The insurance policy generally allows the insurance company to require the claimant to be the subject of an independent medical examination (IME) or other independent expert evaluation. It allows the company unilaterally to select an independent medical expert or other expert, and usually does not permit the joint selection of the doctor or other expert by the claimant and insurer. The result is often a biased report in favor of the insurer and gives the insurer an excuse to limit, deny, or terminate the claim. While some reports prepared for some carriers are straightforward and accurate, many others are significantly biased.
Why is there a need for an Independent Medical Exam (IME)?
Generally the victim is examined and treated by a doctor chosen by the victim. So it is possible that the doctor may be biased towards the victim while determining the extent of the victim’s injuries. The party from whom the compensation is being sought may want an IME in order to have an unbiased view. The objective of an IME is to determine whether or not the victim indeed suffered the injuries which he or she claims to have suffered and that the accident is indeed the cause of the injuries.
When does an IME become required?
Under certain circumstances, the victim cannot refuse an IME. In many states, the law allows insurance companies to compel an independent medical examination if the claim appears questionable. However, the policy must specifically state that the insurance company can require the insured to submit to an IME. The insured may be exempt from this examination if requiring the examination would result in undue hardship to the insured, such as undertaking an overnight journey.
In most states, the judge can order an IME if the circumstances of the case require him or her to do so. Generally, judges can order an IME when the injuries are in dispute. If an injured victim sues only for property damage suffered in the accident and not for injuries, then such an examination cannot be ordered. Similarly, if the injury has healed completely, such examination cannot be ordered.
Independent medical examinations can be ordered in other lawsuits such as child custody lawsuits to determine if a parent is mentally capable of managing a child.
Independent Medical Exam (IME) Process
Sometimes the victim may have to undergo more than one exam. The party seeking the examination must pay for the costs. In some cases, the party seeking the examination can also select the physician who will conduct the examination. If the victim does not agree to the physician chosen by the other party, the court will decide on the physician. The victim’s lawyer may also attend the examination.
If you are claiming compensation for your injuries, you should be prepared to submit yourself to an IME. Treat it like a regular medical examination. There is nothing to be worry about. If the physician’s report goes against you, you can challenge the report in the court.