Tuesday, July 14, 2009

IME - Insurance Medical Examination

There are many situations during the pendency of a claim or lawsuit that the other side (the insurance company) is entitled to have a doctor of their choosing examine you. Insurance companies refer to these exams as “independent medical examinations.” Make no mistake, these “exams” are paid for by the insurance company and the outcome or “medical report” is usually predictable. In many cases, the insurance doctor will boldly conclude you had some sort of pre-existing underlying condition, and the accident related injury is merely superimposed upon your “pre-existing” condition.

Even instances where the claimant (you) had no prior problems, or was asymptomatic (didn't have any symptoms), the insurance doctor often concludes the accident related injury only lasted a matter of months and any other pain you are experiencing is due to old age (or anything else they can blame it on). Basically, they claim that your pain came from anything else other than the accident your were involved in. It goes without saying that insurance companies like these doctors, as they give the insurance company a reason to cut off your benefits. Thus, we see the same doctors used time and again (even though some of them had their medical licenses revoked in other states for committing malpractice!).

Do I have to attend the IME?

That is something to discuss with your personal injury attorney. There are various consequences to failing to attend a scheduled insurance medical exam. You can be forced to pay the cost of an IME if you fail to show up. You may even have your claim dismissed for failing to attend a scheduled IME. In some cases, the court will make you attend the IME.

What should I expect to happen during the IME?

A well prepared insurance doctor will have received many of your accident related medical records as well as prior medical records pertaining to the same or similar body parts injured in the accident. The insurance doctor oftentimes will also have the police report, property damage reports and photographs, and sometimes your deposition transcript. The insurance doctor will most likely have reviewed the records prior to your exam and should be somewhat familiar with your case.

Sometimes, the insurance doctor will go so far as to spy on you while you are waiting for your insurance medical exam or after you are leaving the office, and write his or her observations in the report.

During the exam, you can expect the insurance doctor to ask questions about your background, including education, military experience, marital status etc. The insurance doctor will ask about other injuries you had to the same or similar body parts both before and after the subject accident. The insurance doctor will ask you what happened during the accident. The insurance doctor will inquire as to your injuries, treatment, and prognosis. The insurance doctor may also ask about any recreational activities you enjoyed before the accident and whether the accident has affected your ability to participate in those activities.

How should I answer the insurance doctor’s questions?

Truthfully! Remember, the insurance doctor likely has all of your medical records, both before and after the accident. The insurance doctor likely knows a great deal about you from reading your records and other documents. Credibility is everything when it comes to making a claim or filing a lawsuit. If you are less than honest or overstate (exaggerate) your case, this will be used against you at a later time.

The insurance doctor may also use orthopedic or neurological tests to try to determine if you are faking your injuries. Again, be truthful. Do not say something hurts if it does not. Be very honest and you’ll have a better chance to prevail.

-Arne Cherkoss

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