What is an IME and do I need to go?

Author: Attorney Jason Macri

In the State of Florida, every driver of an automobile is required to have auto insurance. The only required coverage in Florida, however, is Personal injury protection. Personal injury protection, or PIP, will provide between $2,500.00 and $10,000.00 worth of medical payments coverage in the event of an injury involving an automobile. PIP will pay 80% of what amount is allowable. Health insurance will cover the other 20% of that is allowable. If there is no health insurance, the medical provider will bill the patient for the other 20%. PIP is primary to health insurance, meaning that a medical provider is required to bill PIP first in automobile related injuries. The provider will then bill health insurance or the patient second.

The Independent Medical Examination (IME)

By law, auto insurance companies have the right to set any person claiming PIP benefits for an Independent Medical Examination, also known as an IME. The insurance company will schedule the IME in advance and send a letter to the patient letting them know the date and time they are to show up for their appointment. Typically the doctor’s office will not be far from the home of the patient because, by law, the insurance company is required to find a location within a reasonable distance from the patient.

Is the IME helpful to me?

One would assume that because this medical examination is going to be “independent”, the doctor will not have any bias and will examine the patient in an effort to render an accurate medical opinion. This could not be further from the truth. The doctor conducting the examination has been hired directly by the insurance company. More than likely, that same doctor has been hired by the insurance company many times in the past. Some doctors have been hired by the same insurance company hundreds, if not thousands of times in the past. Essentially, that doctor works for the insurance company. The doctor is sometimes able to make hundreds of thousands of dollars per year to conduct these examinations. It is safe to say, based on these facts, the doctor has a major bias and will only render an opinion that helps the insurance company. Do not expect this doctor to attempt to help you in any way. The doctor has solely been hired to help the insurance company.

Do I need to go to my IME?

The short answer to this question is yes. You must appear for your IME. If you do not go to your IME, the insurance company will immediately cut your PIP benefits and will not provide you with continuing medical payments coverage. If you know you will not be able to attend the IME, you must notify your lawyer or the insurance company immediately. In most cases, the IME can be re-scheduled to a time more suitable to you as long as you notify the insurance company in advance.

Should I continue to get medical treatment if I have been cut off from my treatment by IME?

If you are injured you should get medical treatment regardless of your IME results. The insurance companies are hoping you will get discouraged by a negative IME result and will stop going for medical treatment. This will, in turn, help the insurance companies because a person without medical treatment has no need for compensation in their eyes. Do not let an insurance company dictate whether you get treatment or not. If you are injured, get the best medical treatment you can, regardless of the opinions of the insurance company’s doctors.

Should I hire a lawyer?

If you are injured in any type of accident, call the attorneys at the Law Office of Dell and Schaefer. We will never allow an insurance company to dictate what you can or cannot do. We have handled thousands of auto accident cases and have over 30 years of experience in this area of law. We will protect your rights and ensure that your claim is not ruined by the dirty tricks of insurance companies.