claimed that because his injuries did not arise out of the September 2009 collision, Brown was not eligible to receive no-fault benefits.  Even though Brown admitted that he did suffer from back pain and discomfort, he also believed the accident significantly exacerbated his pain and dysfunction – a claim that was substantiated by his doctor and supported through additional evidence.

In making its decision, the Court referenced its holding in Mollitor v Associated Truck Lines (1985), wherein it held that “a first -party no-fault claimant ‘may recover if he can demonstrate that the accident aggravated a pre-existing condition.'” The Court the found that Brown had presented enough evidence that he would be allowed to make his case to the jury on the issue of whether the accident played a role in his increased back pain — essentially, the circuit court improperly dismissed his first party claim.  In so holding, the Brown court stated the following:

Viewed in the light most favorable to Brown, the evidence supports that the September 2009 auto accident either exacerbated an underlying condition or caused a new back injury . . . . [t]he record contains evidence that, if credited by the fact-finder, could support that the accident caused back problems resulting in reasonable and necessary medical expenses . . . .

The analysis that goes into determining whether an individual can receive no-fault PIP benefits sustaining injuries in a car accident can be challenging and frustrating, especially if there are prior injuries to consider. For this reason, instead of trying to go it alone, it might be better to consult with knowledgeable Michigan auto no-fault attorneys who can provide you with the clarification you need.

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