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What Are Independent Examinations?

Posted by David P. Martin | Dec 28, 2022 | 0 Comments

I am David Martin with the Martin Law group. We help people with disability policies and ERISA claims. I post a new term every Thursday. Subscribe to get the Edge in understanding your policy.  Today let's talk about what it means when the policy says it can require “examination by a doctor of our choice”?

This means that the insurance company may require you to be examined by a doctor it chooses. Several concerns arise. How far do you have to travel? Will it hurt?  Will it be fair? All good questions. First of all, the insurance company or their vendor keep data on the physicians used.  They know how often each doctor helps deny claims. Insurance company selected doctors often do much of this work and want the repeat business. The insurer also wants to keep costs down, so many reviews are given to the doctor to allow the charge to be lessened.

Since only certain doctors are used that means the insured may be required by the insurer to travel to that doctor. The exam can hurt as well, and my past experience shows neither the insurance company nor the medical boards do anything about that. The exam will not often produce a fair report. It is biased to help obtain repeat business for the doctor. I could go on of course but suffice it to say that it is important to take a witness to one of these examinations. It also is wise to ask that the examination be videotaped to protect all parties. The insurance company may offer to provide a ride for travel but will not pay for the witness. Some consideration as to what is best in your circumstances is needed. I would get an attorney if such an exam is requested. Every time.

Remember we are here to help if you run into problems. Call us at the first hint of trouble.

The lawyers in our firm are focused on helping people with disability policies and ERISA claims. We want to give you the edge in understanding your policy. Today, we want to help you understand what the term “independent examinations” means in your disability policy. Remember our ERISA attorneys and long-term disability lawyers are here to help if you run into problems. Contact us at the first sign of trouble with your disability claim. Whether you or your client needs advice before applying or appealing for ERISA benefits such as long-term disability, short-term disability, life insurance, pension, or retirement, contact an experienced ERISA disability attorney at The Martin Law Group at 800-284-9309.

About the Author

David P. Martin

Senior & Managing Attorney

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