#2 Why am I being sent for an Independent Medical Exam (IME)?

PREGUNTA: Why am I being sent for an Independent Medical Exam, IME?​

ANSWER: Insurance companies require you to attend an IME to find reasons to stop paying for your treatment after a car accident. The IME doctor, who is hired by the insurance company will examine you and ask you a number of questions to justify ending your PIP benefits. Common reasons the IME doctor is listening for in your responses include minimal car damage, delays in seeking treatment, gaps in treatment, prolonged treatment duration, or pre-existing conditions. This process is used by insurance companies to reduce claim payments, not to assess your recovery needs accurately.

Why am I being sent for an Independent Medical Exam, IME?

The insurance company responsible for paying the PIP benefits for your medical bills for the injuries from your car accident looks for reasons to stop paying the medical providers who have been treating you since your accident.

Following are some of the main reasons why the PIP carrier can use to justify they no longer are responsible for the payment of your medical treatment related to your accident.

1. There’s little visible damage to the cars involved in the collision. Insurance companies take the position that if there’s little visible property damage, you must not have been injured. The truth is people can be — relatively speaking, significantly injured in a minor collision. Just like someone can be involved in a collision where there is a great deal of visible damage to the vehicles in the accident and not have any injuries. 
2. There was a gap between the car accident and when treatment started. Unfortunately, sometimes patients wait four, five, or even six weeks to be examined after their accident and before they begin receiving treatment for their injuries. They think that they’re going to get better and that they don’t need to see a medical provider to be evaluated. While that is an understandable position, the longer the gap is from when the auto accident happened to when you first receive treatment, the insurance company will assume you weren’t injured because if you were you would have seen a provider right away. Therefore they will very likely send you for an IME. 
3. Similarly, if there was a gap in the middle of your treatment, the adjuster for the PIP carrier will take the position that you didn’t sustain injuries from the car accident. They assume something else must have happened unrelated to the accident and that’s why you’re resuming treatment. 
4. That you’d been treating for four months since the accident and you should be fully recovered. The insurance adjuster will say, “Well, you should be healed by now, there’s no reason why you need to continue with your medical treatment. Something else must have happened that’s causing you to continue to need treatment.” 
5. If you have pre-existing conditions, the insurance company will blame all of your medical treatment on those conditions and not on injuries from the auto accident

These are the primary reasons that PIP carriers use to stop paying the bills for your medical treatment for your auto accident injuries.

The mistake that people injured in a car accident make is that they try to make sense out of the reasons the PIP adjuster gives about why they’re threatening to stop their medical benefits coverage and send them for an IME.

The reality is that this is the protocol and system insurance companies use to minimize the money they have to pay out for auto accident claims — and not helping you to recover from your injuries.

Ya sea nuestro cliente o no, queremos ser un puente de apoyo para usted.

Hemos desarrollado una sólida biblioteca de artículos y videos organizados en cuatro temas que incluyen nuestras respuestas a las preguntas más frecuentes relacionadas con los reclamos por lesiones personales.

• Los 10 Principales Errores En Lesiones Personales Que Debe Evitar
• Lo Que Necesita Saber Sobre Su Reclamo
• ¿Cómo Se Pagan Mis Facturas Médicas y la Pérdida de Salario?
• Cómo Prepararse para Su Examen Médico Independiente

Los artículos brindan consejos y pautas para ayudarle a navegar cada fase del proceso de reclamos por lesiones personales. Ya sea que lo representemos o no, nos apasiona ayudarle a proteger sus derechos, asegurando que reciba la atención médica necesaria para recuperarse de sus lesiones y que tenga la información necesaria para evitar errores que puedan perjudicar su reclamo por lesiones personales.