When your injuries are considered stable and stationary your lawyer will organise for you to undergo medical examinations.
These examinations are known as medico-legal examinations.
It is important to understand that the doctors that you are referred to are not treating you for your injuries, hence the phrase medico-legal.
They are seeing you for the purpose of providing a report for submission to the Court describing your injuries.
As a general rule you should not obtain a medico-legal report from a doctor who is treating you because that doctor in providing treatment cannot be independent.Start My Claim
Usually, after having received the injured person’s medico-legal reports the Insurer will want an independent report.
It is the custom to provide a panel of three Specialists from whom the injured person can choose to be examined.
You must complete a document called a Notice of Claim for Damages.
This document can be obtained from the Motor Accident Insurance Commission and has basic details regarding the accident including –
Download a Notice of Accident Claim Form (DOWNLOAD LINK) must be forwarded to the Compulsory Third Party Insurer of the vehicle responsible for the accident within 9 months of the accident or within 1 month of you consulting a lawyer.
The following are examples of a typical motor vehicle accident –
The examinations you will need to undergo depend on the injuries you sustained in the accident.
By way of example, if you sustained a musculoligamentous injury to the cervical spine (whiplash) it is likely that you will be seen by an Orthopaedic Surgeon.
If you sustained head injuries including a period of concussion you would likely be seen by a Neurosurgeon.
If you sustained psychiatric injuries arising out of the accident then you would be seen by a Psychiatrist.
With respect to each report that is commissioned on your behalf the Insurer has a right to an Independent Medical Examination (“IME”). This means, with the example of an orthopaedic injury, once you have obtained a report from an orthopaedic specialist the Insurer has a right to get an independent examination from an orthopaedic specialist. As is the custom, they will provide a list of 3 specialists from whom you can choose to be examined.
The Insurer will meet any cost associated with the IME report.
In a short period of time the Insurer will respond as to whether they consider the Notice of Accident Claim Form compliant with the provisions under the Motor Accident Insurance Act.
If the Insurer is not satisfied regarding compliance there are generally some matters to attend to.
Often the compliance issue is the absence of a Medical Certificate and that is the result of a delay in your treating doctor completing such Medical Certificate.
Once the Insurer is satisfied regarding compliance they will generally be prepared to meet your reasonable and appropriate rehabilitation expenses.
By way of example, when completing the Medical Certificate if treating doctor suggests that you need physiotherapy then the Insurer will request a Treatment Plan be provided by the Physiotherapist.
The Treatment Plan, which is generally approved, will be for a certain number of sessions of physiotherapy over a certain number of weeks.
Once your rehabilitation is complete and your injury is stabilised then it will be time for you to be assessed for any ongoing impairment. This is the point at which you are referred to a medical specialist for what are known as independent medico-legal reports.
It is important to note that the doctors who provide those independent medico-legal reports are not treating doctors because they should be independent and not providing medical treatment to you.
As detailed above, with a standard whiplash type injury, an independent medico-legal report would be obtained from an orthopaedic specialist.
The Insurer may then request an IME by way of reply.
The Insurer also has to response with respect to its attitude to liability.
In a motor vehicle accident it is generally clear who is responsible for the accident.
If the Insurer is of the view that their insured driver caused the accident then they will admit liability.
The admission of liability means there is no need to prove who is at fault and the only issue in the case becomes one of providing your injuries.
Once all the evidence regarding your injury(s) has been gathered the parties prepare to proceed to a compulsory conference held under the provisions of the Motor Accident Insurance Act.
At the conference the parties must make genuine efforts to resolve the claim.
If the matter does not resolve at the compulsory conference the parties are required to exchange Mandatory Final Offers which are open for a period of 14 days.
At the expiration of the Mandatory Final Offers proceedings must be filed in Court within 60 days of the compulsory conference.