Why Insurance Companies Request an Independent Medical Examination and What to Expect
A letter arrives asking you to see a doctor you have never heard of, chosen and paid for by the insurance company. Is this normal, and should you be worried about it? Independent medical examinations show up often enough in injury claims that understanding what they actually are, and are not, can keep the process from feeling as unsettling as it first sounds.
What an Independent Medical Examination Actually Is
An independent medical examination, often shortened to IME, is an evaluation performed by a physician selected and paid for by the insurance company rather than your own treating doctor. Despite the name, the examining physician is not neutral in the way the word independent might suggest. They are retained by the insurer, and their findings are typically used by the insurance company to evaluate your claim. Once a lawsuit has been filed, these exams can also be compelled through the formal discovery process. South Dakota’s civil procedure rules, specifically SDCL 15-6-35(a), allow a court, on a motion showing good cause, to order a party to submit to a physical or mental examination when that party’s condition is in controversy.
Why Insurance Companies Actually Request One
Insurers do not request these exams at random. Common reasons an IME gets scheduled include:
- Questioning whether your injuries are as severe as described in your own treatment records
- Determining whether your current symptoms are actually related to the accident
- Evaluating whether you have reached maximum medical improvement
- Assessing whether ongoing treatment is reasonable and necessary going forward
- Building a basis to dispute or reduce the value of your claim
That last point matters. While an IME can serve a legitimate evaluative purpose, insurance companies also use these exams strategically, and the resulting report sometimes downplays injuries in ways that differ noticeably from what your own treating providers have documented.
What Actually Happens During the Exam
An IME typically involves a review of your medical records, a physical examination, and sometimes diagnostic testing, all condensed into a single appointment that may last anywhere from twenty minutes to an hour. The examining physician will usually ask about your symptoms, your accident, and your daily limitations. It is worth remembering that the exam itself is being documented, often including notes on your demeanor and how you describe your pain, which can later appear in the physician’s written report.
Contact Hoy Law Before Your Scheduled Examination
Preparation genuinely matters here. Bring a written list of your symptoms and limitations so you do not forget important details under the pressure of a short appointment. Answer questions honestly and consistently with what you have already told your own treating providers, since inconsistencies tend to get highlighted in the resulting report. Whether someone can accompany you, and whether you can get a copy of the report, depends on the court order or the terms of the exam, and requesting the report can have legal consequences worth discussing with an attorney first.
An independent medical examination can carry real weight in how an insurance company values your claim, and walking in unprepared rarely works in your favor. Hoy Law represents injured clients throughout South Dakota, including Sioux Falls, and our Sioux Falls car accident attorneys can help you understand what to expect and how to protect your claim along the way. Reach out to our office before your exam so we can help you prepare.
Suorce:
sdlegislature.gov/Statutes/15-6-35