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Physical examinations requested by insurers

Physical examinations requested by insurers

If your insurance company requests that you submit to a physical examination, do you have to go? The short answer is yes (unless they are sending you to repeated examinations). A NY disability lawyer will explain that most insurance policies include a clause granting the insurer the right to have you submit to a physical examination. If you do not go, the insurance company will probably terminate your benefits for your failure to cooperate. Many courts have upheld an insurer’s right to terminate benefits for failure to cooperate.

Just because you have to go to a physical examination does not mean you go in unprepared. There are certain steps you should take before going to the examination.

First, research the reputation and credentials of the doctor. Ask your doctor if he or she knows of the doctor. Look on the Internet. Check with the American Medical Association. Is the doctor affiliated with a reputable hospital? Does the doctor have publications? Does the doctor have training in the correct specialty? In addition, a NY disability lawyer will have further connections that they can use to help establish whether or not the doctor is right for you.

If your research shows a problem with the doctor’s credentials or specialty, before the examination send the insurer a letter voicing your concern. Creating a paper trail on these issues may help you attack the report of the doctor if it proves to be unfavorable.

Second, if you can, do not go to the examination alone. At a minimum take your spouse or a friend. The best case would be to hire a nurse to observe the examination. Having a witness observing the scope of the examination could be invaluable in attacking the doctor’s report, says a NY disability attorney. We have had clients who were examined in less than 5 minutes. One client did not even take off his coat! A witness will help you prove that the examination was cursory.

If the examination turns out to be cursory, you should obtain a written statement from the witness documenting his or her observations. You should also send a letter to the insurer complaining about the examination.

A nurse can often be found through your doctor or by contacting your local Visiting Nurses Association. A NY disability lawyer at our firm will be able to help you correctly through this process, and avoid pitfalls that might otherwise have not been caught.

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