The Scenario: You were involved in a car accident in Oregon. So, like a good neighbor, you dutifully report the accident to your insurer. After- all they are on your side. You naively believe you are in good hands. A lizard with an English accent assures you that you have no fault insurance up to $15k (or more)– not to worry. He transfers you to a sweet, perky and quite funny young lady who pays a few of your medical claims.
A few weeks or months later she calls back. “Uh, Mrs. America?” “Yes”, you utter, wondering why she called. “It seems as though you have degenerative disc disease…we would like you to be examined by our friendly ‘independent’ medical examiner. You comply. The next week she calls back wanting another “independent” medical exam and then another. Now you are suspicious. “What is going on?” you wonder. This is my insurance company! I paid premiums to be treated like this???
What is an IME? An IME or “independent” medical exam is not independent at all. These exams are more accurately defense medical exams…because the doctors your auto insurer hires does in order to cut off your PIP medical benefits prematurely (prior the year anniversary of your accident, when Oregon PIP benefits expire). An ‘independent medical exam may also be requested by the other guys’ insurance company…in order to undermine your liability claim against the driver at fault. Some doctors can be bought…especially those who regularly earn income from “independent medical exams” The law office of Richard Rizk has access to past testimony of IME doctors which can be useful in undermining bad IME doctors “opinion(s)”.
Does the insurer have a right to a so called independent medical exam?
It depends. Your insurer as PIP (no fault medical insurer) almost always has a right to conduct at least one medical exam. Why? Your policy will require it. Look to your policy for specific terms regarding independent medical exams. Under Oregon law, a PIP carrier is only required to pay for “reasonable and necessary” medical charges related to an accident. A PIP carrier seeks a medical exam to show your treatment is neither reasonable nor necessary.
An opposing insurer will usually have the right to at least one medical exam for each condition involved in the accident after suit is filed. However, only a judge can order you to attend a medical exam sought by the bad driver’s insurer (assuming you were not at fault).