Filing an auto insurance claim can be quite overwhelming. The insurance company may require specific documentation, recorded statements, and even an Independent Medical Examination (IME). By understanding what an IME entails, why it is conducted, and what to expect, you can, hopefully, ease some of the stress you’re experiencing as you navigate this new endeavor.
What are Independent Medical Examinations (IMEs)?
Independent Medical Examinations, commonly referred to as IMEs, are medical evaluations requested by an insurance claims adjuster and conducted by a healthcare professional who isn't involved in the direct care of the patient. They are designed to help insurance companies assess the extent of injuries sustained by you, the claimant. This is not to say that they work perfectly. Unfortunately, a lot of times the “objective” doctor is not very objective and is hired by the insurance company to say that the claimant requires no further treatment or compensation. If this is the result of your IME though, do not worry. Call an attorney at (855) LAW-MICH and we can help. With this caveat in mind though, let’s continue to look at what else you should know about IMES.
Why and How Are They Used?
IMEs can serve several purposes for an auto accident claim:
Corroboration of Injuries: IMEs are designed to corroborate the nature of the injuries you claim. Again, it is supposed to be an objective evaluation to ensure that you are receiving treatment and compensation that aligns with the extent of your injuries. They also are supposed to check if your injuries necessitate work loss, attendant care, or replacement service benefits. Whether or not the “independent” doctor is doing this objectively is another story.
Conflict Resolution: Additionally, IMEs are supposed to be used as a means of resolving disputes between you, the claimant, and the insurance company. This goes hand in hand with the previous purpose, but if the insurance company does not believe you require further benefits, whereas you do, the IME is supposed to bring about an objective resolution.
Determining Causation: If there is a gap in treatment, another intervening event, a pre-existing condition, etc., which make it hard for the insurance company to determine the cause of your injuries, IMEs can be used to determine causation.
What to Expect at an IME?
Most IMEs are very short, cursory examinations. The doctor will typically ask for a brief medical history, do a quick physical exam, and then write out their report. Here what you can typically expect from the process:
Scheduling the Appointment: You really don’t have to do anything for scheduling the appointment. Unfortunately, you usually don’t get a say in the date or time. The insurance company will schedule the appointment with a doctor of their choosing and send you a letter notifying you of the time, date, and location of the appointment. If you know that you cannot attend this appointment, let them know right away to reschedule. There can be steep cancellation fees if you wait till the last minute. If you need transportation to the appointment, also let them know right away and they can arrange a ride for you.
Reviewing your Medical History: As mentioned, the doctor will likely ask for a brief medical history. It’s very important that you are honest here. The insurance company is looking for any excuse to attack your credibility.
Physical Examination: Just like any other doctor’s appointment, the IME doctor will conduct a physical examination. If they ask you to do any sort of objective testing or imaging, consult an attorney. You are only there for a physical examination unless the judge orders otherwise.
Questioning: The doctor will likely ask you several questions about your medical history, pain, details of the accident, etc. Answer the questions but be concise. Don’t give them any more information than they require. Also, be courteous. Flat out refusing to answer the questions or being curt with the doctor is not going to help your case.
Writing the Report: The doctor will document their findings in a report for the insurance company. They will then use this to evaluate your claim.
What Typically Happens After an IME?
The insurance company will review the final report by the IME doctor and decide how to proceed with your claim. There are a few possible outcomes, but again, please keep in mind that it is very common for you to have a not so positive one. That is not the end all, be all and that is why it is so important to contact an attorney and talk through the specifics of your claim.
Some Possible Outcomes:
Confirmation of Claims: This is the best-case scenario. The IME will corroborate the severity of your injuries and push the insurance company to pay out the compensation you require and continue to pay your medical bills.
Discrepancies: Again, confirmation of claims is the best-case scenario. It is also, unfortunately, fairly unlikely. You should be prepared for the IME findings to dispute your claims. The insurance company can then use this as grounds to adjust or even stop the type of compensation and benefits you have been receiving.
Further Action: It also very well could be that further negotiations and legal proceedings are required to come to a full resolution.
In Conclusion
The whole process of filing an auto claim can be overwhelming, but that is why our expert legal team at MichiganLawsuit.com is here to help. IMEs are common, and while they can be scary when you don’t know the impact they’ll have on your case, we hope the knowledge above can help. If you have further questions about the process, please give us a call at (855) LAW-MICH. We deal with IMEs all the time and would be happy to impart our expert knowledge and advice.
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