WHAT IS AN “IME” ?

WHAT IS AN “IME” ?-

“IME” is the abbreviation used in the insurance world for “Independent Medical Examination.”  

If your insurance company is paying for your medical care following an incident such as an automobile accident, they may ask for you to attend a medical examination by a doctor of their choosing.  The term that is used in these instances is “Independent Medical Examination.” 

The rationale behind giving an insurance company the right to send an insured to such an examination is that the company is entitled to a second opinion about whether or not the care that you are receiving is reasonable, necessary, and /or caused by the incident for which you have coverage.    While this makes sense on the surface, like many things that have good reasons behind them, the practical application of the right to send an insured to an IME is more nuanced.  

Insurance companies handled thousands and thousands of claims.   If a doctor elects to earn a living by conducting IMEs for insurance companies, they can get paid handsomely.   If a doctor finds reasons that the insurance company should no longer pay for care for their insured, then the insurance company saves money.  When each examination can cut off an insured from future medical benefits of thousands of dollars, this savings adds up quickly.  Meanwhile, the insurance company now has a legal means of stopping benefits.   Whether a type of care or how much care is reasonable and necessary to treat an injury is something that is highly debatable and unique to each individual case.  Doctors who consistently find ways for an insurance company to cut off benefits to their insureds will probably get hired more in the future by that insurance company.  While certainly, not all doctors will compromise their personal ethics in order to make more money in this manner, it only takes a few doctors in any given region to decide to line their pockets in this way and they are then used over and over again by the insurance companies in the area for this purpose.  

If you have been asked by your insurance company to attend an IME of Independent Medical Examination, this is a sign that you should, at a minimum, talk with a seasoned personal injury attorney about your case.  You may not need representation, but you definitely should make use of the free consultation to make certain you fully understand what you should be doing regarding the requested examination and what it means for your individual claim.   Wiener and Lambka, PS is pleased to provide free consultations to new potential clients at any stage in the claims process.