Can an Insurance Company have a Doctor Examine Me? Yes, it’s called an IME!

surgeon-3-1562055Independent Medical Examination, commonly referred to as an “IME.” Two of the most common, yet significant reasons behind this request can be:

  • Concern is shown by the defending party or the insurance company that the injuries, which you have suffered from, are not as severe as one claims; or,
  • They are trying to find out the exact reasons of your damages.

Regardless of what the reason might be, you as a victim need to know some basic facts about an independent medical examination – to deal with the opposing party and acquire the compensation successfully.

Prerequisite to Conduct an Independent Medical Exam:

After your accident, you will by examined by a physician. The doctor will outline all of the injuries you have suffered. As expected, the defending party or the insurance company would certainly appreciate a second opinion and would likely ask for an IME.

The advanced medical qualification of a professional carrying out the IME varies quite a lot and can differ from jurisdiction to jurisdiction.

However, the necessary requirements demand that the IME is performed by an M.D. or a D.O. For example, the IME should not be carried out by the psychiatrist, but can monitor an Independent Psychological Examination or IPE. On top of that, the medical professional conducting the IME needs to be seasoned in two different areas:

  1. Training, experience and should preferably hold appropriate credentials in the specific niche of IME.
  2. Medical knowledge or experience related to the area; per the victim’s case.

The qualifications mentioned above are not a necessity for all sorts of lawsuits. However, to obtain the highest-quality IME, professionals recommended such qualifications!

Steps to Follow and Generic Requirements to Request an IME:

When and if you are not available to submit to an independent medical examination, there are certain situations in which you might be compelled to attend the IME. For example, in cases where physical injuries have been alleged, the court or the jurisdiction might compel you to attend the hearing and the IME respectively.

This means that you are not eligible to file a lawsuit extensive to physical injuries, and then refuse to receive an IME. Upon a court’s motion made by the defendant, such as the insurance firm or the court’s decision, the plaintiff would be compelled to be examined by an IME.

The standards set for an IME usually vary from state to state; However, there are several basic requirements which you should be familiar with:

The insurance company or defendant is to pay for the entire independent medical examination.

At the trial or the deposition, the independent medical examiner needs to be available – to allow the plaintiff’s lawyer to cross-examine the professional.

A single IME is permitted – unless and until there is a procedure which needs to be further examined.

The insurance company or defendant needs to give the victim, which is you – a decent notice of the location, the time, the manner and the scope of the IME.

Arrangement of an Independent Medical Examination Report:

IME needs to provide and create a report, which should be given to both you and the opposing party for cross-examination. Furthermore, an introductory section needs to be there, including descriptive data, such as the summary of both conclusions and the injury dates.

Then, the claim needs to be presented with a brief history, in line with an in-depth review of your medical reports. Moreover, the document should contain the initial conversation between the examiner and yourself. On top of everything else, insight on the physical examination should be mentioned in the report – ended with a complete medical diagnosis.

The Relation Between Insurance Companies and IME’s:

In most lawsuits like these, the insurance companies are the ones calling for an IME, rather than a defendant. Most insurance companies ask for a long list of requirements in their policy clauses – related to IME’s.

These insurance firms call for a significant number of IME’s every year and are likely to use the same medical examiner. By doing so allows professionals to act bias and for the insurance company; which would be one of the most daunting challenges faced by you as the victim in the case. In most jurisdictions, the victims should bring their witnesses or physicians to an IME.

What to expect from an IME:

People usually tend to get nervous when an IME examines them – Quite often it can be a challenge – especially when you’re dealing with an IME; related to an insurance claim. As a victim, you need to be exceptionally punctual and required to bring forth all the medical records related to the case. In most cases, your attorney will be able to prepare you for the independent medical examination systematically.

However, you need to make sure that if you have not hired an attorney, and the IME is related to an insurance company – the answers need to precise. Instead of trying to explain your case, you need to make sure that they can restrict your replies to a simple ‘Yes’ or ‘No,’ if possible. Nonetheless, it is vital that you do not become hard to deal with or irresponsive and answer all the questions truthfully; to obtain all the records!

Author Information: percy martinez

To get more information about an Independent Medical Exam and how it works – make sure to visit our blog! This article should not be taken as legal advice. Percy Martinez, a Miami Medical Malpractice Lawyer, wrote this article, has been practicing law for over 20 years in the state of Florida.