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State Farm tries to use IME report to dismiss car crash case

Thankfully, court rules jury must resolve fact disputes between State Farm’s hired-gun independent medical examination doctor and car accident victim’s treating doctors

State Farm thought it should be able to get car accident lawsuits dismissed just because their own hired-gun, IME doctors say there’s “nothing wrong” with the crash victims.

Fortunately, it didn’t work. Far too often, though, insurance companies like State Farm and Allstate use an aggressive IME policy to try to rob innocent car accident victims from promised No Fault benefits that it owes these people. And why not? This IME policy saves the company $30 million annually in payouts. In the big picture, companies like State Farm are getting away with this strategy that devastates the people it promised to help.

But that didn’t happen in a recent case where the Michigan Court of Appeals ruled the insurer’s IME doctor was neither the final nor the only word on whether car accident victim, Fleeta Johnson, was injured enough to be entitled to pain and suffering compensation.

In Johnson v. Glosson, the Court of Appeals concluded a jury should decide Johnson’s lawsuit, even though State Farm’s doctor had opined:

  • “[T]here was no clinical evidence of any functional impairment, or any traumatic injury, related to [Johnson’s] accident.”
  • “[T]he anomalies seen in the MRIs of [Johnson’s] shoulder and spine were degenerative and consistent with her age, and not the result of a traumatic injury.”
  • Johnson “was possibly magnifying her symptoms.”

The Court of Appeals reasoned that the medical opinions from Johnson’s doctors as well as evidence of a pre-existing injury “created a genuine issue of material fact” — that only a jury could resolve — about whether Johnson’s “shoulder, spine, and neck are degenerative or traumatic in nature.”

This unanimous ruling from the Court of Appeals is very significant for its ability to halt insurance companies, defense lawyers and some judges from erroneously oversimplifying the factual issues at work in a car accident lawsuit and, thus, hurriedly and unjustly dismissing the case before it gets to a jury.

What does court ruling say about need for independent medical examination reform?

The trial court’s dismissal of the lawsuit in Johnson — apparently on the sole basis of the opinion of State Farm’s IME doctor — also highlights the urgent need for IME reform. Most judges know that these doctors who perform these one-time insurance medical exams are making huge amounts of money and are picked by these claims adjusters and defense lawyers precisely because they rarely find anything wrong with the people they examine that they relate back to a car accident. It is a broken system with the insurance companies heavily incentivized to find the worst doctors possible to perform these so-called independent medical examinations. It them is corrupted even more by the huge amounts of money these insurance companies throw at these doctors as they perform hundreds of IME exams a year.

While auto accident lawyers and most judges for that matter know exactly what these doctors who perform IME exams are, in this age of insurance company donations to judicial campaigns, some judges will use these IME reports to try to throw out legitimate car accident lawsuits in Michigan.

More than ever, we need safeguards such as videotaping and a requirement of an active-clinical-practice requirements for IME doctors to ensure both the integrity of the exams and the judicial process.

Why wasn’t the opinion of the independent medical examination doctor enough to justify dismissal?

Notably, the following medical opinions of the car accident victim’s treating physicians served as a counterpoint to the opinions of State Farm’s IME doctor:

  • “Dr. Hall found that while plaintiff had some degenerative conditions, there were a number of acute findings that suggested that the October 22, 2014 accident either caused new injuries to plaintiff or aggravated a preexisting condition, or both.”
  • “Dr. Mendelson found that the tear in plaintiff’s left shoulder was caused by her accident with Glosson, and that the tear was the cause of the pain she experienced when reaching overhead and lifting objects with her left arm.”
This entry was tagged Tags: IME, independent medical examination, Michigan Court of Appeals, State Farm insurance
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Blog Author Steven M. Gursten
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