The term “IME” is an acronym for “Independent Medical Exam.” That said, there really is not such a thing as a truly “Independent” medical exam. These exams are not typically ordered by some independent neutral. The doctor chosen to do the exam is not handpicked to be fair by a judge. These doctors are hired and chosen for a specific purpose – to deny your claim or minimize the value of your claim. If you are injured in a motor vehicle accident, you may be making claims for medical benefits through your own insurance or making injury claims against the other driver who caused the accident. In certain circumstances the insurance company involved may request, or be entitled to, a medical exam by a doctor of their choice.
I refuse to refer to these exams as “Independent Medical Exams.” Depending on the context of the exam, I will refer to these as either “Insurance Medical Exams – IMEs” for when your own insurance company requests an exam or a “Defense Medical Exams – DMEs” when the other driver’s insurance company requests an exam.
If you file a lawsuit, typically the defense has a right to have you examined by a doctor of their choice (DME). If you make a claim for medical benefits through your own auto insurer, your own insurance company may request you be examined by a doctor of their choice (IME) so your own insurance company can deny the bills for your treatment and essentially end your ability to seek medical treatment for your injuries. Whether an IME or a DME, understand that if you are asked to attend one of these exams that these doctors are not examining you for the purpose of treatment, nor to help you recover from your injuries. These doctors are paid to gather information that will allow your own insurance company to end its obligations to pay for your medical expenses or so the at-fault party’s insurance company can argue that your problems are pre-existing, were caused by something other than the crash, or that you are making the problems out to be much worse than they really are.
Most IME/DMEs are requested and paid for by insurance companies. The doctors hired directly, or indirectly through a third party, by insurance companies to perform IME/DMEs typically are biased in favor of the insurance companies. Many doctors who perform these exams for insurance companies make hundreds of thousands of dollars a year performing these exams and writing reports. It doesn’t take a rocket scientist to understand that doctors who perform IMEs and want to maintain this stream of income are going to routinely offer opinions that support the outcome desired by the insurance companies.
For many years in Pennsylvania, insurance companies have argued that they are entitled to these IMEs whenever they want because most insurance policies contained language that required their insured’s cooperation and gave the insurance companies the right to demand these exams. They argued they were entitled despite the fact that our law, the Pennsylvania Motor Vehicle Responsibility Law, required that if your own insurance company wanted you to attend an exam that the company must file a petition with a court showing good cause. Over the years, many judges ordered these exams despite the law citing that the policy language permitted the exams. Recently, the Pennsylvania Supreme Court weighed in.
In Sayles v. Allstate Insurance, 2019 Pa. LEXIS 6457 (Pa. Nov. 20, 2019), the court found that policy language requiring an insured to submit to an IME as a prerequisite to receiving first-party medical benefits was void, since it was in direct contradiction to the express language contained in the Pennsylvania Motor Vehicle Financial Responsibility Law. Insurance companies can no longer make payment of medical benefits conditioned on the attendance to an IME without first obtaining a court order requiring the examination. This decision is not expected to stop insurance companies from requesting IMEs of their own insureds. While you should always seek a free consultation after an auto accident, if you are not represented and you are asked by your insurance company to attend an IME, you can and should refuse unless and until the insurance company obtains an order from court demanding your appearance at an exam.
If you are asked by your own insurance company to attend an IME and you are not already represented by an attorney, you should seriously consider engaging representation at this point because you should expect that your own insurance company is going to engage a doctor that will issue an opinion that will be harmful to you and your case. Mooney Law offers free consultations for auto accident cases. We have recovered tens of millions of dollars on behalf of those injure din auto accidents. What is your case worth? Find out for free. Call 833-MOONEYLAW to 717-200-HELP.