Can the Insurance Company Force a Medical Evaluation After a Car Accident?

If you’ve been in a car accident, the insurer responsible for paying your claim may ask you to undergo an independent medical examination (IME).

In personal injury cases involving car accidents, the primary evidence that is used is the medical records of the victim. Seeing a doctor after being in an accident is crucial for having the grounds to file a claim. However, many times, it’s not as simple as getting checked, receiving a prescription, adding up the numbers, and giving the bill to an insurance company.

Insurance companies are for-profit companies, and they will always try to pay as little as they can for the claims they receive. Insurers use different tactics to minimize their liability and pay smaller settlements. Often, the people who are insured or who file third party claims are not fully aware of what an insurance company can and can’t do.

Policies are often complex contracts between an individual and a company. They include very specific details about the circumstances and limits of coverage. For the average Joe, an insurance policy might not be 100% clear.

Are You Required to Attend an IME?

An independent Medical Examination (IME) is an evaluation required by the insurance company in order to prove that the treatment you are receiving from your own doctor is, indeed, necessary, if there is causation between your accident and your injuries, or if you are actually injured at all.

What you need to know is that the insurance company is, indeed, entitled to request an IME if they need extra information. If you refuse going to see the doctor proposed by the insurer, you might not receive any compensation whatsoever.

Things to Know Beforehand

However, it’s very important to know what an IME implies and how to avoid being denied your rights by compromising your case during such a visit. An independent medical examination is not intended to give you a treatment and it is not based on a normal doctor-patient relationship. Doctors who perform IMEs are often paid regularly by insurance companies to be on their side and may find ways of minimizing your injuries, by placing blame on pre-existing conditions or underestimating the treatment you need.

While such an extreme practice is, indeed, a sign that the insurer and the doctor are acting in bad faith, it’s not always so easy to prove such a case. One of the best things you can do when the insurance company requests an IME is to get in touch with an experienced St. Louis auto accident attorney if you haven’t already.

IMEs Doctors Are Not Your Friends 

An IME doctor would often receive a brief from the insurance company before seeing you. It is important to be honest about your injuries from the start and avoid exaggerating them. Keep in mind that the IME doctor is likely paid directly by the company and will perform a one-time, short examination that doesn’t follow regular confidentiality rules. Remember this before being seen by an independent doctor and make sure to follow your attorney’s advice. 

How to Challenge an Independent Medical Exam in a Car Accident Case

While an IME can be a useful way to get more information about your injuries, the findings can sometimes be strongly adverse to your claim. If you believe the findings are unwarranted, there may be a few things you can do.

Bring Someone to the IME

One way to challenge an Independent Medical Exam (IME) is to bring someone with you to the examination. This could be a family member, friend, or even your attorney. Having another person present can help to ensure that the IME is conducted fairly and that all of the relevant questions are asked.

Additionally, this person can take notes on how the examination went, including how long it took, what questions the doctor asked, and what areas were examined. This can be valuable information if the IME results are unfavorable and you need to contest them.

Request to Have a Copy of The IME Report 

Often, the examiner will only summarize their findings to the insurance company. If this is the case, you should generally request a copy of the full IME report. This way, you can cross-check it and confirm that the findings are factual and there are no errors. In case of any errors or mistakes, like missing tests, point them out. This incompleteness can then be used to contest the findings. 

Another thing to look for is whether all issues present at the time of the accident have been addressed in the IME report. If not, then again, use this incompleteness to raise doubts about the findings of the IME. You can also check for any contradictory statements in the report. Any contradictions can be used to show that the findings are not credible. 

Find Experts Who Are Willing to Review the Report and Provide an Opinion About It

Another way to challenge an IME finding is by bringing in your expert, who will review the first doctor’s conclusions and may be able to offer a different opinion. If the independent medical examiner relied heavily on a certain test or procedure in making his or her determination, you might want to try to get that test or procedure repeated with a different doctor.

You may also point out any inconsistencies between the IME report and the treating physician’s notes or records. These inconsistencies can be used to show that the IME report is not accurate or reliable. 

The Insurer About Their Relationship with the IME Doctor

If you can establish that the IME doctor is biased, their credibility may be questioned. Even if you can’t establish a clear bias, you can still use their relationship with the insurer to argue that their findings should be given less weight. For example, you could argue that the IME doctor is more likely to find against your claim because they don’t want to upset the insurer.

Our St. Louis Car Accident Lawyer can help!

Ultimately, whether or not you successfully challenge an IME will depend on the specific facts of your case. However, if you feel that the examination findings are unjustified and adversely impact your car accident claim, don’t hesitate to reach out for help. The St. Louis car accident attorneys at Hoffman Law Firm are here to help St. Louis car accident victims through every step of the process and fight for the compensation they deserve. Contact us today to schedule a consultation.