How to Prove Your Bone Fracture Was Caused by a Bronx Crash

You survived a serious car crash on the Grand Concourse or a slip and fall near Fordham Road. Now, you are dealing with the sharp, agonizing pain of a fractured rib, a cracked vertebra, or a broken joint. You assume your medical bills and lost wages will be covered because your injuries are clear. However, you soon receive a devastating letter from the insurance adjuster. They claim your fracture is not from the crash at all. Instead, they argue it is a pre-existing degenerative condition, pointing to your old medical records to prove it.

According to Bronx crash data analyzed by the safety organization Transportation Alternatives, bone fractures are legally classified as serious injuries under New York State law, yet insurance companies routinely try to devalue them. Insurance adjusters are trained to save their companies money. They will dig through your past medical history to find any mention of arthritis, osteoporosis, or back pain. Then, they use that history as an excuse to deny your claim. This step-by-step guide will show you how to fight back and protect your right to fair compensation.

Step 1: Request Your Complete Medical History Immediately

First, you must gather your own records before the insurance company can mischaracterize them. Do not wait for the adjuster to request your files. Instead, contact every doctor, hospital, and physical therapy clinic you visited over the last five years. You have a legal right to these documents under federal privacy laws.

Meanwhile, make sure you obtain the actual imaging films, not just the written reports. You will need the raw X-rays, MRI scans, and CT scans. Having the complete file allows you to see exactly what the insurance company sees. Consequently, you can prepare your defense before they even launch the pre-existing condition argument.

Watch out: Insurance adjusters will often ask you to sign a broad, unlimited medical authorization form. Do not sign it. This form allows them to fish through your entire life history, including unrelated childhood injuries or mental health records, to find anything they can use against you.

Step 2: Understand the Eggshell Skull Doctrine

Next, you must learn the legal rule that protects vulnerable victims. In New York, personal injury law relies on a concept known as the “Eggshell Skull” doctrine. This rule states that a defendant must take a victim as they find them. Therefore, if you have fragile bones due to age or osteoporosis, the negligent driver is still fully responsible for the harm they caused.

For example, an older adult might suffer a severe spinal fracture from a low-impact crash that would only cause minor bruising in a younger person. Under New York law, the insurance company may not discount your claim just because your bones were already weak. Our Bronx personal injury lawyers have decades of experience helping accident victims hold negligent parties accountable under this exact legal standard.

Pro tip: Even if you had mild, pain-free arthritis before the crash, you are entitled to compensation if the accident aggravated or accelerated that condition into a painful, disabling injury.

Step 3: Secure Objective Diagnostic Imaging Tests

Also, you must fight their subjective opinions with objective medical science. Insurance doctors often look at a standard X-ray and claim a vertebral compression fracture looks “old and healed.” To counter this tactic, you need advanced diagnostic imaging that proves the fracture is brand new.

Ask your treating physician for a bone scan or a magnetic resonance imaging, also known as an MRI. An MRI can detect bone marrow edema, which is swelling inside the bone.

Bone marrow edema appears in many conditions, not only fresh acute fractures. If your MRI shows edema around the fracture site, it can be helpful in demonstrating that the break occurred during the recent accident, not years ago.

Watch out: Insurance companies frequently rely on their own hired doctors, who only review your paperwork without ever examining you, to claim your injury is degenerative. Objective imaging like an MRI makes it incredibly difficult for these paper-reviewing doctors to deny the truth.

Step 4: Obtain a Detailed Letter of Causation from Your Doctor

In addition, you need your treating physician to actively advocate for your recovery in writing. A simple medical chart note is rarely enough to defeat a stubborn insurance adjuster. Therefore, you should ask your doctor to write a formal “letter of causation.”

This letter must explicitly state that, within a reasonable degree of medical certainty, the physical trauma of the accident caused your specific fracture. Your doctor should explain how your current symptoms differ entirely from any past complaints. Our injury attorneys in the Bronx handle car, construction, and slip-and-fall cases, and we know that a strong, clear letter from a local treating physician is one of the most powerful tools in a personal injury claim.

Pro tip: Ask your doctor to compare your pre-accident physical abilities with your current limitations. This comparison clearly demonstrates the direct, life-altering impact of the new fracture.

Step 5: Document Your Pre-Accident Baseline

Finally, you must show the human side of your injury by establishing your pre-accident baseline. Insurance adjusters treat victims like file numbers, but you need to show them who you were before the crash. Gather evidence of your active daily life prior to the injury.

For instance, collect recent photos of you playing with your grandchildren, testimonies from coworkers, or gym membership logs. If you were working full-time and walking through Bronx parks without pain before the crash, the adjuster cannot easily argue that your pre-existing condition was already disabling. Showing this stark contrast proves that the accident, and the resulting fracture, is the sole cause of your current suffering.

Pro tip: Keep a daily pain journal. Documenting how the fracture prevents you from sleeping, dressing, or driving provides concrete, daily evidence of your damages.

Overcoming the Pre-Existing Trap

Bottom line: defeating the insurance company’s favorite tactic requires preparation, objective medical evidence, and aggressive legal representation. Adjusters want you to feel discouraged so you will accept a lowball settlement. However, by securing your complete records, obtaining advanced imaging, and understanding your legal rights, you can protect the true value of your claim.

If you need an experienced Bronx accident lawyer, our firm is ready to fight for you. We understand the local courts, the neighborhood streets, and the games insurance companies play. Contact us today to schedule a free consultation and let us help you secure the compensation you deserve.

Sources

• National Institutes of Health, Falls and Fractures in Older Adults: Causes and Prevention