Factors Insurance Companies Consider When Evaluating an Oregon Personal Injury/Auto Accident Claim – Part Eleven – The So-Called “Independent” Medical Examiner, and the Myth of the “3-Month Healing Ceiling.”
This post addresses a prevalent myth that drives down claim value, and how insurance companies manage to exploit it, the myth being that “soft-tissue injuries heal in 3 months or less.” Insurance companies are able to do this by hiring a so-called “independent medical examiner” or “IME” to review injuries and give their “independent” opinion.
The person hired as an IME is usually a licensed medical doctor. They are independent of the plaintiff’s chosen circle of practitioners, but beyond that they are not independent in any real sense. In fact, they are contractors hired and paid by an insurance company. This system exists because insurance companies believe that the typical injury claimant is “a liar, a cheat, and a fraud” even if this may not be the case. By extension, it is claimed, that the plaintiff’s attorney and his doctors are also liars, cheats, and frauds. This can be very problematic for an individual who might actually be suffering due to personal injury. They might not get the proper compensation or attention for their full recovery.
A claim treatment period longer than 3 months for a soft-tissue injury is perceived as a challenge by an insurance company. Because duration of treatment indicates seriousness of an injury, and serious injury carries high claim value, insurance companies customarily spend good money on a medical-examiner contractor. Their job is simple: to rebut the claim that more than 3 months of treatment was necessary medically in a particular case. Several IME contractors in Oregon have made a lucrative living by doing little more than saying, “In my professional experience, soft-tissue injuries heal in 3 months or less” in court.
It is important to refute these claims with medical science. Failing to do so will result in a lower settlement value. An experienced Oregon personal injury lawyer knows how refute these claims many, many times throughout each month. Feel free to call us if you think you are being held hostage by one of these IME’s opinions.