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April 23, 2019 by Greg Baumgartner
After you have made a personal injury claim, the insurance company may try to dispute that the accident caused any injury or that the claims made are excessive. One of the ways defense lawyers try to prove faking or exaggeration is through an “IME” with a paid defense doctor.
The insurance company will review your injuries. In some cases, after a personal injury lawsuit is filed in Texas, the defense may request that you visit a physician they pay and choose to evaluate your injuries. If you have put your medical condition in question with the case, the judge will likely order you to appear for a defense doctor exam.
An independent medical exam (IME) is an examination by a physician who is alleged to be neutral to a particular insurance claim or injury case. An IME is commonly associated with workers’ compensation cases but may also be used in personal injury cases. An IME doctor is supposed to provide an unbiased medical opinion about a person’s medical condition and prognosis following an injury.
A physician is qualified to be an independent medical examiner only once certified. The insurance company will generally provide a list of physicians to choose from or may provide you with the name of a specific doctor.
An IME exam usually follows a specific list of requirements. You will be asked to make certain movements that will indicate the condition of your injury.
The insurance company may request that you submit to an IME. If they make that request, you should first speak with your attorney. Generally, the law allows an IME through the Texas Rules of Civil Procedure. An examination by a third party must be warranted. An IME is only allowed in cases with good cause for the exam, and the person’s medical condition is controversial.
Requesting an IME is to refute a person’s medical claims. For example, if you provide information about a back injury, the company may not want to provide payment until it verifies the details of the injury. A request for an IME typically means a dispute regarding the injuries. Before you proceed with the request, this should be reviewed and discussed with your attorney.
The truth is that many physicians constantly work with the insurance industry to give opinions that can be predicted in advance—the claimant was not hurt or badly hurt, the medical treatment was unwarranted, and the victim is faking are all common opinions from defense doctors.
Some of these doctors make hundreds of thousands of dollars a year simply by helping the people who pay them by giving adverse opinions in personal injury cases.
It is so bad that in Texas, with some IME doctors, plaintiff attorneys can predict what the doctor will testify to before the exam.
Be cautious when speaking with an insurance adjuster. Keep in mind that all of your conversations will likely be recorded. Therefore, do not casually answer questions without asking your attorney for direction. Negotiations with an adjuster must be done with preparation and care.
Remember that the insurance adjuster is not your friend and is likely looking for a way to reduce the amount of your claim. Contact your attorney before you speak with the insurance company. Your lawyer will advise you on moving forward and help you evaluate your claim with the best outcome possible.
If you were hurt in an accident, do not settle your claim until you talk to a skilled Houston motorcycle accident lawyer.
Contact our legal team in Houston at Baumgartner Law Firm for a free initial case consultation. Call (281) 587-1111!
Resource:
Texas Rules of Civil Procedure Rule 204
Since establishing Baumgartner Law Firm in 1985, Greg Baumgartner has built a reputation as one of Houston’s leading personal injury attorneys, dedicated to representing severely injured victims and families who have lost loved ones due to negligence.
Greg holds two law degrees, a distinction earned by less than 1% of all attorneys, demonstrating his exceptional legal expertise. He is also a prestigious Trial Lawyers College graduate, further enhancing his skills in trial advocacy and litigation.
His relentless commitment to legal excellence and client advocacy has earned him recognition from prestigious organizations, including Super Lawyers, the Top 100 Trial Lawyers, and many others.
With decades of experience, Greg has consistently received top peer reviews. He holds a preeminent rating, a testament to his unwavering dedication to securing justice and maximum compensation for his clients.
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