Does the no-fault insurance company have a right to have an injured person undergo a medical exam?
As soon as you make a no-fault insurance claim, many people injured in auto accidents may receive a letter from their auto no-fault insurance company’s adjuster, requesting a so called “independent medical examination” and more accurately historically known as “insurance medical examinations.” If you sue, you can also be required under Michigan Court Rule 2.311 to undergo a physical or mental examination of your medical condition is at issue in the case. The Michigan no-fault act, in MCLA 500.3151, provides that when the mental or physical condition of a person is at issue, a no-fault insurance company can request the claimant to undergo a “mental or physical examination by physicians.” The auto insurance contract also has a similar provision but cannot violate MCLA 500.3151. Michigan law does not allow the insurer to have the claimant(s) examined by other types of medical practitioners, such as psychologists or neuropsychologists.
What types of doctors can perform a medical exam?
The 2019 new no-fault reform law adopted some new limitations on the rights of insurance companies to conduct an independent medical examination. The new legislation requires that medical evaluations be performed by physicians with the specialization like those of the injured person’s treating physician(s). Specifically, MCL 500.3151(2)(a), states:
“If care is being provided to the person to be examined by a specialist, the examining physician must specialize in the same specialty as the physician providing the care, and if the physician providing the care is board certified in the specialty, the examining physician must be board certified in that specialty.”.
Now, certain physicians performing exams for insurance companies must meet requirements to qualify as an examining physician. The new no/fault law provides that in all cases, an examining physician, during the year prior to the medical evaluation, “must have devoted a majority of his or her time in active clinical practice of medicine or to teaching in a medical school or in an accredited residency or clinical research program for physicians.” See MCLA 500. 3151(2)(b). The rules went into effect on June 11, 2019.
What should an injured person do if requested to undergo an insurance medical exam?
The injured person is required to attend the non-invasive medical examination if the request is reasonable. MCLA 500.3153, provides that if a claimant refuses to submit to an independent medical examination, a court can issue orders that are appropriate under the circumstances, including prohibiting the claimant from introducing any evidence of his or her mental or physical condition. Under MCL 500.3152, the claimant who undergoes an insurance medical examination (IME) may request a copy of the report. Insured claimants should never refuse or ignore an insurance company’s request for an independent medical examination. The insurance company can terminate benefits if you unjustifiably fail to appear for the insurance medical exam. Our experienced personal injury auto accident attorneys know that 9 times out of 10, the insurance medical examiner is biased and writes a report favorable to the auto insurance company. There is no independent process for the selection of IME doctors. Bottom line is the independent medical exam is not independent and bias should be explored in each instance by your skilled personal injury lawyer. A lawyer can ask several questions to expose the bias of the IME doctor. The following are some examples:
1. Number or percentage of the time doctor does legal exams for the defenses;
2. How much income each year from doing legal exams for auto insurance companies and their lawyers;
3. Make sure expose the fact that IME doctor is not offering care, recovery or rehabilitation services to the patient and there is no physician patient relationship established.
4. IME doctors usually perform the exam at a non-licensed medical facility that does not provide treatment.
5. Some IME businesses file reports with the State of Michigan LARA that expose what they really are.
6.Financial relationship offered to show bias is generally is admissible even if insurance is mentioned. See MRE 411. In Windham v. Sabbath, an unpublished opinion, our law firm won an auto accident trial verdict. The Michigan Court of Appeals upheld the jury verdict we obtained for our car accident injury client. The defendant argued plaintiff's counsel, Joseph Dedvukaj, should not have been allowed to cross examine Dr. Mary Kneiser about her relationship with the defendant's insurer Allstate Insurance Company. The Michigan Court of Appeals held the questioning was properly permitted under MRE 411:
"Dr. Kneiser testified about her independent medical examination of plaintiff. On cross- examination, plaintiff’s counsel, over defendant’s objection, questioned Dr. Kneiser about whether she performed examinations at the request of automobile insurance companies and defense attorneys. Plaintiff’s counsel also questioned Dr. Kneiser about the fact that she faxed her report to defense counsel and “Allstate.” The trial court did not abuse its discretion in determining that the questioning was relevant to Dr. Kneiser’s credibility and for the purpose of showing bias, a purpose expressly permitted by MRE 411. Furthermore, the court gave a cautionary instruction to the jury, advising it that the question of insurance had no bearing on any issue in the case and that it must refrain from any inference, speculation, or discussion about insurance. To the extent counsel’s questions or comments implicated MCL 500.3030, the court’s instruction was sufficient to cure any perceived prejudice."
In a recent published Michigan Court of Appeals decision in Schaumann-Beltran v Gemmete, the Court held that courts cannot permit parties to video record their medical examinations under MCR 2.311. In this medical malpractice case, the parties agreed that the plaintiff would submit to a neuropsychological evaluation. The plaintiff wanted her attorney to be present to record the examination. The defendant opposed the plaintiff's requests. The trial judge ordered that the plaintiff could record the evaluation instead of having her attorney present. The plaintiff does not need to show good cause. The Appeals Court held that under MCR 2.311(A) the examinee’s attorney can be present. However, the Michigan Court rule does not allow recording the exam.
The Joseph Dedvukaj Firm, P.C. is located in Bloomfield Hills, Michigan and serves the entire State of Michigan. Past results are not a guarantee of future results, and the outcome of your particular case or matter cannot be predicted using a lawyer’s or law firm’s past results. Contacting us through our website does not create an attorney-client privilege. This website is attorney advertising.
Attorney Advertising. This website is designed for general information only. The information presented at
this site should not be construed to be formal legal advice nor the formation of a lawyer/client
[ Site Map ]