When you bring a liability or no-fault injury claim, the respondent or defendant has a right to conduct a medical examination. These medical exams are usually conducted by doctors hired by insurance companies. The examinations are often called Independent Medical Examinations (IME) by those asking for them. However, there is nothing independent about them. These examinations are also referred to as Defendant’s Medical Examinations (DME) or Insurance Medical Examinations.
If you are injured in a motor vehicle accident you are entitled to no fault benefits paid by the no-fault insurance company. The no-fault insurance carrier is entitled to require that you attend as many medical examinations as they deem necessary. They may require that you attend an examination by doctors in different fields of medicine. Failure to appear for a designated examination may result in not only the denial of future benefits, but the denial of payment of past treatment and benefits. The purpose of the examinations is to determine if future medical benefits are necessary. The insurance company will deny future medical treatment if the doctor opines that the patient has fully healed, or will no longer benefit from treatment. Because the insurance companies have a financial interest in terminating benefits, they tend to use doctors who are more likely to write reports that will find benefits are no longer necessary.
A defendant during the course of a personal injury lawsuit also has a right to conduct a medical examination by doctors of their choosing. The defendant’s doctor will write a report and testify at a trial. The defendant attorney will call the defendant’s doctor to testify at trial to try and convince a jury that the plaintiff has made a greater recovery than claimed, or that the injuries claimed are not as a result of the subject accident. These doctors are paid by the defendant’s insurance company.
Because these doctor exams are adversarial in nature the injured party has a right to have a representative present. This representative can be a friend or family member, the injured party’s attorney, or any other person. Often, our office sends an independent party, often called a Watchdog or Companion, to take notes about the examination and make sure that the doctor does not go beyond the appropriate scope of the examination. The representative may later become a witness at the trial, especially if the examining doctor writes a report which is believed to be untruthful. While there has been much litigation on the subject, the Courts have routinely upheld the right of a litigant to have a representative present at a defendant or insurance medical examination.
When attending a no-fault insurance examination, or a defendant’s liability medical examination, it is important to understand the purpose of the examination, the adversarial nature of the examination, and your right to have a representative at the examination.