IME Insurance Corruption

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PostPosted: Wed May 08, 2013 10:08 am   Post subject: IME Insurance Corruption  

My wife suffered personal injury (broken ribs, compressed vertebrae) as a result of an auto accident when another car pulled out of a parking lot into the road and we ran into it. My wife's condition did not improve after a year but got worse, and one of our doctors noted that she had a permanent injury and would never be able to lift heavy objects, walk long distances, etc. Despite this, the insurance company ordered an IME (independent medical evaluation). The doctor who wrote the IME wrote a report stating that my wife was exaggerating her symptoms and recommended medical care be stopped and that she do home exercises. Being a medical professional myself, I went over this doctor's report and noted numerous unprofessional and unethical statements in the report. He said the examination of my wife was 45 minutes. It was actually 20 minutes (I was there). He said he asked 18 validation questions; he only asked about 8. He said he studied the medical records. He did not. We had brought in numerous MRIs, hospital reports, doctor's reports, as requested, and he did not look at any. I wrote a response to the insurance company, Nationwide, and they took a week to review my response and then wrote that they were upholding their decision to stop medical treatment for my wife even though the doctor admitted that he didn't look at medical records because his "machine" wasn't working. They offered to send the records to him for him to review at a later date! After further investigation I found that this doctor had 20 offices in 20 different counties in Pennsylvania in which he did nothing but write IMEs. He is a veritable IME factory. And I can just imagine how quickly he churns them out. This makes me think that the insurance industry is rife with corruption. The industry uses IME's to stop payment on personal injury claims, and I can just imagine how many doctors there are like this doctor, and many life or death decisions are made by the insurance industry based on fraudulent IMEs. My wife has suffered pain every day since the accident, frequently has migraines and throws up, has tried physical therapy, cortisone shots, accupuncture, pain medication, chiropractry, you name it. She is not exaggerating her symptoms. I live with her and I know. Are there any others out there who have had similar experiences?

Exceemide
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PostPosted: Wed May 08, 2013 1:57 pm   Post subject:   

Quite disheartening to hear all this from you and it disappoints me about the performance of the insurance industry. You can inform the FTC and the CFPB about all that both of you have gone through to get what you are entitled to.

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PostPosted: Thu May 09, 2013 1:06 pm   Post subject:   

Many have had similar experiences. Consult an insurance agent if required.

PatriciaSanders
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PostPosted: Sun Jun 02, 2013 11:52 am   Post subject:   

Quote:
You can inform the FTC and the CFPB
and
Quote:
Consult an insurance agent if required.
None of this information is correct. If you are in an adversarial situation, you will, unfortunately, require legal counsel. You can consult with most attorneys at no cost on Personal Injury matters such as this. Choose the one who makes you feel most comfortable, not the one who makes promises that cannot be guaranteed.


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CA-licensed Life & Disability Analyst. CA Insurance Lic #0596197. Also investigating insurance company abuses, and providing litigation support/expert witness services. Send me your questions, and I'll send you my answers.
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