Do I have to go to an Independent Medical Examination (IME)?
My No-Fault insurance company wants me to see one of “their” doctors. What if I don’t go?
If you have no-fault insurance coverage in Michigan, your insurance carrier may hold up paying your medical, wage loss and other no-fault benefits until you have been seen by a doctor chosen by the insurance company. This is a so-called “Independent Medical Examination” and it is permitted by section 3151 of the No-Fault Law.
It probably makes sense to you to think that, since you paid for no-fault coverage, if you get hurt, the insurance company should pay your medical and wage loss claims without arguing about it. However, things don’t work that way, as you have probably found out if you are reading this. Your no-fault carrier only has to pay your benefits as long as it is convinced that the expenses are reasonable, necessary and are related to the accident. All three of those have to be true, in their opinion, or they won’t pay.
What insurance companies often do is set you up for an “examination” with a doctor who will probably find that 1) you aren’t “really” hurt, or 2) you may have been hurt initially, but you are ok now or 3) whatever is wrong with you isn’t due to the car accident. Any of those approaches will give the insurance company the right to not pay you or your doctors. These tactics drive a lot of people to seek the advice of lawyers who handle Michigan no-fault cases.
OK, you say, I just won’t go to the “independent” medical exam. Then the insurance company doesn’t have any basis upon which to cut me off, right?
The insurance company can’t “make you” go to a doctor. But they can stop paying your benefits if you don’t go. Your policy probably contains a clause that says they have the right to send you for an evaluation. And Michigan courts have ruled that the No-Fault Law itself requires you to cooperate with efforts to have you evaluated.
If you have been cut off from no-fault benefits after an “independent” medical exam, or have been told that you have been set up for such an exam by your no-fault adjuster, please consult a lawyer who practices no-fault law in Michigan immediately. There are steps you can take to protect yourself from some of the risks described in this posting, but they are more complicated than anyone can cover in a few sentences.
Steven J. Matz is a founding shareholder of Matz Injury Law. The firm’s concentration is on personal injury litigation, with an emphasis on traumatic brain injury.
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