What is the purpose of IME exams?

Auto Law accident

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Introduction

Crash victims deserve to be treated fairly when it comes to being sent to an independent medical evaluation (IME). This means insurance companies should not be permitted to take unfair advantage of vulnerable people who have suffered injuries due to someone else’s negligence in a car accident. The insurers’ goal should be to assess damages fairly, accurately and honestly so they can compensate the victim accordingly. However, insurance companies sometimes run afoul of these principles by requiring crash victims to attend unnecessary or abusive IMEs.

Why does an insurance company require an independent medical examination?

Theoretically, an insurance company may require an independent medical examination (IME) to determine the extent of your injuries, and whether or not you are still in need of treatment. They will also use the exam to determine if you can return to work.

Thus, it is extremely important that you provide accurate information about how much time has passed since your accident occurred and how severely your injuries have affected your ability to function normally on a daily basis.

If the IME doctor finds that your injuries are as serious as you claim and your injury-related impairments are as disabling as you claim, then that will be reflected in the doctor’s IME report and based on that report, the insurance company will likely be obligated to continue to pay benefits to you under your policy.

In reality, this does not occur often because the goal of most insurers is to use IMEs as a way for the insurance company’s doctor to find a way to say you’re not injured or that you have fully recovered. Then, insurers can reject your claim and/or cut-off your benefits and claim it’s because the IME doctor (who was hired and paid for by the insurance company and who likely makes most of their living doing IMEs for insurance companies) said you were “fine” now.

When can an insurance company require that a crash victim attend an independent medical evaluation?

Depending on the laws of the state in which your car accident occurred, insurance companies can generally require that a crash victim submit to an IME by the insurance company’s doctor any time the victim’s physical and/or mental condition is materially relevant to his or her claim for insurance benefits as a result of the auto accident. 

How can my attorney help me avoid abusive independent medical examinations? 

Your attorney can help you avoid an abusive IME. Your attorney can negotiate the terms of the IME, including:

  • Who will conduct it
  • What types of tests and procedures will be performed
  • How long will it take to complete
  • Videotaping or otherwise recording the IME (depending on the laws of your state)
  • Having your lawyer or a witness present for the IME
  • Preventing you from having to drive unnecessarily far distances when an IME could be conducted closer to you

Your attorney may also assist you in preparing for any medical examination by gathering information from your doctors or other sources regarding any existing conditions that may affect their ability to perform certain tests or procedures during an independent medical exam. This information can be useful when negotiating with opposing counsel about what types of testing should be done during an independent medical examination (IME). For example, if there is a serious risk that performing certain diagnostic tests could cause further injury or harm to your client’s condition, then these tests should not be ordered by either party’s IME doctor(s).

Crash victims have rights when it comes to being sent to an IME.

Depending on the laws of your state, you may have the right to require that the IME doctor is actually a licensed physician. You may also have the right to require that an IME doctor specialize in the same specialty as your treating specialist. This includes requiring the same board certification where applicable. You may also have the right to require that the IME doctor devotes a majority of his or her professional time to actually treating patients – and not just exclusively doing insurance IMEs.

Conclusion

Crash victims have the right to be treated fairly when it comes to being sent to an IME. If you’ve been asked to attend one, contact a Michigan Auto Law auto accident attorney immediately. We’ll help you protect your rights and make sure that the insurance company isn’t abusing its power by requiring an unnecessary examination.

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