Understanding Independent Medical Examinations (IMEs) in Washington State

In the aftermath of a car accident, individuals often find themselves navigating the complex world of insurance claims. One aspect that frequently arises is the Independent Medical Examination (IME), a crucial component that can significantly impact your claim. Insurance companies are trained on minimizing the money they must pay, and IMEs are one of the most effective tools at their disposal.

Essentially, the insurer requires the claimant to attend a medical examination with an “independent” physician who ultimately provides recommendations as to whether treatment is reasonable. Unfortunately, these hired doctors are often beholden to the insurer because the insurance companies pay their bills. Understanding how IMEs work is important to ensuring a successful car accident injury claim.

Personal Injury Protection (PIP) and IMEs: Personal Injury Protection (PIP) is a type of insurance coverage that pays for medical expenses and, in some cases, lost wages and other damages resulting from a car accident, regardless of who was at fault. In Washington State, PIP coverage is mandatory, and it provides an injured party with quick access to medical treatment.
When a PIP insurer requests an Independent Medical Examination, it is typically to assess the extent of the claimed injuries and determine the necessity of ongoing medical treatments. PIP IMEs are generally focused on ensuring that the medical expenses being claimed align with the injuries sustained in the accident. These exams are often used to cut off medical treatment or recommend other avenues for treatment.

Liability Insurance and IMEs in Lawsuits: In contrast, liability insurance comes into play when one party is deemed responsible for causing the accident. If a personal injury lawsuit is filed against the at-fault party, their liability insurance company may request an Independent Medical Examination for a different purpose.

Liability insurance companies utilize IMEs to challenge the severity and causation of injuries claimed by the plaintiff. The primary objective is often to dispute the extent of the damages and, consequently, reduce the amount of compensation owed. Insurance adjusters may use the findings from the IME to contest medical expenses, future treatment needs, and even the overall impact of the injuries on the plaintiff's life.

How IMEs Affect Your Personal Injury Claim: Whether it's a PIP or liability IME, the results can significantly impact the outcome of your personal injury claim. It's crucial to understand that the doctor conducting the examination is typically chosen by the insurance company, raising concerns about potential bias.

For PIP IMEs, the focus is on confirming the necessity of medical treatments and expenses covered by the policy. Poor results from these exams may lead to higher out of pocket costs for treatment or an inability to get treatment covered by insurance. However, with liability IMEs, the intention is often to challenge the legitimacy of the injuries, aiming to minimize the compensation owed by the at-fault party's insurance.

Independent Medical Examinations are integral to the personal injury claim process in Washington State. It's essential to be aware of the distinctions between PIP and liability IMEs, understanding how each can influence the outcome of your case. If you’ve been in a car accident and are subject to an IME, contact the experienced personal injury team at the law offices of Magnuson Lowell PS for a free case evaluation.

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