If your car were hit by an uninsured driver, then you would need to file a claim with your own insurance company. That is called a first-party claim.
What is required of a policy holder making a first-party claim?
That claimant/policy holder must provide the insurance company with timely notice of the accident. Claimants that wait too long to report such an incident could find that their claim has been denied.
The claimant must authorize the insurance company to obtain the medical records of the injured victim. Claimants need to use a good deal of caution, when signing the document that ensures the delivery of such authorization. That document should specify the release of only those records that related to the incident that had caused the claim’s submission.
By the same token, the claimant needs to authorize a release to the insurance company of information from the claimant’s employer. The desired information should concern only the details on the claimant’s income. The insurance company would have no right to see the details on the claimant’s sick leave or available vacation time.
Restrictions placed on insurance company, regarding an IME
The insurance company does have the right to schedule an independent medical exam (IME) for the injured victim/claimant. Still, there are restrictions that should be followed, when an IME gets scheduled. The victim should not need to travel a great distance. In other words, the IME should be arranged at a time and location that meets with the victim’s needs.
If the victim’s injury would prohibit performance of an act such as driving to the site of the examination, the insurance company must respect that fact. It should arrange for the necessary transportation. During the scheduled exam, the examining physician should study only the areas of the victim’s body that were injured. That particular physician does not need to complete a general examination.
How this IME differs from other IMEs?
Injury Lawyer in Mississauga that files a claim with the insurance company of a defendant in a personal injury case might need to undergo an independent medical exam (IME). Still, in that situation, the insurer would have the right to schedule one or more examinations, if the results from the first one did not prove satisfactory.
The insurer that has received a first-party claim does not enjoy that same right. In that case, the insurer must deal with the facts obtained from a single examination. That restriction works to the advantage of the policy holder.
If the examining doctor has confirmed the prognosis given by the treating physician, then the insurance company would need to accept the treating physician’s report. That could mean accepting the policy holder’s request for a decent level of compensation.
