What is an IME?

Insurance Medical Examination: A Wolf in Sheep's Clothing

1. WHAT IS AN IME?

The IME is an adversarial proceeding that is performed to limit how much care you receive from your insurance company. It is a two-part examination, including both an oral component and a physical component. Initially, the doctor will ask you 15-30 minutes of questions regarding your injuries. This will be followed by a 5-10 minute physical examination.

2. IS THE EXAMINATION INDEPENDENT?

No. Though the insurance companies may refer to the exam as being an Independent Medical Examination, there is nothing independent about it.

Consider the following:

• The vast majority of doctors who perform the exams rely on a heavy stream of business from the insurance companies.
• It is usual for the insurance examiner to earn $600 - $2,500 for the 30-45 minutes the doctor spends doing the exam
• Some examiners admit to earning more than $200,000 annually in IME fees

3. HOW DOES THE INSURANCE COMPANY HAVE THE RIGHT TO HAVE ME SEE ONE OF ITS DOCTORS?

Hidden in every auto insurance policy is a clause that requires an insured to cooperate with the insurance company’s requests. In another hidden clause is a requirement that the insured attend a physical examination by an insurance company doctor as often as the insurance company reasonably requires.

Reading those two clauses together, the insurance company can contractually require you to attend an examination, which it can use to deny your bills.

4. DO I HAVE ANY RIGHTS WITH REGARD TO THE IME?

Yes. Your rights are outlined in a set of rules commonly referred to as the WACs (Washington Administrative Code). The WACs set obligations that the insurance companies must follow, thereby affording you rights. In brief, you have the right to have your reasonable and necessary medical bills and time loss paid, and very well may have the right to have future medical bills and time loss paid.

The Jones Firm prides itself on working hard for each client while finding creative and effective solutions to get the insurance companies to fulfill their obligations and also acknowledge the rights of each client.

Here is what we will do for you:

• We will meet with you and prepare you for the IME:
• Outline for you what questions to expect at the IME
• Help you to know how best to honestly and completely respond to the questions, and
• We will point out common tricks used by the examiners so that you can avoid them
• We may have a representative attend the IME with you
• We may audiotape the examination and/or video record the examination

5. IF I HAVE AN AUTO INJURY CLAIM WHAT SHOULD I DO?

You should contact Dax Jones at The Jones Firm so that you protect your rights. We will work with you throughout the claims process and do all that can be done so that you get the care you need and the bills get paid.

Many people don’t understand how the insurance companies ‘think,’ and unknowingly harm their claim.

For example,

• Did you know that the Personal Injury Application must be returned within 2-4 weeks and if not, the insurance company may set you up for an IME?
• Did you know that the insurance companies strongly consider the amount of property damage to your car when they decide how much care they think you need?
• Did you know that having prior injuries to your neck or back may actually help you get the longer duration of care you need if you have a lower property damage injury claim?

6. WHAT CAN THE JONES FIRM DO FOR ME?

We will work hard for you. Our goal is to handle the legal issues so that each client gets the maximum benefit from his/her insurance policy. We will also work hand in hand with you and your medical team so that to manage the legal issues to get you the care you need.