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You need to Protect Legal Rights while Ensuring Agreeable Compensation

While an injury claim is made, certain insurance policies may mandate the victim to submit to independent medical examination (IME) if the insurance provider so desires. As the examination is arranged by the adjuster, there are provisions for protecting yourself during as well as after the exam, in case the report submitted by the physician is not accurate or is adverse to the claim.

Get the Optimal and Reasonable Compensation that You Deserve

While going for an IME, it is better to have either a family member or a friend along with you. Explain the scenario to them, let them take notes of the exact time of beginning and ending of the exam, what questions were asked by the physician, and the tests performed by the physician with the duration details. Apart from these, other details that you find hard to remember may also be noted. This person who accompanies you may act as witness if any dispute arises later, about the accuracy or fairness of the examination. Being accompanied by another person also helps in avoiding the physician acting rude or intimidating you.

How can an Unacceptable Report be countered?

IMEs are normally being conducted by physicians who work on a regular basis for insurance providers, making them tend to satisfy their employers for want of obtaining continuous lucrative examinations through referral. This may create bias when reporting the real extent of injuries sustained by victims. To be able to face such eventuality, injury victims may follow certain important steps as listed below:

  • Get a copy of the IME Report
    • The first thing before starting discussion about an IME report is to take possession of one – get a copy of the complete IME report
  • Specify the Inaccuracy or Deficiency of the report to the adjuster
    • Identify and indicate the unreliability of the report toward actual intensity of your injuries – material from your medical records may be used for pinpointing the trouble
  • Point out Unfairness
    • If the IME turned out to be unfair or performed without collecting complete medical history or symptoms from you, inform this to the adjuster – offering verbal support of the person who accompanied you
  • Compare the time and effort
    • Contrast the considerable time taken for diagnosing and treatment of injuries with the brief extent of time spent during the IME – indicate this to the adjuster
  • Engage your own physician
    • In the event of the adjuster following an extremely negative IME report and denying a fair settlement, you may take a writing from your own physician who treats you – just check whether your physician’s charges in this regard are worth the claim
  • Check the relationship of the Insurance Company with the IME physician
    • Ask for statistics such as the insurance provider’s referral to the physician, charge of the physician per IME, and the number of IMEs performed by him on behalf of the insurance provider – although the adjuster may not provide these details, this may ensure their proper response toward negotiating a settlement

By following these legal and fundamental factors, you can ensure proper negotiation and fair settlement of your work injury claim.