Medical causality in personal injury cases: we keep going where others stop

17 January 2026

Arslan Advocaten

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Medical causality in personal injury cases: we keep going where others stop

In many personal injury cases, everything ultimately revolves around one question: are your symptoms the result of the accident? This is also known as medical causation . It is precisely at this point that victims often get stuck. Insurers dispute the connection, files are labeled ‘medically complex’, and not infrequently legal representatives withdraw.

At Arslan Advocaten that doesn’t happen. Where others stop, we go on the offensive. If necessary, out of court, but if need be also through robust court proceedings such as a preliminary expert report or a partial dispute procedure.

What is medical causation in personal injury claims?

Medical causation concerns the link between the accident and your symptoms. The key question is:

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

If the answer to that is “no”, or even “probably not”, then in principle there is a causal link. That sounds simple, but in practice this often leads to heated debate.

Why is medical causation so often a problem?

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

whiplash symptoms;
back and neck complaints;
psychological complaints;
persistent pain without clear objective abnormalities;
worsening of existing complaints.

Precisely then, medical causality becomes the crux of the case.

Common defenses by insurers

In case files we repeatedly see the same arguments:

“The complaints are not objectively verifiable”;
“There is a pre-existing condition”;
“The complaints are not consistent with the accident”;
“Recovery should have occurred by now”;
“The clinical picture is multicausal”.

For many victims, this means a wall they cannot get through. And unfortunately, that also applies to some representatives.

Where other lawyers give up, we start

We see it regularly: as soon as a case becomes medically complicated, the file is called “unfeasible”. There is a push for a low settlement or even termination of the case.

That is not how we work.

At Arslan Advocaten applies: if the causal link is legally and medically defensible, we persevere. Even if that means we take the case out of the negotiation process and litigate.

Proving medical causality: how do we approach that?

We work in a structured and strategic manner. In doing so, we look at, among other things:

your functioning before the accident;
the progression of symptoms after the accident;
consistency in medical documentation;
treatment records from physicians and therapists;
daily functioning and limitations;
alternative causes (and the absence thereof).

In addition, we explicitly look beyond just the standard medical reports.

Preliminary expert report: the tipping point

When insurers continue to refuse to acknowledge the causal link, we regularly initiate a preliminary expert report in.

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 link with the accident;
the impact of any pre-existing conditions;
the expected recovery.

Such an expert report is often decisive. Insurers cannot easily evade it.

Partial dispute proceedings on medical causality

Also the partial dispute procedure is a powerful tool. With it, we submit a specific legal issue — such as causation — to the court, without immediately starting full proceedings on the merits.

This offers several advantages:

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

Where others keep negotiating without result, we force progress.

Out of court if possible, litigate if necessary

We do not litigate for the sake of litigating. On the contrary: if a matter can be properly resolved out of court, we do that. But we never let ourselves be held hostage by an insurer who keeps stalling.

Often, the mere willingness to litigate results in a serious settlement being reached.

Medical causation and pre-existing conditions

Even with pre-existing conditions or predisposition, many parties drop out. Unjustified.

The legal principle remains that a liable party must take the victim as they find them. If the accident aggravated or accelerated existing conditions, compensation is still possible.

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

Psychological complaints and causation

Insurers often contest psychological complaints most vigorously. Yet anxiety, depression, or PTSD can also be legally causally linked to an accident.

We do not shy away from these discussions and are not deterred by the label “subjective”.

Why this makes the difference for victims

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

Where others stop, we press on. That is often the difference between:

no compensation or a low lump-sum settlement;
and recognition, clarity, and full compensation.

What can you do if medical causality is disputed?

Is causality 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 clear;
engage legal assistance with litigation experience.

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

Will 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 often also applies to partial disputes and expert procedures.