Is an Independent Medical Examination Required by Ontario Insurers?

independent medical examination for accident benefitsIf injured in an accident in Ontario, you may be eligible to claim accident benefits to help cover your medical bills and other related expenses. The amount of available accident benefits coverage to you will depend on the severity of your injuries. To help prove the extent of the injuries you sustained, an insurer may require that you attend an Independent Medical Examination (IME).

Greg Monforton & Partners is prepared to help you claim the accident benefits you need. There is no risk in calling us and no obligation to retain our services after completing an initial free consultation.

What is an Independent Medical Examination?

Ontario is a no-fault province when it comes to car accidents. This means that your insurer is expected to pay for certain accident benefits if injured in a crash. However, independent medical examinations are commonly requested by insurers after an injured victim has filed a claim for accident benefits.

An IME is a review of your medical status by an independent medical examiner. He or she will look over your medical history and current health related to your claim and offer a written opinion of your injuries and recovery. The medical examiner will not provide any treatment or medical advice directly to you.

The purpose of an IME is to provide insurers with a report from a doctor who is not treating you. They want an unbiased, neutral perspective on the injuries you suffered in order to pay out.

Other Reasons an Insurer May Require an IME

An IME is supposed to help an insurer determine whether or not an injured victim is eligible for compensation under Ontario’s Statutory Accident Benefits Schedule. Yet, some insurers may use an IME as a tactic to delay paying what is owed or attempt to deny paying altogether.

They may argue that your injuries are non-existent, pre-existing and unrelated to the recent accident or not as serious as you claim.

Working with an experienced lawyer can help ensure that you receive all of the accident benefits you may be qualified to receive without having your claim unjustly delayed or denied.

What to Expect at an IME

Insurers must issue injured victims advanced notice to attend an IME, which includes the date, time and location. The medical examiner will conduct an interview, asking you questions about the accident, your injuries and how they have progressed, the treatment you have incurred and how you are recovering.

The medical examiner will also likely review any other medical records and have you undergo a physical examination. This examination will vary based on your injuries. For instance, if you sustained a back injury in the accident, you be may asked to bend or move in different ways to determine your pain level.

It can take multiple hours to complete an IME, based on how extensive and severe your injuries are. Afterward, the medical examiner will send the report directly to your insurer who will then use it to assess your claim for accident benefits.

If you must attend an IME, it is important to remember that the independent medical examiner works for the insurer and is not your doctor. Be sure to not exaggerate or downplay your injuries. Be honest about any issues you are having since the accident, but do not volunteer information about your injury.

A Windsor-based personal injury lawyer from our firm is here to help prepare you for an IME, including providing guidance on what to expect and how to best conduct yourself.

What If I Refuse to Attend?

Refusing to attend an IME could harm your chances at obtaining accident benefits. The insurer may deem you non-compliant and deny your claim. Do not give an insurer any reason to try and limit the amount of money they may be required to pay you after being injured an accident.

Call Us for Help Claiming Accident Benefits

Greg Monforton & Partners has helped many injured victims file claims for accident benefits. An initial consultation is completely free and confidential. You are not obligated after meeting with us to hire our firm, but if you do, we charge no upfront fees. We only receive payment if you obtain compensation.

Give us a call at (866) 320-4770 to get started.