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.
I presented her testimony about the answers she claimed my client gave. And then I showed what my client really said.”
The hired expert is not only attempting to have the blog entry removed, but she is even asking the state bar’s disciplinary board to punish Mr. Gursten for simply calling attention to these events. It’s not an idle threat as this doctor is actually on the very same disciplinary board she is asking to punish Mr. Gursten!
This highlights the need for attorneys willing to protect clients from abusive insurance company techniques and stand up to the doctors they hire.
Some IME doctor’s lack specialized training in the area they testify about, or are no longer actively practicing medicine. Their medical license may be expired or lapsed, or even only from another state or country. Nonetheless, they can still examine claimants and make conclusions about injuries, past treatment, and even recommend ceasing further treatment. A doctor may have trained and focused on an unrelated area during their career in medicine. In one instance, a trained oncologist was conducting exams for insurers and defense lawyers, and offering her expert opinion on orthopedic injuries. It’s not uncommon to encounter doctors who gave up private practice entirely, in favor of this lucrative IME work.
D’Amore Law Group seeks information about every IME doctor’s credentials and requests a chaperone be permitted to attend the examination with our client. When appropriate, DLG has demonstrated the need for an objective record of the examination to the court. Exposing the tactics of insurance companies favored experts is important. It’s a fight the attorneys at D’Amore Law Group face on many cases. We do not back down from this challenge – it’s too important for our clients and it’s too important for everyone else victimized by insurance company tactics.
