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IME Insurance Company Abuse Adds Insult to Injury

June 18, 2021 by Steven M. Gursten

IME Insurance Company Abuse Adds Insult to Injury

IME insurance company abuse takes new shape as insurance companies and claims adjusters are insisting that car accident victims travel hundreds of miles and many hours away to attend compulsory independent medical examinations. But what’s adding insult to injury is that these companies are not only requiring these people to travel for hours to see some very notorious insurance doctors, but that they are insistent that the car accident victims – not the company – also foot the bill for travel expenses.

Abuse of independent medical examinations is nothing new. Companies have been abusing these so-called “independent” compulsory medical examinations with a doctor of their choosing for decades in order to “cut-off” No-Fault benefits by using hired-gun independent medical exam doctors. These doctors are selected and well-paid by the company to terminate payment of No-Fault benefits or to use as a defense in a civil lawsuit for personal injury when they are selected and hired by the defense lawyers and companies of the person who caused the car accident.

Unfortunately, the new auto No-Fault law passed in 2019 did next to nothing to protect car accident victims. Indeed, it can be argued that the new auto No-Fault law in Michigan is essentially a giant boondoggle to the independent medical exam doctors, as it will be these same horrible doctors who will make up the bulk of the doctors in charge of approving medical care under the new managed care option.

But with the newest wrinkle to IME insurance company abuse, insurers are trying to up their game of harassment, frustration, and intimidation by forcing car accident victims to travel in many cases literally across the state of Michigan at the own expense – not to mention at the expense of their own health and well-being as many already have serious injuries that make traveling and sitting very difficult.

Why? My hunch is that claims adjusters are making a cynical calculation that some accident victims will refuse, whether because of pain and injuries or because of the financial expense involved. This will give these adjusters and companies a basis for then denying and/or dismissing the injured victims’ No-Fault claims. Basically, they can cite non-cooperation with the company as a basis to immediately suspend and cut-off all medical and wage loss payments and other necessary No-Fault PIP benefits if the accident victim cannot or will not comply with a deliberately unreasonable request.

Below I will discuss steps that car accident victims can take to protect themselves.

What is an independent medical examination?

An independent medical examination is a non-medical examination conducted by a doctor selected, hired and paid by your insurance company. The doctor’s goal is NOT to diagnose your medical condition or provide treatment. His or her goal is sadly but far too often just to try to find a reason to say “nothing is wrong” so your insurance company can stop paying benefits.

Do you have to go to an independent medical exam?

If you have filed a claim for No-Fault benefits based on injuries you suffered in a car accident, then you do have to go to an IME insurance exam with a doctor selected by your auto insurance company when your auto insurer tells you to.

However, under Michigan’s auto No-Fault law, the independent medical exam doctor must meet the following criteria: (1) be a licensed physician; (2) have the same specialty as your treating physician; (3) be board-certified in the same specialty that your treating physician is board-certified in; and (4) have devoted a majority of his or her professional time in the year preceding your IME to the “active clinical practice of medicine.” (MCL 500.3151(1) and (2))

Use the auto insurance policy to stop IME insurance company abuse

One tactic for trying to stop IME insurance company abuse is for your attorney to use your own auto insurance policy against your auto insurance company. If the policy does not require you to travel wherever the insurer tells you to and to pay out-of-pocket for the travel expenses, then you do not have a duty to do either if the request is patently unreasonable. I do not recommend you do this without an attorney to help you. You still have a duty to cooperate and this should be something your attorney should be doing on your behalf, with a detailed explanation of why this request is unreasonable to document the claims file if litigation proves necessary.

The No-Fault law says that auto insurance companies can include “reasonable provisions” for IME in their auto insurance policies. (MCL 500.3151(1))

Most policies impose a strict contractual duty on car accident victims to attend independent medical exams conducted by doctors selected by the insurer “as often as [the insurer] may reasonably require.”

However, most auto insurance policies do not contain IME exam provisions that allow the insurance company to require car accident victims to travel wherever the insurer says for the exam or to require the car accident victim to pay for his or her transportation costs for going to and from the independent medical exam.

Even when such provisions do exist in policies, the independent medical exam provisions would still have to be “reasonable” – a standard that many of these new travel requirements that the auto accident attorneys in my office are seeing would still fail to meet.

Use the No-Fault law to stop IME insurance company abuse

Another tactic for trying to stop IME insurance company abuse is to use the No-Fault law which allows a court to “enter an order” to “specify the time, place, manner [and] conditions” of an IME where “good cause” has been shown that the order is necessary “to protect against annoyance, embarrassment or oppression.” (MCL 500.3159)

It is also important to note that even though the No-Fault law allows companies to require car accident victims who are claiming No-Fault benefits to “submit” to an independent medical exam by a insurance company doctor (see MCL 500.3151(1)), the law does not give insurers the authority or the right to require victims to travel unreasonable distances to “submit” to an IME and/or to bear the cost of that travel themselves.

Protecting against abuse

Using the terms of your auto insurance policy and the No-Fault law’s “annoyance, embarrassment or oppression” protections, you could make the following arguments if your insurer wants you to travel hundreds of miles and pay out-of-pocket to attend the IME your insurance company is requiring you to submit to:

  • Neither the auto insurance policy nor the No-Fault law requires a car accident victim to travel unreasonable distances to attend an IME ordered by the auto insurance company.
  • Neither the policy nor the No-Fault law requires a car accident victim to pay his or her own transportation costs for traveling to and from an independent medical exam ordered by the company.
  • Traveling (by car, truck, bus, van, plane) long-distance to and from the independent medical would be painful, exacerbate the victim’s injuries and interfere with the healing process.
  • Mileage and transportation costs of traveling distance to and from an independent medical exam would be prohibitive for victim.
  • The car accident victim cannot drive him or herself to the independent medical exam and has no driver.
  • The insurance company’s IME doctor could travel to where victim is for exam.
  • There are literally dozens or even hundreds of other doctors with the same qualifications and who practice the same area of medicine who practice closer to the accident victim who could also conduct the company’s desired independent medical exam.

Need help? Call the auto accident attorneys at Michigan Auto Law

If you have been injured in a car accident and you have questions about how to protect yourself against IME insurance company abuse, please call us one of our experienced auto No-Fault attorneys toll free anytime 24/7 at (800) 777-0028 for a free consultation. You can also get help from an experienced auto accident attorney by visiting our contact page or you can use the chat feature on our website.

IME Insurance Company Abuse Adds Insult to Injury

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