Why insurers call them “independent”
Insurers call these exams independent medical examinations, or IMEs. The insurer selects the doctor, usually through a vendor, and pays for the exam and the report. The doctor does not treat you. The report often concludes that you have recovered, that treatment is no longer needed or that your problems are not from the crash. The insurer then stops paying.
Your obligation to attend
MCL 500.3151(1) requires a person claiming PIP to submit to a mental or physical exam by physicians when the person’s condition is material to the claim and the insurer requests it. Under MCL 500.3153, if you refuse without good cause, a court may treat the insurer’s view of your condition as established, bar evidence, enter judgment against you on all or part of your claim, or order you to pay the insurer’s attorney fees.
Courts do not jump straight to dismissal. In Gueye v State Farm (2022), the Court of Appeals held that before dismissing a PIP claim for a missed IME, a trial court must weigh the circumstances and consider lesser sanctions. Still, missing an exam hands the insurer a defense. If the date, place or doctor is a problem, put your objection in writing before the exam.
Who can examine you
The 2019 amendments added requirements in MCL 500.3151(2). The examiner must:
- Be licensed as a physician in Michigan or another state
- Practice the same specialty as your treating physician, if a specialist is treating you
- Be board certified in that specialty, if your treating specialist is board certified
- Have spent the majority of their professional time in the year before the exam in active clinical practice, or teaching at an accredited medical school or residency program, in that specialty
A retired surgeon who does nothing but insurance exams does not qualify. Neither does an orthopedic surgeon examining a patient whose treating doctor is a neurologist. Ask the insurer for the examiner’s name in advance and check their specialty and board status. If the examiner does not meet the statute, object in writing.
How to prepare
- Confirm the details in writing. Date, time, address, examiner, and what kind of exam.
- Arrange transport. Mileage to an insurer exam is an allowable expense. If you cannot drive, ask the insurer to arrange it. See medical mileage.
- Bring a list of your symptoms, medications and treating doctors, and your limits with daily activities.
- Be accurate. Do not exaggerate or minimize. Describe a bad day and a good day.
- Write it down afterward. How long the doctor spent with you, what tests were done, what you were asked. These notes are useful if the report does not match what happened.
Assume you are observed from the parking lot on. Surveillance at IMEs is common. See social media and your claim.
After the report
Ask for the report. MCL 500.3152 requires the insurer to provide copies of the examiner’s written reports on request. Share it with your treating doctor. If your doctor disagrees, a written response explaining why, with the findings that support it, is often the most important document in the case.
An IME report is an opinion, not a ruling. The question of whether treatment is reasonably necessary is decided by a judge or jury, and juries often give more weight to a treating doctor who has seen you for months than to a doctor who saw you once. See benefits denied or cut off.
The clock keeps running after a cutoff. Under the one-year-back rule in MCL 500.3145, you generally cannot recover benefits for losses incurred more than one year before you sue. The period is tolled from a specific claim until the insurer formally denies it, but only if you pursue the claim with reasonable diligence. Do not wait to act on an IME cutoff. The deadline calculator can help.
Sources: MCL 500.3145; MCL 500.3151 (as amended by 2019 PA 21 and 22); MCL 500.3152; MCL 500.3153; Gueye v State Farm Mut Auto Ins Co (Mich. Ct. App., Sept. 22, 2022).
Questions people ask us
Do I have to go to an insurer medical exam in Michigan?
Yes, if your physical or mental condition is material to your claim and the insurer requests it. MCL 500.3151 requires it. Refusing can lead a court to limit your evidence, dismiss part of your claim or award fees to the insurer.
Can the insurer send me to any doctor it wants?
No. Since June 11, 2019, if a specialist is treating you, the examiner must practice the same specialty, and if your specialist is board certified, the examiner must be board certified in that specialty too. The examiner must also have spent most of the prior year in active clinical practice or teaching.
Can I get a copy of the IME report?
Yes. MCL 500.3152 requires the insurer to give you copies of the examiner’s written reports if you ask. Asking gives the insurer a right to your own related medical reports.
Can I bring someone with me?
The statute does not answer this, and policies and court orders vary. Ask the insurer in writing before the exam whether a companion may attend, and keep the answer.