Independent Medical Examinations (“IMEs”)

If your insurance company has scheduled you for an “independent medical examination” or “IME”, it means that they have scheduled an appointment for you to see a doctor of their choice. The insurance company will use the report of the doctor to cut you off from your no-fault benefits. The doctors that are typically selected by the insurance company are chosen because they will reliably provide a report that is favorable to the insurance company. While it is not fair, it is simply the way insurance companies work.

What to do when you get a notice to attend an independent medical examination:

1. Attend the appointment. If you miss the appointment, your insurance company will suspend your no-fault benefits and will charge you as much as $800 for the cost of the missed appointment. If you cannot make the appointment, it can be rescheduled, but make sure you provide enough time to get the appointment rescheduled so there is no cancellation fee. Communication is essential.

2. Keep track of the amount of time that is spent at the appointment. Note the time you arrived, the time you leave, the amount of time the doctor spends talking to you and the amount of time the doctor actually spends examining you. Keep a journal of the questions that the doctor asks you, what answers you give ans ell as the list of symptoms that you gave the doctor. If you feel symptoms while the doctor is examining you, tell him or her, but do not exagerrate. If the doctor tells you anything about his impressions or other comments, jot them down. Finally, not how thoroughly (or casually) the doctor performs his exam.

3. When you receive the doctor’s report, review it carefully and compare it with your journal. The doctor will usually state how much time he or she spent with you. The doctor will also report the comments that you make and his findings from the exam. It is helpful in contesting the insurance company’s eventual denial with as many discrepancies with the doctor’s report as possible. Provide us with a copy of your comparison and journal as soon as possible. We will use it in fighting your insurance company.

Fighting an insurance company denial or cutoff.

If your insurance company either cuts off your benefits as a result of an independent medical exam, or simply refuses to pay bills or benefits related to a motor vehicle accident, you can fight them. Here is how:

1. Arbitration

   Minnesota law allows for the arbitration of no-fault disputes. The insurance company has 30 days from receiving reasonable proof of a loss to make payment. If payment is not made after providing sufficient information to the insurance adjuster, you can file a no-fault arbitration. Arbitration is a process that allows for the disputed benefits to be presented to a neutral lawyer from your area to decide if the insurance company has to pay. The process is much faster and much less expensive than going to court. The hearing is informal, and your lawyer will help you through it.

   Arbitration is limited to claims of $10,000 or less at the time of filing the claim. The amount of the claim can exceed $10,000 so long as the amount of the benefits are under $10,000 at the time of claim filing. This means that you must let your lawyer know if you have not received wage loss benefits for a long period of time, or if you have been treating with a doctor or chiropractor for a long period of time and you are then told by your doctor that your insurance company has not paid. Your lawyer will then immediately start an arbitration to ensure that you can have your claim heard by an arbitrator. Finally, if you are scheduled for surgery and your insurance company has not been paying your benefits, let us know right away so we can file the arbitration prior to having your surgery.

2. Trial

   If your benefits that are denied by your insurance company exceeds $10,000, you can choose to go to court to have a jury determine whether the insurance company has to pay.

3. Settlement

   Sometimes it makes sense to settle your no-fault claim with your insurance company on a “full and final” basis. This means that, in exchange for a sum of money, you release your auto insurance company from any and all future benefits that you may have been elegible to receive. Obviously accepting such a settlement would require you to understand exactly what you would be giving up, so you would want to discuss this with a lawyer.

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