While most car crash victims are not surprised to hear that an at-fault driver’s insurance company is going to hire a doctor who will say they are not hurt, clients are often surprised to learn that their very own insurance companies can employ similar tactics and that they will then use the outcomes of these exams to try to escape payment of claims.
Last year around this time, we first introduced the concept of an “Independent Medical Examination” or “IME” in a 3-part series dubbed The Not-So-Independent Medical Examination. We blogged about what to expect from such an exam and set some ground rules if you must undergo an IME. But how is it possible that your own insurance company can make you submit to one of these IMEs?
When you take out an automobile policy of insurance on your car, you may not realize it, but that policy is governed by a policy contract. That contract sets forth the rules by which an insured person must play in order to receive benefits she has paid for. Among those rules almost always lies a provision that reads something like this:
“Under Uninsured Motorist Coverage and/or Underinsured Motorist Coverage, any person making a claim must:
(1) give us written notice and documentation of loss;
(2) submit to examinations by physicians we select as often as we require; and
(3) authorize us to obtain medical reports and other pertinent records.”
This provision is often referred to by insurers as a cooperation clause and insurers can and do deny coverage to their insureds who refuse to submit to examinations when requested.
While in theory, requiring an insured to undergo an IME before she can access benefits is a perfectly reasonable and acceptable practice, the sad truth is that some insurers employ doctors who almost always produce findings which are favorable to the insurance companies (meaning findings which justify denial of or lesser payment for an injury claim). Frequently, these IME reports will even contradict the opinions of the injury victim’s own treating doctors.
So what can you do to level the playing field if you are hurt due to another driver’s negligence and you need to access the Uninsured/Underinsured Motorist coverage on your own auto policy? You should seriously consider retaining a law firm with attorneys who have worked for insurance companies and know their tricks firsthand like the Colorado Springs Injury Attorneys at Rosenbaum & Wootton, P.C. Schedule your complimentary consultation to see if we can help by calling 719.634.0102 or by clicking on this link to schedule your FREE INITIAL CONSULTATION.