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Vancouver, Washington

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Don Jacobs
Don Jacobs
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Independent medical exams

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Ever had to make a claim with your auto insurance company for medical bills because of an accident? This type of coverage is commonly referred to as Personal Injury Protection, or “PIP” coverage. If you live in Oregon, this type of coverage is automatically on your auto policy. In Washington, the coverage is optional, although your insurance company has to make you sign something rejecting the coverage or it automatically applies. They also have to keep a copy of the signed rejection in the file. If they can’t produce it when asked, they have to pay for your medical bills, even if you remember signing the form. Both states have lots of rules concerning how long they have to pay the bills after submitted and what happens if they want to issue a denial. Both states also give insurance companies the right to challenge the care as unnecessary or unrelated to the accident. Now you wonder, if my doctor says I need it, how can an insurance company say otherwise? Well, they do all the time. One of the tools they use to back up their denial is the misnamed “Independent Medical Exam”, or “IME” in insurance lingo. This involves you having to submit to a medical exam with a doctor of their choosing. If you don’t go, they cut your benefits. Unfortunately, if you do go, more often than not the same thing happens. They seem to be able to find physicians who always disagree with the treating doctors. It doesn’t matter what letters your doctor writes disputing the IME findings. They strictly adhere to whatever their doctor says. At least in Washington, in order to put you through this they have to make sure the doctor they choose has the same degree as your doctor. This isn’t much consolation, but at least if you are treating with a chiropractor they have to use a chiropractic examiner.