An Independent Medical Examination is Not Independent

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An Independent Medical Examination is not independent. The doctor that performs Independent Medical Examinations typically works for a company that was hired by your automobile insurance company. This evaluation is not intended for treatment. The purpose of the exam is to determine whether your automobile insurance company has to pay for your future medical treatment. If the doctor performing the examination determines that you no longer need a certain type of medical care, your insurance company will stop paying for that medical care. For example, if the doctor determines that you no longer need chiropractic care, your automobile insurance company will stop paying for chiropractic care.

What do I do If My Automobile Insurer wants Me to Attend an Independent Medical Examination?

Do not ignore your insurance company’s request. You have to attend the Independent Medical Examination. If you do not attend, you will be in breach of your insurance contract and your insurance company will refuse to pay for any future medical treatment. Once you receive the request for the exam, notify your attorney and your treating physician. Your attorney may or may not want to be present for the Independent Medical Examination.

Schedule an appointment with your treating physician for the same day as your evaluation. Bring a notebook to your appointment. In your notebook, note the time that you arrive, the time you spend in the waiting room, and the time that the physician actually spends examining you. You should be courteous to the doctor and the their staff.

Fill out all paperwork honestly. During the examination, the doctor will ask you questions. Answer doctor’s questions honestly, but do not volunteer information. Do not confuse the role of the Independent Medical Examination Doctor with your treating physician. The Independent Medical Examination Doctor is not there to assist you, but there to assist the automobile insurer.

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What Happens After the Independent Medical Examination?

After your medical examination, the doctor will generate an Independent Medical Examination report and submit the report to your automobile insurer. The exam report will either state that the doctor believes that you require additional treatment, or it will state that further treatment is not necessary. Usually, the report concludes that further treatment is not needed. If the Independent Medical Examination concludes that further treatment is not necessary, your automobile insurance company will send you a letter advising you that your insurance company will no longer pay for certain types of treatment.

What do I do If My Automobile Insurer Refuses to Pay for Future Medical Benefits Based on an Indepent Medical Examination Report?

Do not stop your medical treatment. Advise your attorney and treating physician that your insurer will not pay for certain medical treatment based upon an Independent Medical Examination Report. Ask your treating physician to send a letter to the automobile insurer disputing the results of the independent examination. This letter must discuss the future treatment that your treating physician believes is medically necessary to treat your injuries. Continue to treat with your treating physician. The first time that your automobile insurer denies a bill based upon the results of the Independent Medical Examination, either you or your treating physician should contact an attorney to pursue payment of your doctor’s bill. Bogin, Munns & Munns, P.A. has attorneys that specialize in resolving personal injury disputes with insurance companies.

You have to attend the Independent Medical Examination. If you do not attend, you will be in breach of your insurance contract…

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You have to go to your Independent Medical Examination. You do not have to accept the results. Your treating physician has been examining and treating you over a period of time. Your treating physician, not a doctor that examined you once, is in the best position to determine medical necessity. If your insurer denies your medical bills based upon this examination, challenge the denial. Do not impede your recovery by stopping your medical treatment.

— Aaryn Fuller

NOTICE: The article above is not intended to serve as legal advice, and you should not rely on it as such. It is offered only as general information. You should consult with a duly licensed attorney regarding your Florida legal matter, as every situation is unique. Please know that merely reading this article, subscribing to this blog, or otherwise contacting Bogin, Munns & Munns does not establish an attorney-client relationship with our firm. Should you seek legal representation from Bogin, Munns & Munns, any such representation must first be agreed to by the firm and confirmed in a written agreement.

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