Insurance Refuses to Pay Due to Pre-Existing Condition...

by Steve
(White Lake, South Dakota, USA)

I was shopping in a store and the shopping cart I was pushing broke. The handle snapped off violently because it was rusted out. From the handle breaking I received a 1 inch cut on my left arm about 3 inches up from my wrist.

I informed the manager of the store and a claim was filed with them. I received medical treatment but it wasn't good enough. I ended up getting an infection in my left arm which then led to inflammation in my left elbow that took 10 months to get rid of.

This is the tricky part. I had an ulner nerve transposition done on my left elbow on Dec. 19, 2009. I was medically cleared by my doctors on May 14th, 2010. The injury to my arm was on May 19th 2010.

So the insurance provider for the store claims that everything that happened to my arm after the cut was because of the surgery I had 6 months prior. They are not willing to pay for any of the incurred costs of this, past $120 for the initial doctors visit. Do I have a personal injury case?

Visitor Question:
Disclaimer: Information provided in our response is NOT formal legal advice. It is generic legal information based on the very limited information provided. Under no circumstances should the information in our response, or anywhere else on this site be relied upon when deciding the proper course of a legal matter. Our response does NOT create an attorney-client relationship. Always get a formal case review from a licensed attorney in your area.

ANSWER for "Insurance Refuses to Pay Due to Pre-Existing Condition...":


From the facts you present it seems you have a basis upon which to make a claim. You should though be prepared for a vigorous defense to your claim. Understanding the process of litigation will help you decide whether or not you want to proceed.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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