• Beware of Outside IME Companies Hired by Disability Insurance Companies

Are the outside companies hired by disability insurance companies to locate IME doctors independent?

In addition to just these doctors that are biased, the in-house doctors and the outside doctors that are hired, we know that they also use these third party companies that are supposed to set up these independent medical exams. Do you guys see that as well?

Correct. There is one PMI, that I see a lot, you’ll see multiple doctors under that company that will go and send some files of the review and it’s almost the same cookie cutter mold review and the response that they will give to specific questions. So how independent is it when a company that employs doctors for the sole purpose of doing these types of things. A lot of people say – it’s a doctors for hire insurance company buying what they want and essentially there’s conferences to train these doctors to perfect the report, they are going out specifically to them with the intent to be able to come up with a reasonable basis for them to try to deny the claim no matter how reasonable it may seem to an average person, not much common sense is involved in it.

Let me tell you about two things you just said. One of them which was in another case that I read today – Hartford Insurance Company would use an outside company to do their exams. This outside company, not Hartford, that’s supposed to be independent over a five year period was paid more than 13 million dollars. And that company’s job was to go out and hire doctors for Hartford. So how neutral, how independent are they? Not only that, in a deposition for somebody from this Universal Disability Consortium, the President of the company said – we usually charge $300/hour but for Hartford we are going to charge $225/hour because they give us volume of work.

So this is the independent company who did a negotiated rate to doctors for them to give reports to them, it’s scary. You mentioned one other thing, there was another company, called MLS, which is a company based out of Michigan and they did a lot of work with Liberty Mutual, CIGNA and Metlife and there was a case couple of years back where MLS, this independent company manipulated the report beyond what the doctor they hired had given them. So now you have an issue of this independent company who now wants to please their employer, this insurance company who is manipulating reports to make them favorable for the insurance company so that the insurance company will keep hiring this so-called “independent company.”

We have actually seen that in many of the conferences that we have attended, these companies set up their booths right there at the conference to basically solicit that insurance company’s business.

I think the last trade show we were at in New York, there were like 8 independent medical exam companies that were going to find doctors for all these insurance companies.

There is one comment so far

  • Just got a letter from MLS requiring an IME. I will request a copy of the report be sent to my attending physician. How do I know that MLS did not manipulate the report?

    Karen Apr 28, 2014  #1

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