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If the insurance company wants me to see their doctor, do I have to see them?

car accident other insurance company doctor

Filing a personal injury claim can be a confusing process for most people, with strange requirements and procedures that can feel invasive, predatory, or intimidating. In most cases, the insurance company is simply looking to verify key claims and statements as they evaluate how to compensate someone for the claim they’ve filed. A medical exam is one such way of verifying statements made about injuries, adverse impacts, and the compensation required to make those things right. Even so, it’s important to understand how laws and claimants’ rights affect this process and apply to the insurer.

Why Meet with the Insurance Company’s Doctor?

Most people are initially surprised that an insurance company would require them to meet with another physician after they’ve already been treated by their family doctor following a personal injury or accident. The reason that this requirement exists, however, is so that the insurance company can protect itself from false, misleading, or outlandish claims concerning the health of a claimant.

Insurance companies are in the business of both compensating injury victims and protecting their own, corporate bottom line, and that means verifying statements made to police, attorneys, and physicians throughout the claims process. For this reason, if an insurance company requests that a claimant meet with a specific physician, they almost always must oblige and schedule an appointment. With that said, it’s important to understand a few essential rights that claimants are entitled to before, during and after this visit:

  • Claimants are allowed to submit additional medical documentation, including any information documented by their regular physician, to the insurance company.
  • The insurer must provide transportation to the medical exam, if requested, and must schedule that exam at a facility within reasonable driving distance from the claimant.
  • A reasonable effort must be made to schedule the insurance company’s exam at a time that works for the claimant.
  • A full report of the examination results must be made available to the claimant if they wish to review it.

Alongside these essential regulations and rights, most states have a law in place that allows a witness to attend the insurance company’s required physical examination, as well. This witness is often a key part of the personal injury claims process. They can often help hold the insurance company and their physician accountable for the examination itself, the results and report issued, and how that information is interpreted in reaching a claim amount or final settlement.

What to Expect at the Examination

When an insurance company requires a physical examination by their own physician, the process is somewhat different from what would happen at a family doctor’s office. The doctor will be trying to ascertain the exact symptoms and suffering caused by the injury or accident, the severity of those symptoms, and whether or not the patient is telling the truth about how they’ve been impacted by the injuries they report. Again, this exam is often scheduled as a way for the insurance company to verify claims, hold claimants accountable, and protect their overall bottom line.

During the exam, it may feel as if the insurance company simply doesn’t believe that these injuries are real or a serious threat to daily life. It may be tempting to exaggerate symptoms, to try and fail any tests required by the physician, or to lie in some way so that a claim is approved. Misleading the doctor in any way during an exam is a big mistake. Being truthful during the exam, and giving full effort on any required tests, will always lead to a better diagnosis, a stronger claim, and a greater chance at ultimate success.

Always Meet with a Family Physician and an Attorney

Don’t wait for an insurance company to mandate a medical exam. Seek treatment by a family physician immediately after the accident or personal injury occurs. Any reports or records produced by this visit can constitute evidence during the claim, especially if the most serious injuries have begun to heal by the time an official exam is ordered.

It’s also important to get in touch with a personal injury attorney as soon as possible after the incident. An attorney can help hold the insurer accountable, protect the claimant’s rights throughout the process, and ensure that the proper documentation makes its way between legal, medical, and insurance officials as the claim proceeds.

The Lamber Goodnow Injury Lawyers are well-versed in these matters. Our lawyers never charge a fee, unless we win your case. Get a risk free consultation today.

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