Independent Medical Examination Requests from Insurance Companies

Independent Medical Examination Requests from Insurance Companies

What is an independent medical examination?

An independent medical examination or “IME” is an assessment carried out by a medical specialist who has never previously had the individual in their professional care.

Technically, an IME is supposed to provide an unbiased and professional medical exam as evidence in legal matters such as disability, personal injury and motor vehicle accidents. The medical professional carrying out the examinations cannot be under the employ of the party requesting the IME; i.e., the insurance company or the plaintiff’s legal representative.

The technical definition is arguably a misnomer, because a party will request an IME in order to get a medical report that supports their position, whether they’re on the side of the plaintiff or the defense, and will choose a doctor who they believe will be partial to their position. Insurance companies typically use the same doctors over and over again to have some control over the outcome of the report. An IME requested by the defense would be called a Defense Medical.

Which types of medical professionals are qualified to be independent medical examiners?

That will depend on the statute of law your case falls under. They may include but not be limited to family physicians, specialists, chiropractors, physiotherapists, psychiatrists and psychologists.

Is it mandatory to have an IME if my insurance company has made a request?

You always have a choice to decline an IME, but it is important to weigh out the possible consequences.

How much do you have to lose? If your claim has already been denied and you are not receiving any benefits from the insurance company, declining an IME will not affect your situation. However, if your claim is still pending or you are already receiving benefits, refusing to undergo an IME may result in being denied or cut off from benefits.  The decision to refuse an IME should be made in concert with your lawyer, who will determine whether the insurance company’s request for an IME is lawful.

Can I record the IME session?

You may record the session with the doctor’s consent in order to have an accurate record of the doctor’s questions and your answers. A recording may also determine whether the doctor’s examination techniques are competent and whether their report corresponds with the insurance company’s decision about your claim.

If the independent medical examiner concurs that the plaintiff’s medical condition is not disabling or not related to the accident in question, the insurance company may deny the claim for benefits.

Can I request a copy of the IME?

If your claim has been denied based on an independent medical exam requested by the insurance company, you will want to know why. You do have the right to request a copy of the IME report. If you are unsure whether the report written by the independent medical examiner was legitimate, call our office for answers.

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