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Building Your Silver Linings IME Playbook

When used prudently, independent medical exams can be powerful claims management tools, exposing malingering and challenging dubious causation.

By Kevin Quinley, CPCU | Updated on March 11, 2013

While tools are handy, their functionality depends on them being used wisely. For instance, my chainsaw can help clear a driveway of a fallen tree limb. Used carelessly, it can also perform DIY amputations. A hammer can help me hang that picture in the foyer. A careless move, though, can cause it to smash my thumb. The tool isn’t the problem; it is how you use or misuse it.  

Independent medical exams (IMEs) can be powerful claims management tools for adjusters. They can prove instrumental in exposing suspect claims, challenging dubious causation factors, or detecting malingering. However, like other tools, IMEs are subject to the garbage in/garbage out principle. If the adjuster selects an IME physician who is vulnerable to impeachment, then this does not help the cause of the adjuster, the defense attorney, or the insurance company for that matter. It also poses a setback to claimants or plaintiffs, who may consequently sue the insurance company for bad faith if they feel the adjuster has gamed the IME process in order to reap financial rewards.

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