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Independent Medical Examinations

When a car accident victim claims that they have suffered injuries, the insurer responsible for paying the claim may ask them to undergo an independent medical examination (IME). “Independent” can be a misnomer because the doctor who conducts this exam is chosen by the insurer and thus is likely to be sympathetic to the insurer’s position. The purpose of an IME usually is to create a different medical opinion from the opinion of your treating doctor so that the insurer has a basis to dispute your claim. However, you likely are required to undergo an IME if the insurer asks for it.

Most of the time, an IME will result in a finding that the victim’s injuries are not as severe as they are asserting, that their injuries did not result from the accident, or that they are not actually injured. While you should be honest with the doctor, you should be careful about what you tell the doctor and how you behave in their presence. You should not exaggerate your injuries, but you also should not downplay them or agree with a doctor’s statements just to be polite. If possible, you should bring someone with you to corroborate your version of events at the IME in case this is contested later. This could be a friend or relative, or it could be another medical professional, which could be helpful if you want to challenge the IME doctor’s findings. You should also get copies of any documents that you sign and make notes afterward about the details of what happened, including any tests and diagnoses.

Typical Situations Involving an IME

If you are bringing a lawsuit based on a car accident, the defendant’s insurer probably will ask for an IME. This can provide information for the defendant’s expert witness at trial when they challenge the extent of your injuries or argue that your injuries were not caused by the accident. Sometimes a victim’s attorney can defeat or limit a request for an IME in the context of litigation.

On the other hand, you probably do need to undergo an IME if you live in a no-fault state and are making a claim under your no-fault car insurance. These policies usually require victims making a claim to undergo an IME as part of the investigation into their injuries.

If you do not live in a no-fault state and are not trying to use your no-fault coverage, you likely do not need to undergo an IME if your insurer requests it. You should be wary of voluntarily undergoing an IME when it is not required under the terms of the policy, even if the insurer requesting it claims that this will make your claim easier to settle. These exams are rarely helpful to a victim’s case.

Challenging the Results of an IME

If the findings in an IME are strongly adverse to your claim, and you believe that they are unwarranted, you may have options to consider. In the event that you brought someone to the IME, you can tell the insurer about the part of the IME that was unfair and warn them that this other person can verify your side of the story. You can also send your medical records to the insurer and point out that these are more likely to be thorough and accurate than a brief IME by an unfamiliar doctor. In extreme situations, you may want to ask your doctor to write a letter responding to the IME report, if you feel that the cost is worth it. You can also ask the insurer about the details of its relationship with the IME doctor. While the insurer likely will not provide this information, it may feel awkward about relying heavily on the report in the wake of refusing to disclose the information.

From Justia  

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