Approx. 7 minute read.
This is a feature blog written by Emily Crocker at Gatti Law Firm for Hosmer Chiropractic Health.
What is Personal Injury Protection?
The chance of suffering spinal and other injuries in an automobile accident is very high. Because of this, the Oregon Legislature has declared that all private auto insurance policies must include a provision for Personal Injury Protection (“PIP”) benefits. This includes a legal minimum of $15,000 in medical expenses, or more if a higher level has been purchased. PIP benefits cover, among other things, all medical treatment that is reasonable, necessary, and related to the collision for two years following the collision. PIP benefits cover all drivers and passengers occupying a vehicle, as well as pedestrians and bicyclists who are struck by a vehicle. PIP benefits apply regardless of who caused the accident.
PIP benefits are undeniably valuable in helping injured individuals receive the care they need; however, the auto insurance industry abuses this system through its option to review the injured party’s medical treatment, and force them to attend an “Independent Medical Examination” (IME). If the injured person declines to attend the IME, this constitutes a breach of the contract, and the insurance company can refuse further benefits.
What is an IME?
Do not be fooled by the word, “independent”; these examinations are biased. The insurance company orders and pays for the exams, and they are conducted by doctors who generally have proven track records of concluding that no further treatment is necessary. The insurance-subsidized doctor will conduct a brief examination and write a lengthy report to the insurance company detailing his or her findings that the injured person is fully recovered and no further treatment is needed.
What Should I Expect at an IME?
The IME will be unlike any normal visit to a doctor. No doctor-patient relationship is created, and no communication to the doctor is confidential. The purpose of the exam is not to provide medical treatment, but to provide the insurance company with a basis to escape its obligation to pay further medical bills. When you attend, remember that this doctor does not have your best interest in mind as a normal doctor would.
The most important thing is to disclose all of your injuries related to the accident, without downplaying or exaggerating. Patients often feel inclined to try and convince the doctor that they are injured, but the doctor will be alert to any reason to discount the patient’s credibility. Simply be honest and matter-of-fact about your injuries. Answer the doctor’s questions fully, but do not go into more detail than he or she asks for.
What’s the Bottom Line?
Ultimately, when faced with a request to attend an IME, it is always a good idea to call a lawyer who specializes in motor vehicle collisions. We at the Gatti Law Firm, and other attorneys who specialize in motor vehicle collisions, fight with insurance companies that prematurely cut off PIP benefits. It is our goal to make sure our clients receive all the treatment they need to fully recover from their injuries, and that the insurance companies pay for this treatment, as they are obligated to do.
Emily Crocker, Attorney at Law
The Gatti Law Firm
Clackamas | Lake Oswego | Salem | Eugene
(503) 363-3443 | www.gattilaw.com