When a person is in an accident they expect their insurance company to open a claim and fairly handle the claim. After all, insurance commercials tell us…
When a person is in an accident they expect their insurance company to open a claim and fairly handle the claim. After all, insurance commercials tell us we’re in good hands with Allstate, and Farmers is on our side. But it’s often a surprise that a person’s own insurance company can choose, hire and pay a doctor to perform a physical or psychological exam. The exam is conducted not only to assess the nature and severity of their injuries, but decide whether the care their own doctor has recommended is appropriate. It’s often a shock that the injured person can also be forced to go through this process by the at-fault party’s insurer as well. The purpose? These exams document the “expert’s” opinion to justify claim denial, cutting off treatment, or discontinuing benefits.
There is often only a handful of experts in each state that the insurance companies use. Most of these doctors are contracted through companies with innocent sounding names that include words like “Impartial”, “Sunrise” and “Oregon Medical”. These companies exist to provide insurance companies with doctors they can hire to examine claimants and form opinions.
Oregon, like most states, provides little actual protection from unscrupulous or even fraudulent behavior by a medical examiner. Imagine a court system that allows a doctor hired by an insurance company to do an examination to defeat your claim, but the same court system does not allow the examination to be recorded. Nonetheless, many courts frequently do not allow the examinations to be recorded or for a witness to be present during the exam under the mistaken belief that these examinations by hired experts are not adversarial. This sets up the potential for a hired expert to claim that the injured person “confessed” any number of statements about the facts of the incident or existence of injuries. And, this hired expert is paid thousands of dollars by the insurance company for their opinion that typically is different than the opinion of the patient’s treating physician.
Michigan attorney Steven Gursten published an account on his blog about a frequently hired insurance psychiatrist’s testimony in trial that directly contradicted actual medical records over and over. Mr. Gursten stated:
“As an attorney, I’ve been shocked by the injustices that occur during many of these IMEs. There are far too many medical professionals who sacrifice their professional objectivity for cash when performing them. I wanted people to know what happens when accident victims are forced to see many of these IME doctors today. So I wrote about what Dr. Griffin did to my client.