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Don't become the victim of an insurer "Doctor Shopping"

Written on the 14 July 2010 by Gavin Hanrahan

What is Doctor Shopping?

If you're involved in a motor vehicle accident or injured at work and make a personal injury claim, expect the insurance company to require you to see one of their doctors for examination. You may hear these reviews being referred to as 'independent medical examinations' (IME).

Requiring an examination by a doctor is quite common and shouldn't be a problem, in fact, it's actually quite reasonable for the insurance company to request this before they agree to pay your personal injury claim.

What is unreasonable is when the insurance company doesn't like or validate the doctor's opinion and they arrange for you to be seen by another doctor, in an attempt to try and find a doctor who will make a diagnosis that is more in their favour. Some insurers will even continue this process multiple times until they receive a doctor's opinion that will allow them to legally refuse to pay your claim. This is known as "Doctor Shopping".

The law can be quite vague when it comes to stopping insurance companies who are 'Doctor Shopping', especially since its common practice for an insurance company to request that you seek an IME from time to time (at reasonable intervals, for example yearly). If you think the insurance company is requesting that you seek too many IMEs, or they are requesting them at unreasonable time intervals (monthly), you should immediately refuse to attend the IME and give us a call to discuss your options. We will be able to determine if the insurance company is acting appropriately or not, and take action against them if they are acting unethically by not adhering to the law.

Too often we get contacted by clients for advice after they have already attended numerous doctors for the insurer and unfortunately in these circumstances the damage has been done.

Don't let this happen to you! If an insurance company contacts you for the purpose of attending one of its doctors for an IME, contact us immediately and we'll let you know if you are required to attend the appointment.

For any advice and assistance related to stopping insurance companies from doctor shopping, or personal injury claims, please call our Compensation & Insurance Claims team on 1800 994 279 or email us. A member of our team will endeavour to respond to your enquiry within 24 hours.

Author: Gavin Hanrahan
About: Gavin Hanrahan is the Managing Partner of Turnbull Hill Lawyers and the Partner-in-Charge of our Business, Commercial & Workplace Team. He advises clients on a broad range of business, workplace and HR issues, ranging from employment contracts to risk management. As one of the leading business lawyers in NSW, Gavin speaks to local business owners every day and understands both the needs and difficulties of launching, managing and growing a business. Our clients appreciate his practical, personal and solutions-orientated approach and his ability to respond to legal issues that are currently impacting businesses all over NSW.
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