I was injured in a car accident that wasn't my fault, and now my own insurance company is requesting that I submit to a medical examination by a doctor of its own choice. Do I have to go?

 



Davis Law Group


A:

Unfortunately, and in most cases, yes. Your insurance company has the contractual right to have you examined and to have your treatment reviewed by another medical professional. Insurance companies like to call these one-time examinations "Independent Medical Exams" or "IME's." This is a gross misnomer however-- they should really be titled "Insurance Medical Exams" because insurance companies use these one-time exams (or in some cases, a one-time medical records review) as a way to terminate benefits regardless of whether you are still benefiting from additional treatment. Insurance companies use "IME's" to save them money and their medical examiners are often "hired guns" willing to offer the right medical opinion to justify this goal. As one doctor friend of mine aptly states -- opinions are commodities like everything else and you can always buy the right one you are looking for. If you find yourself being requested to submit to an "Insurance Medical Exam," here are a few suggestions. First, before submitting to an exam, read your policy! The insurance company's right to request an exam is contained within the insurance contract. Review it to make sure the company is not violating any of the policy provisions. Second, you really should consider hiring an attorney. Recent case law has suggested that the "IME" report may be discoverable by the third party tortfeasor, providing additional ammunition for the defense attorney. Attorneys can often insist that the exam be delayed and insist that an impartial observer be present during the exam. Third, make sure you give the examiner an accurate description of your prior health problems, current complaints, and the facts of the crash. Any discrepancies will be used against you. Lastly, recognize that the examiner will be looking for all signs that you are not injured -- how you walk into the examination room, how you sit, how long you sit, facial expressions, etc. In one case I handled, the examiner wrote in his report how he watched my client drive into the parking lot, "jump" out of his car with no "apparent difficulty" and "ran" into the building entrance! Need I say more?








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