Why do I have to see a doctor the insurance company has chosen? Sometimes, your injuries will be evaluated by a doctor if the other side’s choosing.

July 22, 2020

Why do I have to see a doctor the insurance company has chosen? Sometimes, your injuries will be evaluated by a doctor if the other side’s choosing.

That happens in one of 3 situations. First, is if you have been in an automobile crash and you have Personal Injury Protection benefits. According to most insurance policies, the insurance company may require you to see their chosen doctor or chiropractor. You have to see their doctor because the contract (policy) says that you have to go.

Next, you have to see their doctor if there is an uninsured motorist/uninsured motorist claim. Again, many policies require you to see a doctor of their choice. You have to go according to the contract.

The third way is only when there is litigation, and your injury is an issue. Florida Rules of Civil Procedure 1.360 allows a Defendant to send you to a doctor of their choosing.

Why would they do that when they could rely on my doctors?

Insurance companies are looking for excuses to avoid paying claims. They have a list of doctors that they know will give opinions against you and favoring the insurance company. Most of the time, insurance companies hire these doctors several times a week for $1,500-$2,000 per 30-minute appointment. Between these appointments, records review, and testimony, some doctors make over a million dollars a year doing work for insurance companies.  Those doctors will be biased against you for two reasons; 1) the money; and 2) their mindset is always looking for excuses for the insurance company not to pay.

I am sure that you are surprised that a doctor, a professional, would be one-sided. But you are never that doctor’s patient. During these examinations, there is no doctor-patient relationship. They are not there to treat you, make you better, or help you. There is also no Hippocratic Oath. https://www.nlm.nih.gov/hmd/greek/greek_oath.html.

What to expect?

Even though the doctor is biased, they will be friendly. They want to get as much information as possible that is favorable to the insurance company’s side. They may try to put words in your mouth or get you to agree with their statements to support their angle.

If the examination is during litigation, there are some limits. Typically, your attorney will raise objections that will result in a Court Order. This list is not exhausted, but your attorney will commonly seek to limit the doctor in several ways, such as limiting the doctor from asking questions about:

Your attorney will commonly seek a Court Order to limit what you have to do during the examination. This means you do not have to:

  • fill out paperwork other than your name, address, and date of birth.
  • bring medical records, MRI’s, CT scans, or X-rays with you to the appointment;
  • get more MRI’s, CT scans, or X-rays if you had one within six months.

Another way that your attorney will protect you and your interests is by seeking a Court Order that:

Each case is different, and a Court may rule in favor of you or the defendant. Depending on the situation, there may be more or fewer objections. This is not advice, just general information. However, if you need a consultation please call us. 561-903-4542.