Unum’s IME Malpractice Procedures

Unum Group’s current IME procedures are quickly becoming a chaotic mess! Reports to DCS, Inc. include accounts of mini-buses with ethnic speaking persons showing up to transport insureds to IMEs without advance notice or confirmation. Those reporting incidences of old, ratty transportation with questionable drivers also indicate reluctance to “catch a ride” for fear of riding with [...]

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Unum’s New IME Tack – Awful and Probably Unlawful

In combination with Unum’s increasing demands for Independent Medical Evaluations, the company recently created a new tack to prevent insureds from attending with witnesses and/or opportunities to audio record evaluations. Recently, DCS received two identical letters stating the following: “However, in order for us to agree to a witness attending the evaluation, we will  need to know [...]

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Unum Uses IMEs to Bolster Claims for Denial – Second Quarter

Quite a few Unum insureds have called and/or contacted DCS recently with news Unum Group is requiring IMEs indiscriminately. Upon further review it appears the company may be  using Independent Medical Evaluations to bolster otherwise weak supported claims to  make terminations appear credible. Of course, Unum’s future feeding frenzy of denied claims may appear credible to regulators [...]

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IME Insurance Bad Boys – When Independent Review Isn’t Fair

It’s no secret most disability insurers now hire some of the worst physicians (unqualified and cheap) to perform Independent Medical Evaluations.  Groups of IME physicians, organized into corporate entities, devote themselves exclusively to performing insurance IMEs because that’s where the money is – and lot’s of it. Instead of engaging in private practice themselves, and having to  pay [...]

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IME “Reasonable Claim Pending” Arguments

Those who have non-ERISA DI policies with IME wording “we may request you be examined by a physician of our choice as often as is reasonable while the claim is pending “, may try to “get out of” the IME by using the argument that once the claim is paid it is no longer pending and the [...]

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The IME Process – Preparing Yourself by Linda Nee

Most likely you will receive a call from your claims examiner asking you to submit to an Independent Medical Evaluation. During this same call, the claims handler will conduct what is referred to as “an in-depth phone interview.” The purpose of the phone interrogation is to obtain facts and comments from you which may be [...]

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IME Checklist by Linda Nee

Prepare for the evaluation in advance. Prepare a written document listing your medical history and place it in a folder. Do not write the “story of your life.” Just list your medical history, dates of diagnosis, physicians treating you, and hospitalizations. Also, put a copy of your social security disability award letter if you have [...]

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Insurance Independent Medical Evaluations – An Introduction by Linda Nee

Employers and disability insurers may disagree with me concerning the motives, philosophy and objectives of being asked to submit to an IME. I will graciously concede that not all policyholders or insurance companies operate in the same manner; however, I think all would agree disability insurers probably are not paying between $2,500-­$6,000 for a medical [...]

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IME Addenda – If You Keep Asking, You Finally Get The Opinion You Want

An interesting and relatively new strategy developing with all major US disability insurers is to continuously go back to an IME physician with additional questions and addenda when the evaluator’s  initial opinion is either favorable to the insured, or is not clear or decisive enough to support a claim termination. Despite the bad press frequently [...]

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