When The Insurance Company Sends You to Their Doctor

If you’re dealing with a short or long term disability claim, your insurance company may ask you to visit an independent doctor of their choice. They chose this doctor, and their assessment informs how much your insurance company must pay out for your claim. At the end of the day, these assessments are in the best interest of your insurance company’s bottom line—not of your health and safety.

Use our comprehensive guide to prepare for your meeting with an independent doctor.

Need to know more about what to expect when the insurance company sends you to their doctor? Share Lawyers’ experienced team is ready to help.

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What to Expect When The Insurance Company Sends You to Their Doctor

When the insurance company sends you to their doctor, it’s essential to understand their role and what to expect.

The Role of Insurance Company Doctors

Independent medical examiners (IMEs) have a noteworthy role in the disability claims process. Your insurance company hires IMEs to offer an impartial evaluation of your illness or injury and how it impacts your ability to work.

An IME’s primary obligation is to your insurance company, which undoubtedly influences their evaluation of your health and their conclusions about your work capabilities.

Independent Medical Examiners

Cost Minimization

The overall purpose of IMEs is to minimize the costs of your insurance company, which may lead them to look for reasons to deny or reduce your claim benefits.


Influenced by

Insurance Co

While they are supposed to provide an impartial evaluation, your insurance company’s guidelines and policies often influence their findings.

Do I Have to Go to My Insurance Company’s Doctor?

The specifics of your insurance policy and the nature of your claim will determine if you need to see an IME, but here are some general guidelines.

Key Points

Insurance Policy Requirements

Most insurance policies will include a clause that allows the insurer to request an IME assessment. When you signed the insurance agreement, you agreed to comply with this requirement, and failing to attend could result in the denial of your claim.

Right to Refuse

While you can refuse to attend an IME assessment, doing so could negatively affect your disability claim. Your insurance company may note the refusal as non-cooperation and potentially lead to the denial of your claim.

You should consult with an experienced disability lawyer before taking this route.

Preparing for Your Examination

Should you choose to attend the IME examination, ensuring you are prepared is crucial. Here’s how you can get ready:

1. Gather Medical Records: Bring any relevant medical documents to your examination, both on paper and in electronic format, including your doctor’s notes, diagnostic test results, and any previous medical reports of your condition. Doing so can help ensure a comprehensive picture of your condition is presented to the IME.

2. Understand Your Rights: Know your right to a fair and impartial examination.

  • You can and should bring a friend or family member to the examination for support.
  • You can and should take notes during the examination for your records.
  • You can and should request a copy of the IME report once completed.

3. Be Honest and Give Consistent Information: Answer all of the IME’s questions truthfully and consistently. Exaggerations or omissions can undermine your credibility and be used to deny your claim or reduce benefits.

What to Do During Your Examination

When the insurance company sends you to their doctor, your examination typically includes a physical assessment and a medical history review. Take detailed notes about the examination and record the duration, types of tests conducted, and any statements made by the doctor.

The doctor should be professional and neutral throughout the duration of the appointment. If you feel uncomfortable or note any apparent biases in their examination, write it down.

What to Do After Your Examination

After the IME examination, the doctor will prepare a report for the insurance company. Here’s what you can expect:

  1. Report Review: You can request a copy of the report. Make sure that you do so and review it carefully to ensure that it accurately reflects your condition and the examination.

  2. Disputing the Report: Disagreeing with the findings is common. If this occurs, seek a second opinion from your doctor and present this additional evidence to the insurance company.

The IME examination's conclusion can drastically affect your claim's success.

  • Claim Approval: If the IME’s findings align with your personal doctor’s, your claim may be approved without further complications.

  • Denial or Reduction of Benefits: If the IME’s report conflicts with your doctor’s findings, your insurance company may reduce the benefits you are claiming or outright deny your claim. If this happens, it’s not the end of the road. An experienced disability law firm like Share Lawyers can help you appeal the denial and secure your benefits.

Appealing Your Denial or Reduction of Benefits

You can appeal
the decision if your claim is denied or your benefits are reduced due to the IME's assessment. While it's possible to gather evidence and appeal on your own, seeking the assistance of a lawyer specializing in disability claims is highly recommended.

Appealing a disability insurance denial can be challenging, and having a disability lawyer, like Share Lawyers, handle the process can ease the burden and improve your chances of success.

With over 35 years of experience in the insurance industry and a proven track record in disability claims, Share Lawyers can effectively advocate for your rights and help you navigate the complex appeals process.

Share Lawyers Won’t Let Your Insurance Company Win

Now that you know what to expect when the insurance company sends you to their doctor, consider your next steps. Even if your claim has yet to be denied, contacting Share Lawyers for a free assessment can help.

We understand your stress and aim to ease that burden while helping you secure the benefits you deserve. For over 35 years, we've helped thousands of Canadians obtain disability benefits and overturn denials. Start with a free consultation, and let us support you.

Still need more information on what to expect when the insurance company sends you to their doctor? A quick conversation with one of our lawyers will help you understand your situation and provide a path forward.

Contact Share Lawyers today and let our 35+ years of experience work for you. We can help you win your case against Canada Life, Desjardins, Manulife, RBC Insurance, Sun Life, and other insurance companies. Our legal team offers a free consultation and works on a contingency basis. There are no fees unless you win your case.

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