Medical Causation in Personal Injury: We Continue Where Others Stop

·5 min read
Medical Causation in Personal Injury: We Continue Where Others Stop

Medical causation in personal injury cases explained. What if insurers dispute the causal link? Arslan Advocaten persists where others give up.

In many personal injury cases, everything ultimately comes down to one question: are your complaints the result of the accident? This is also known as medical causality. It is precisely on this point that victims often get stuck. Insurers dispute the connection, files are labelled 'medically complex' and not infrequently, legal representatives give up.

At Arslan Advocaten, that does not happen. Where others stop, we go on the attack. Out of court if possible, but if necessary also through robust legal proceedings such as a preliminary expert report or interim dispute proceedings.

What is medical causality in personal injury cases?

Medical causality concerns the connection between the accident and your complaints. The key question is:

Would these complaints also have arisen if the accident had not occurred?

If the answer is "no", or even "probably not", then in principle there is a causal connection. That sounds simple, but in practice this often leads to fierce debate.

Why is medical causality so often a problem?

Insurers initially often acknowledge liability for the accident, but later still dispute the damages. Particularly in cases involving:

  • whiplash complaints;
  • back and neck complaints;
  • psychological complaints;
  • prolonged pain without clear objective abnormalities;
  • aggravation of pre-existing complaints.

It is precisely then that medical causality becomes the breaking point in the case.

Frequently used defences by insurers

In files, we consistently see the same arguments recurring:

  • "The complaints are not objectively verifiable";
  • "There is pre-existence";
  • "The complaints do not match the accident";
  • "Recovery should have occurred by now";
  • "The pattern of complaints is multicausal".

For many victims, this represents a wall they cannot break through. And unfortunately, this also applies to some legal representatives.

Where other lawyers give up, we begin

We see it regularly: as soon as a case becomes medically complicated, the file is deemed "unwinnable". A low settlement or even termination of the case is pursued.

That is not our approach.

At Arslan Advocaten, the principle is: if the causal connection is legally and medically defensible, we push forward. Even if that means taking the case out of the negotiation track and proceeding to litigation.

Proving medical causality: how do we approach it?

We work systematically and strategically. In doing so, we examine, among other things:

  • your functioning before the accident;
  • the development of complaints after the accident;
  • consistency in medical reporting;
  • treatment reports from doctors and therapists;
  • daily functioning and limitations;
  • alternative causes (and the absence thereof).

In addition, we expressly look beyond the standard medical reports.

Preliminary expert report: the turning point

When insurers continue to refuse to acknowledge the causal connection, we regularly deploy a preliminary expert report.

This is a legal procedure in which an independent medical expert is appointed by the court to answer questions about:

  • the nature and severity of the injury;
  • the connection with the accident;
  • the influence of any pre-existing complaints;
  • the expected recovery.

Such an expert report is often decisive. Insurers cannot easily escape from this.

Interim dispute proceedings in medical causality

The interim dispute proceedings are also a powerful tool. Through these proceedings, we submit a specific legal point of dispute — such as the causal connection — to the judge, without immediately initiating full proceedings on the merits.

This offers several advantages:

  • swift judicial clarity;
  • pressure on the insurer;
  • breaking through deadlocks;
  • costs are often recovered from the insurer.

Where others keep negotiating without results, we force movement.

Out of court if possible, litigation if necessary

We do not litigate for the sake of litigating. On the contrary: if a case can be settled properly out of court, we do so. But we never allow ourselves to be held hostage by an insurer that keeps stalling.

It is precisely the willingness to litigate that in many cases ensures that a serious settlement is ultimately reached.

Medical causality and pre-existing complaints

Even in cases of pre-existence or predisposition, many parties give up. Unjustly so.

The legal starting point remains that a liable party must take the victim as they are. If the accident has aggravated or accelerated existing complaints, compensation remains possible.

You can read more about this on our page predisposition and pre-existence in personal injury.

Psychological complaints and causality

Psychological complaints are often the most fiercely contested by insurers. Yet anxiety, depression or PTSD can also be legally causally connected to an accident.

We do not shy away from these discussions and refuse to be deterred by the label "subjective".

Why this makes the difference for victims

For victims, our approach means they do not have to settle too quickly for a rejection or a minimal settlement.

Where others stop, we push forward. That is often the difference between:

  • no compensation or a low buyout sum;
  • and recognition, clarity and full compensation.

What can you do if medical causality is disputed?

Is the causal connection being disputed in your case? Then it is important that you:

  • do not agree too quickly with the insurer's position;
  • fully document your medical history;
  • make your functioning before and after the accident transparent;
  • engage legal assistance with litigation experience.

You can also find more general information on our page personal injury lawyer.

Does litigation cost me money?

In personal injury cases, the costs of legal assistance and proceedings are in most cases recovered from the liable party or their insurer. This also often applies to interim dispute proceedings and expert procedures.

You therefore need not fear that pursuing litigation automatically entails financial risk.

Why choose Arslan Advocaten?

We are known for our tenacity in complex personal injury cases. Medical causality is not a reason for us to stop, but rather a reason to sharpen our approach.

Where others give up, we go full on the attack. Out of court if possible. Through the courts if necessary.

Are you unsure whether your case still has a chance of success? Please feel free to contact us for an honest and substantive assessment.

Frequently asked questions

Wat is medische causaliteit?
Het verband tussen het ongeval en uw klachten. De vraag is of de klachten ook waren ontstaan zonder het ongeval. Zo niet, dan is er in beginsel causaal verband.
Moeten mijn klachten objectief aantoonbaar zijn?
Niet altijd. Klachten hoeven niet medisch objectiveerbaar te zijn, mits het klachtenpatroon reëel en plausibel is en past bij het ongeval.
Wat kan ik doen als de verzekeraar het verband betwist?
U kunt een voorlopig deskundigenbericht of een deelgeschilprocedure starten, naast een goede medische onderbouwing met dossier en behandelaarsverklaringen.
Wat betekent pre-existentie?
Dat klachten al bestonden vóór het ongeval. Een verzekeraar gebruikt dit als verweer, maar ook verergering van bestaande klachten door het ongeval kan voor vergoeding in aanmerking komen.
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