What You Need To Know Before Going On Your No-Fault IME

If you are injured in a car accident, chances are you will be sent for at least one independent medical examination (IME) by your insurance company. The IME is a medical examination with a physician chosen by your no-fault carrier. Florida is a “no-fault” state, meaning your medical expenses and lost wages are paid by your car insurance company without allocating blame for the accident. This insurance coverage is called Personal Injury Protection (PIP), and in Florida, the mandatory coverage limit is $10,000. Florida law allows the insurance company to require you to attend a mental or physical IME to determine if it should continue paying your no-fault benefits. The reasons insurance companies deny claims after an IME include:

• The IME examiner is of the opinion that your treatment has reached a point of maximum benefit and is no longer necessary.
• The IME examiner believes your injuries were not caused by the accident.
• The IME examiner determines that your injuries have resolved.

Preparing for the IME

When you are injured in a car accident, it is important to get the medical treatment and testing you need, and PIP coverage is supposed to provide for this. There are several important facts about a no-fault IME that you should know before attending the examination:

• An IME is not really “independent.” The examiner is paid by the insurance company, which tends to use physicians it believes are more likely to recommend denying the claim. The examining physician may be subconsciously biased for fear that not denying enough claims will result in not being hired to conduct IMEs in the future.
• It is important to tell the IME physician all of your present physical complaints relating to the accident, even if they do not relate to the doctor’s specialty.
• The examination must be conducted by an active physician in your area or at a reasonably accessible location. This generally means within 10 miles.
• The IME must be with a Florida licensed physician in the same specialty as your treating physician.
• The IME physician must only examine you, not treat you, interrogate you or ask you to do something you are physically unable to do.
• Take notes at the examination, recording when the exam begins and ends and what the exam involves.

A no-fault IME can have important ramifications on your doctor’s ability to get paid without you having to pay out of pocket. The ability to continue receiving needed treatment and diagnostic testing can also affect your ability to prove you suffered a serious injury in your lawsuit against the other driver. For these and many other reasons, it is a good idea to consult with a St. Petersburg car accident attorney.