Key Takeaway
Attorney Jason Tenenbaum questions whether insurance carriers should be allowed to substitute IME doctors at trial, seeking input on courts permitting this practice.
Independent Medical Examinations (IMEs) are a cornerstone of New York no-fault insurance disputes. These medical evaluations, conducted by physicians chosen by insurance carriers, often determine whether an injured person’s treatment is medically necessary and related to their accident. But what happens when the IME doctor who conducted the examination can’t testify at trial?
This question touches on fundamental evidence rules and the integrity of the no-fault system. When an insurance company wants to use a different doctor to testify about an IME they didn’t perform, it raises serious concerns about hearsay evidence and due process. The practice essentially allows secondhand medical testimony, potentially undermining the reliability of medical evidence in no-fault insurance cases.
The issue becomes particularly complex when considering the different types of medical reviews in no-fault cases, from hands-on examinations to paper reviews of medical records.
Jason Tenenbaum’s Analysis:
I am going on record with my personal opinion that an insurance carrier at trial or framed issue hearing should not generally be able to substitute IME doctors, with two caveats. First, if a peer doctor relies upon an IME among other records, then under the professional reliance exception to hearsay, the IME should be considered. Second, if the IME is more of a peer review, then a substitute doctor would be proper. But, if the IME reaches a conclusion based upon 98% evaluation and 2% record review (the normal IME), it seems like blatant hearsay if some other doctor is retained to testify.
What triggered this post? I understand that some firms are using substitute IME doctors and judges are allowing this practice.
What judges and Courts are allowing this? Thanks
-Jason
Key Takeaway
The use of substitute IME doctors at trial raises significant hearsay concerns when the substitute physician didn’t conduct the actual examination. While exceptions may exist for peer reviews or professional reliance situations, allowing substitution for standard hands-on IMEs could undermine the evidentiary foundation of no-fault insurance proceedings.
Common Questions
Frequently Asked Questions
What is New York's no-fault insurance system?
New York's no-fault insurance system requires all drivers to carry Personal Injury Protection (PIP) coverage. This pays for medical expenses and lost wages regardless of who caused the accident, up to policy limits. However, you can only sue for additional damages if you meet the 'serious injury' threshold.
