What Is an IME? Understanding Insurance Medical Exams in NY
In New York personal injury cases, an IME is incorrectly referred to as an “Independent Medical Exam.” There is nothing independent about it! An IME is an Insurance Medical Exam.
The insurance company selects the doctor to perform the exam. The insurance company pays the doctor.
These exams are used to deny your claim.
IME Do’s and Don’ts
| ✓ DO | ✗ DON’T |
|---|---|
| • Attend the scheduled exam (refusal can deny benefits) • Bring a photo ID • Answer questions about your medical history • Fill out basic info (name, DOB, accident date) • Be honest about your injuries and symptoms • Contact your lawyer before the exam |
• Don’t bring your medical records • Don’t fill out detailed forms • Don’t discuss the facts of the accident • Don’t minimize your symptoms • Don’t reschedule more than once • Don’t go alone without consulting your lawyer first |
Why Insurance Companies Rely on IMEs
Insurance Medical Exams are a central tool used by no-fault insurance carriers to control claim costs.
Once you begin treatment, the insurer looks for opportunities to limit its obligation to continue paying for care.
The IME allows the carrier to obtain a medical opinion that supports reducing or cutting off benefits, often regardless of what your treating doctors have documented.
IME doctors typically do not review your full medical history, do not order diagnostic testing, and do not provide treatment recommendations.
The Role of the IME Doctor
The IME doctor is not your treating physician and does not have a doctor-patient relationship with you.
Their role is limited to evaluating you on behalf of the insurance company and issuing a written report.
That report often includes conclusions such as:
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You have reached “maximum medical improvement.”
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Your injuries are resolved or pre-existing
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Further treatment is no longer medically necessary
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Any remaining complaints are subjective
These conclusions are frequently inconsistent with the findings of your treating doctors.
IME Timeline & Key Facts
| Key Question | Answer |
|---|---|
| Can I refuse an IME? | No – refusal can deny benefits retroactively to the accident date |
| Can I reschedule? | Yes – but only once |
| Bring medical records? | No – not your responsibility, despite what the letter says |
| Fill out detailed forms? | No – only basic info (name, DOB, accident date) |
| Stop treatment after denial? | No – denial is limited to one specialty; continue as the doctor recommends |
How an IME Can Affect Your Case
An IME can have immediate and significant consequences. A negative IME report may lead to:
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Denial or termination of no-fault medical benefits
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Unpaid medical bills
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Pressure to stop treatment prematurely
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Disputes between the carrier and your medical providers
Insurance Medical Exam FAQ
Get answers to the most important questions about your rights.
Q: Can I Refuse to Attend an IME?
A: Refusal to attend an IME can result in a denial of your no-fault benefits.
In fact, this denial can be retroactive to the date of your accident.
Q: Can I reschedule my IME?
A: You are allowed to reschedule your IME once, and only once.
Q: Why is the insurance company scheduling multiple exams with different types of doctors?
A: If you are treating with multiple specialists, like an orthopedist or neurologist, the insurance company is entitled to have you examined by a doctor in each specialty.
That’s how they deny your no-fault benefits for each specialty.
Q: Should I bring my medical records to the IME?
A: The answer is no. Despite what their letter says, it’s not your responsibility to supply those records.
You are not required to bring those records.”
Q: What should I expect in an IME?
A: An IME will include a physical examination.
While the doctor may ask you questions about your medical history, you should not answer questions relating to the facts of the accident.
Q: Do I need to complete forms at the IME?
A: We advise our clients NOT to fill out any detailed forms at the IME.
However, you can fill out your name, date of birth, and date of accident.
Q: Does a no-fault denial mean I need to stop my treatment?
A: No. It is important to note that the no-fault denial is limited to the specialty of the examining doctor.
For example, only your orthopedic treatment may be denied. It does not apply to all of your treatment.
More importantly, the no-fault denial means the no-fault carrier will not voluntarily pay for future treatment.
The no-fault carrier may still end up paying for future treatment. You should discuss your options with your lawyer and treating doctor.
Q: Can you fight the NF denial?
A: If your symptoms persist and your treating physician believes that further medical treatment or a procedure is necessary, you should continue with your treatment.
Your treatment after the denial will help your treating doctor prove in court that further treatment was necessary.
Q: What is a positive IME?
A: Although you received a “Denial of Claim” form, it’s not bad news.
While the carrier is “attempting” to limit your future treatment, the good news is that the insurance doctor agreed that you need more treatment.
Please keep in mind, however, that the insurance company is not allowed to cut off your treatment at some random time in the future.
Contact Greenstein & Pittari, LLP
If you’re scheduled for an IME, the personal injury attorneys at Greenstein & Pittari, LLP can help.
We will help you prepare for the IME. The accident attorneys at Greenstein & Pittari, LLP will protect your interests at the IME and throughout your entire accident case.
Our firm’s motto is “Don’t Be A Victim Twice.” If you are a victim of an accident, call 1-800-VICTIM2 (1-800-842-8462) to schedule a confidential consultation.
Contact Greenstein & Pittari, LLP: Whether you’re in Manhattan, the Bronx, Brooklyn, Queens, or Staten Island, our experienced team is ready to protect your rights during the IME process.
The call is free. The consultation is free. You don’t pay us unless we are successful. That’s our “Our Fee Guarantee – No Fee Unless Successful.”