• Lisa Brown

Can the Insurance Company Require Me to be Examined by Their Own Doctor?

When you submit a claim to an insurance company for personal injuries, you will have to provide the company with medical records from your doctor(s) that will support your claim that you were injured in the accident, whether it be a Florida car accident or any other type of accident.  Although you may think that the records you provide will be more than enough information for the insurance company to make a decision regarding payment of your claim, the insurance company will, in most cases, want more.   You see, when you file a claim for personal injuries, your medical condition, both past and present, is highly scrutinized by the insurance company.  Insurance companies do not like paying claims.  This is why they won’t just rely on what you give them in deciding how much to pay you, if at all.

What is a Compulsory Medical Examination?

During the course of your personal injury claim, the insurance company will ask you for information that it will claim that it needs to fully evaluate your injuries.  Most of the information requested will be in the form of records, such as past medical records.  The insurance company will ask for past medical records to see if you’ve ever made similar types of physical complaints before.  Another request you may get is to submit to an examination by a doctor on behalf of the insurance company.  If you get this request and you have not yet filed a lawsuit, you do not have to do this unless it is your own insurance company that is asking for it.  If you have filed a lawsuit, however, you don’t have a choice.

Florida Rule of Civil Procedure 1.360 permits a party to a lawsuit to request an examination in circumstances “when the condition that is the subject of the requested examination is in controversy.”  When you make an injury claim, your physical condition is obviously in controversy.  This is why, when you are involved in a personal injury lawsuit, you will have to submit to such an examination.

A Compulsory Medical Examination (CME) is a medical examination by a doctor that is hired and paid by the insurance company defending your claim.  Insurance companies like to refer to these examinations as Independent Medical Examinations (IME) because they would like people to believe that the doctor they choose is completely neutral and independent.  However, this is never the case, as these doctors often perform many (hundreds/year) of these examinations at the request of insurance companies per year.  These doctors are also generously compensated for their services.  Some insurance company doctors make hundreds of thousands of dollars per year performing these examinations.  This is why they are no longer called Independent Medical Examinations.   They are now called compulsory because you don’t have a choice.

What Happens During a Compulsory Medical Examination?

When you appear for a Compulsory Medical Examination, the insurance company doctor will spend most of his/her time taking down your history.  Although the doctor should already have a complete copy of your medical records, they rarely review them in advance.  We instruct our clients to limit the discussion with the doctor to solely matters relating to their medical condition.  Often times the doctor will ask for details about the accident, and how it occurred.  We instruct our clients not to answer these types of questions, as the examination is not meant to be a deposition, and questions about the accident have likely already been asked by the defense attorney. After taking your history, the doctor will then perform a cursory physical examination, checking such things as range of motion, looking for spasms, etc.  We do not permit testing such as x-rays.  The entire examination, with history, usually takes 30 minutes or less.

What Can I Do to Prepare for a Compulsory Medical Examination?

There is really nothing that you can do to prepare for a Compulsory Medical Examination.  We advise our clients that the examination starts from the time that you pull into the parking lot and that it ends when you drive away.  We have encountered several insurance company doctors who actually watch people as they walk into and out of the exam, and also monitor them as they sit in the lobby.   They do this in hopes of catching the person doing something that is inconsistent with their history and complaints.  We also instruct our clients to be completely forthcoming about their injury and complaints, and we warn against any type of exaggerating.  We let our clients know that the insurance company doctor will have an opinion that is adverse to their case and that there is nothing that they can say or do during the examination to change this.

In order to best protect our clients, we also always have a videographer present to document the examination.  This way the insurance company doctor can’t claim to have done a test that they didn’t or claim that they spent more time with the client than they did.  We have also had several instances where the doctor will claim that our client was combative and uncooperative when the video clearly showed otherwise.

Free Information

If you have questions about your Florida accident case, you can download our Free Reports:

  1. What You Must Know if You Were in a Car Accident;

  2. The Ultimate Guide to Florida Slip and Fall Cases; and

  3. 5 Medical Mistakes That Will Destroy Your Personal Injury Case

which are available on our website, or you can click the link provided.  You can also contact us at (813)419-3866 to talk directly to an Apollo Beach personal injury attorney now.

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