What is Personal Injury Protection?

Apr 12, 2016

The chance of suffering from spinal and other injuries after being involved in an auto accident in Atlanta is very high.

Because of this, the Georgia Legislature has stated that all private automobile insurance policies must contain a provision for Personal Injury Protection (“PIP”) coverage.

This includes a legal minimum of $15,000 in medical expenses or more if a more comprehensive level has been purchased. PIP benefits cover, among other things, all medical treatment that is necessary, reasonable, and related to the collision for two years following the incident.

PIP benefits protect all drivers and passengers occupying a vehicle, as well as pedestrians and cyclists who are struck by a car. PIP benefits apply regardless of fault.

PIP benefits are indisputably valuable in helping injured parties receive the care and attention they need; however, the auto insurance industry abuses this system via its option to review the injured party’s medical treatment, and compel them to attend an “Independent Medical Examination” (IME).

If the injured person refuses to attend the IME, this constitutes a breach of contract, and the insurance provider can deny further benefits.

What is an IME?

Do not be misled by the word, “independent”; these examinations are biased. The insurance provider orders and pays for the exams, and they are typically performed by doctors with proven track records of concluding that no further treatment is required.

The insurance-subsidized doctor will conduct a brief assessment and prepare an extended report to the insurance company detailing his or her findings that no further treatment is needed and the injured person is fully recovered.

What Should I Expect at an IME?

The IME will be unlike any traditional doctor visit. No doctor-patient relationship is established, and no communication to the physician is considered confidential.

The purpose of the exam is not to provide medical guidance or treatment, but to provide the insurance company with a basis to abdicate its obligation to pay further medical expenses.

When you attend, remember that this doctor does not have your best interest in mind.

The most important thing is to describe all of your injuries related to the accident, without exaggerating or downplaying.

Patients often feel inclined to convince the doctor that they are hurt, but the doctor will be alert to any reason to doubt the patient’s credibility.

Simply be honest and straight-forward about your injuries. Answer the doctor’s questions thoroughly, but do not provide more detail than he or she requests.


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