Cape Cod Car Accidents and the "IME"....NOT!
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Do you know what IME stands for? How about "Independant Medical Exam". When it comes to car accidents and insurer requested IME's, falser words were never spoken.
If you have had a car accident, and are receiving No Fault PIP (Personal Injury Protection) benefits, your own carrier has a right to schedule an IME. This is because the carrier only has to pay for reasonable and necessary medical expenses. Beginning to get the picture yet? Your carrier schedules the IME and two weeks later you get a letter saying your carrier will no longer pay for your medical bills. But, you say; my doctor says I need three weeks of additional PT . Tough, your carrier says, our IME doc says you're fully recovered. Now, your lawyer has to not only fight against the carrier for the at fault operator on your bodily injury claim, but has to fight with your own carrier to get your medical bills paid.
How does this happen? Interestingly, the NY Times had a piece this week on IME docs doing workers compensation exams in New York. As one doc said" If you did a truly pure report, you'd be out on your ears and the insurers wouldn't pay for it. You have to give them what they want, or you're in Florida. THAT'S THE GAME BABY."
Another doc said, "basically, if you haven't murdered anyone and you have a medical license, you get certified. It's a nice way to semi-retire."
I could write a book about fraudulent IMEs I have seen in my practice in Massachusetts. For example, there is a well known IME doc on the South Shore that I prevailed against in a medical negligence case. The doc paralyzed my client during back surgery. He no longer sees patients, but does insurer IMEs all day long. I had a case recently where another well known IME doc said in a report that a herniated disc shown on an MRI was not really a herniation, but a mere sprain. This happens is cases every day. Most of these docs are retired and now do nothing but these "independant" exams for insurers. They get paid by the insurer. Think they're going to be "independant" and write a true and accurate report??? If you do, I have some PAVE PAWS land you might want to buy for development purposes.
This is another reason why it is so important to have competent and experienced counsel when you have been injured. We know who the scam docs are. We have another word for them. Suffice it to say it rhymes with "bore". We know how to protect you when you go to an IME. We know how to fight the carrier when an IME is written that is nonsense. We almost always have your own physician on our side because it is your doc that knows what you need; not an IME guy that examined you for 5 minutes and then cranked out a 15 page canned report. Plus, of course, the carrier is attempting to avoid paying your physician for their legitimate services.
Stay away from the lawyers on TV. They're just marketers and all they do is send you to another attorney. Make sure your lawyer is experienced, knows his or her way around a courtroom, and will fight for your rights when the "well intentioned" insurance companies try to deprive you of those rights.
Bruce Bierhans