What Is an Independent Medical Examination (IME)?

An independent medical examination, or IME, is a medical evaluation ordered by an insurance company and performed by a doctor the insurer selects and pays for, not a doctor you choose.

Why Do Insurance Companies Request an IME?

Insurers order an IME to gather medical evidence supporting their position in your claim and to check whether your reported injuries match your treatment. Adjusters compare the exam findings against your treatment records, watching for signs that your injuries improved faster than your doctor’s notes indicate, and often use the resulting report to justify a lower payout. After a car accident, this scrutiny frequently begins once treatment extends beyond a handful of visits.

Why Is an IME Not Actually Independent?

The doctor performing your exam works for the insurance company, not for you. Insurers select physicians who examine claimants regularly on their behalf, and many earn a substantial share of their income from these referrals. The same dynamic applies whether your claim stems from a slip and fall incident or a different type of injury.

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What an IME Exam Typically Involves

An IME follows a standard format regardless of which insurer requests it. The appointment itself is usually brief, though many claimants wait far longer in the lobby than the exam takes. A typical visit includes:

• Review of your medical records and treatment history
• A physical evaluation focused on the injuries you reported
• Range-of-motion, strength, or neurological testing
• A written report sent to the insurance company after the visit

The exam does not include treatment, and the doctor will not discuss your prognosis or offer medical advice during the visit. You should answer questions consistently throughout the appointment, since if you tell the examiner you cannot lift your arm but then reach for your bag without difficulty, that inconsistency can end up in the report and be used against your claim. The exam’s purpose is documentation for the insurer’s file, not care for your recovery.

Do You Have to Attend an IME?

Whether attendance is mandatory depends on how the request arrives. In a lawsuit, the defense can ask a judge to compel an exam under Texas Rule of Civil Procedure 204, which requires a showing of good cause.

Outside litigation, your auto policy may include a cooperation clause requiring attendance when your insurer asks. Refusing a legitimate request can delay benefits or lead an insurer to deny your claim. Rescheduling ahead of time protects your claim far better than not showing up.

How Does Legal Guidance Affect the IME Process?

Our attorneys help you prepare before an IME and protect your rights throughout the process, including reviewing the examination notice, explaining what to expect, and flagging any requests that go beyond what the insurer is entitled to.

After the exam, comparing the IME report with your treating physician’s records can identify inconsistencies or unsupported conclusions that could affect your claim.

Will an IME Affect the Value of Your Claim?

An unfavorable IME report can lower what an insurer offers, though it does not end your claim automatically. Under Texas Insurance Code Section 1952.151, PIP (personal injury protection) coverage applies to medical expenses that are reasonable and necessary, and insurers often cite IME findings to argue treatment no longer meets that standard.

Disputes over what counts as reasonable happen often in claims involving brain injuries, since symptoms in these cases are harder to measure through a single exam appointment. Once the findings reach the insurer’s file, they tend to surface in several places:

• Reduced settlement offers: Insurers cite the report to argue that your injuries do not justify the amount requested.
• Treatment denials: Insurers stop paying for care that their findings supposedly do not support.
• Increased scrutiny at trial: The defense may call the IME doctor to question your credibility.
• Delayed claim resolution: Disputes over accuracy can stall settlement talks for months.

None of these outcomes is automatic, and you can challenge an inaccurate or incomplete exam before it does lasting harm. The strength of your treatment records often determines how much weight the report ultimately carries.

What if You Disagree With the IME Results?

You have options if the IME report misrepresents your injuries or exaggerates your recovery. Requesting a full copy of the report is a reasonable first step, since insurers do not always share it unless you request it. From there, several actions can strengthen your position:

• Compare the findings against your treating physician’s notes
• Ask your treating doctor to respond to the report in writing
• Request a second opinion from an independent specialist
• Raise inconsistencies during depositions or before trial

Every IME dispute is different, and the appropriate response depends on how the examination was conducted and the conclusions in the report. Keeping your own detailed notes about the appointment provides an important point of comparison if the examiner’s account is incomplete or inaccurate.

Frequently Asked Questions About IMEs in Texas

How Long Does It Take to Get a Copy of the IME Report?

There is no fixed deadline for insurers to hand over the report once you request it, and delays of several weeks are common. If your attorney has requested a copy and the insurer stalls well past a reasonable window, that delay can itself be raised as an issue, especially if the insurer is using the report to justify a lower offer at the same time it is withholding it from you. Following up in writing rather than by phone creates a record that helps if the delay becomes a dispute later.

Who Pays for the Exam?

The insurance company covers the doctor’s fee directly since it requested the exam, though you remain responsible for your own transportation, parking, and any missed work tied to the appointment.

Can You Request a Different IME Doctor?

Rarely, and only in limited situations. If the assigned doctor has a documented conflict of interest, lacks the appropriate specialty for your injury, or the exam location creates an unreasonable hardship, you may have grounds to request a change, though insurers are not required to grant it.

What Happens If You Miss an IME Appointment?

Missing an IME without rescheduling in advance can be treated by the insurer as a refusal to cooperate, which may pause or reduce PIP benefits. In a lawsuit, it can also give the defense grounds to ask a judge to compel attendance or limit what evidence you can present later. A single missed appointment due to a genuine emergency is usually resolved by rescheduling promptly and documenting the reason, but repeated no-shows without explanation put real weight against your claim.

Talk to Our Team About Your IME Notice

An IME notice sets a clock running on your claim, and insurers move quickly once they have a report in hand. Our team at Mokaram Injury Lawyers reviews every IME notice for clients across Houston because we treat each client like family, not a file number.

Our phones stay open around the clock, including nights and weekends, since many people reach out after hours. Call 281-222-2222 for a free case review, or contact us online to walk through your notice today.