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What Really Happens on an “Independent” Medical Examination?

Independent Medical Examinations

Few things can change your life more than being involved in a car accident. They can completely transform your health, finances and quality of life; and yet, they are impossible to prepare for or avoid completely. However, one of the primary ways that you can protect yourself is by learning what to expect if you are injured in a car crash in Minnesota.

How are laws designed to protect you in Minnesota?

Minnesota law requires that your own auto insurance policy pays up to $20,000 for your car crash related medical expenses, along with up to $20,000 in wage loss or replacement services. These services might include hiring people to help you perform tasks that you can no longer do because of your injuries, or for time missed from work because of your crash-related injuries. In the case where you don’t own a vehicle or live with a relative that owns a vehicle, the insurance policy covering a vehicle involved in the accident would then be required to pay these expenses.

This requirement ensures all who were involved in the accident will have medical services, wage loss or and/or replacement services covered. The “no fault” benefits apply to you whether you were at fault, another vehicle was at fault, or you were just a passenger involved in the accident–hence the term “no-fault” benefits. So in theory, it’s simple for everyone to be covered, since insurance benefits are not issued by the person responsible for the accident. However, if you have the misfortune of being involved in a car accident in Minnesota (contact our specialists here), you’ll soon realize that’s not always the case.

As the process begins, your auto insurance company (or whichever company is legally obligated to pay) will likely begin paying medical and wage loss benefits after a collision. If your injuries are severe and you quickly exceed the $20,000 medical expense threshold, it is likely that your auto insurer will pay the entire $20,000. The same is true for the part of the “no-fault” law for wage loss/replacement services. However, what if you suffer a “whiplash” type injury? No doubt, you know the injury is very real: the extreme pain you suffer, the debilitating impact on your quality of life, as well as the ongoing treatment necessary to recuperate from the injury. And yet, whiplash is the most common type of injury that insurers will deny medical expense benefits for. How is this possible? Let’s take a close look at how the insurance industry will try to maneuver things.

Auto Insurance and their “exams”

After someone is involved in a car accident, insurance companies will want to know in what way their customer was injured, since they are required to pay for treatment and expenses. So to make sure that they are fully aware of what’s taken place, there is a Minnesota law that requires any person in need of insurance benefits to undergo a medical examination. This examination will reveal what sort of injuries their customer has suffered and establish what treatment will be needed. And all of this makes sense… until insurance companies try to tilt things in their favor.

Remember, an insurance policy is a contract between you and your insurer spelling out what will happen if an accident happens and establishing that you both agree to those terms. And it’s important to note that every auto insurance policy written in Minnesota has a “cooperation clause”. Essentially, this is language in your insurance policy that requires you to cooperate with their investigation of your claim. The most common way for your insurer to “investigate” your claim is to demand that you attend an “independent” medical examination. How do they go about doing this?

Typically, a friendly insurance adjuster will give you a call and to schedule you for an appointment with a medical “expert” who will evaluate you and make sure you are getting the proper treatment. But in case you haven’t picked up on where things are going by now, this “independent” medical examination couldn’t be further from the truth.

Why not? Put simply, because there is nothing “independent” about these medical examinations. Personal injury attorneys—like those here at Weston Law Office, who represent people injured in car crashes—are very used to delving into the facts about what really happens at these medical exams. Actually, attorneys often call these types of examinations “adverse” medical examinations. Why?

The doctor who your insurance company sends you to isn’t independent at all. In reality, he’s hired by your insurance company—the same entity that is responsible under law to pay your medical expenses, loss of wages and replacement expenses from the accident. Thus, his or her interests are opposite of yours. Because they have been selected by the insurance company and are being paid by them, the doctor has every incentive to deny your medical and wage loss benefits in order to save the company money.

What happens at the examination

So what can you expect to happen at this examination? First, you will be sent to a medical office to be examined by a doctor chosen and hired by your insurance company. The first thing the doctor will explain to you is that in these examinations, there is no doctor/patient relationship created—thus no legal liability for the examining doctor misdiagnosing you or recommending that you don’t need treatment that you actually need. You might be asking at this point, “But isn’t that illegal?” Maybe you’re thinking about the hippocratic oath that all doctors have to take—“to do no harm”. Well, unfortunately for you, the insurance companies have found a way around that.

Because the doctor isn’t technically treating you, the hippocratic oath doesn’t apply in this situation. So, you go through the charade of them reaching their “diagnosis” as they examine your injuries sustained from the accident. And at the end of the examination, the doctor will write a report to your insurance company detailing his or her “findings” and opinion as to your condition. They will also comment on what they recommend for your future treatment as well as whether your past treatment was appropriate or not.

What ensures that the doctors will carry out the examination in a way that benefits the insurance companies? It’s important to note that the doctors who perform these examinations aren’t merely hired by the insurance companies; they make thousands of dollars for each examination—which by the way, typically last less than an hour. Thus, they have every incentive to write a report stating that you were only mildly injured in the crash, your treatment has been excessive, and that you need no further treatment. By telling your insurance company what they are hoping to hear–that no further treatment is needed–these doctors are doing themselves a favor: They’re proving their loyalty to the insurance company and are making sure that their lucrative income stream—a.k.a. performing these “examinations”—will continue.

What you can do about it

After finding out the truth behind how these adverse medical exams take place, you might feel like you have no chance at getting the justice and compensation you deserve. Afterall, Weston Law Office has represented hundreds of clients injured in car crashes. Thus, we have reviewed hundreds of these adverse examination reports. We know how the insurance companies like to pull the strings—in fact, we can count on one hand how many reports gave an opinion that even some future medical treatment was necessary, while 99% of the rest gave an opinion that the person was completely healed and that no further treatment is necessary. The insurance company then uses this opinion to deny further treatment, expenses and wage loss/replacement service payments. In some cases, we’ve even encountered insurance companies that have denied benefits retroactively, not only leaving the accident victim with huge unpaid medical bills, but an inability to get future treatment that they needed or to be compensated for time missed from work.

Sadly, the insurance company will try to manipulate things in their favor, denying you the compensation you deserve for medical bills, loss of wages and replacement services. However, it’s essential that you know one thing about this whole process: you can fight back. How? By having Weston Law Office on your side. We know the game insurance companies try to play with you, and we know how to stop them in their tracks. Weston Law Office is experienced in challenging denials of no-fault benefits and exposing the rigged “independent” medical examination system for what it is: a complete sham. We know how Insurance companies—even your own—don’t see you as a person, but as a number. We know all about how their policy of premature benefit denial is applied across the board, saving them thousands of dollars on each case which amounts to millions in profit for them—and hardship for their customers, whom they’re supposed to protect.

So before you try and take on your insurance company by yourself, know that Weston Law Office has already helped hundreds of car accidents victims get justice, and they can help you too. Contact us today for a free consultation.

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