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Vancouver, Washington

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Don Jacobs
Don Jacobs
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Insurance Medical Examinations

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After an injury accident, many consumers get demands from an insurance company that they be examined by a doctor of the insurance company’s choosing. Laughingly referred to by the insurance industry as “Independent Medical Exams”, many companies use these as a tool to limit insurance benefits. Insurance adjustors are trained to tell someone injured in a car accident that the exam is set up to help them learn more about their injury or to get a specialist’s opinion on what further care they should receive. However, as lawyers know, these are often set up to cut off care or limit your benefits. Insurance adjustors are hired to adjust claims, which is the process of determining what benefits a consumer is entitled to under a policy. The problem is they don’t seem to ever adjust them up, just down. Nothing in the law requires you to attend one of these exams. However, almost all insurance policies have provisions permitting the company to refuse to pay any benefits if you don’t. So you are stuck in a Catch 22. If you don’t attend, they can cut of your benefits. If you do, most of the time the “independent” doctor will claim you don’t need any further care. So what to do? When a company requests an exam, this is a real red flag you need some help. Consult a lawyer. Often the attorney can talk them out of an exam or seek concessions. If not, he or she can at least make sure they comply with state laws concerning the type of specialist required for the exam.