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A New Trend in Independent Medical Examinations?

Perhaps I am incorrect in calling this a new trend, but I have noticed a change in the way auto insurance companies are scheduling independent medical examinations (IMEs).   Lately I have noticed IMEs are getting scheduled by the insurance company at an earlier and earlier stage of the claim.

For starters, an “independent medical examination” is when an auto insurance company or workers compensation company schedules an examination between the claimant and a doctor hired by the insurance company to presumably offer an honest, unbiased assessment of the claimant’s injuries and prognosis for recovery.  However, the term “independent” is not accurate.  Instead the IME is scheduled by the auto insurance company to “cut-off” the claimant from further benefits and/or to say the auto accident or work place accident did not cause the claimant’s injuries.

Essentially, it provides the auto insurance company an out from paying anything more on the claim.  The insurance adjuster will claim the doctor is “independent”, but the doctor chosen is paid directly by the insurance company for his or her opinion.  Often, these IME doctors or cut-off doctors do not have regular medical practices of their own.  Instead, their income and livelihood is dependent on insurance companies hiring them for their “opinion.”  You can guess what that does to their independence.

However, recently I’ve had a number of clients who have been scheduled for IME exams by their auto insurance companies at very early stages of their claims.  For example, one client who was just given an appointment is only 7 weeks post car accident!  Another client is less than 10 weeks post auto accident.   Both clients are just starting their post auto accident recovery.  One is in the middle of physical therapy while another is beginning to receive steroid injections.   They are both injured and still in a lot of pain after violent auto accidents.

Both of these clients do not have their own health insurance.  They are dependent on the auto insurance company and the no-fault policy they purchased to provide them with medical benefits.  Unfortunately, the insurance companies know this.  But rather than giving these clients an opportunity to seek medical treatment and recover from their auto accident injuries, they want to end all benefits immediately, thereby saving the insurance company money.

I’m not puzzled by this more aggressive approach by the insurance companies.  Their business model of delay, deny and defend has earned them billions in profits over the past few years.  Still, this model is both illegal and morally wrong.  Why does an insurance adjuster believe an independent assessment is needed less than 2 months after an auto accident?  Even more frightening, how can a physician make an “honest” medical assessment on a claimant’s injuries, their relationship to the car accident or work accident and the claimant’s prognosis for recovery only a few weeks post accident?  Is it even medically possible?  Does making these decisions so quick after an accident follow proper medical guidelines?   If so, what guidelines are these and where do they come from?

There are many questions that need to be answered in this new “quick track” IME approach by the insurance companies.  I intend to ask these questions quite often during the depositions of the insurance adjusters who inappropriately schedule these exams.