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Q. After a Motor Vehicle Accident (MVA) claim is started what Medical Examinations will I have to undergo?

Compulsory Conference

It is a requirement under the Motor Accident Insurance Act that Claimants and Insurers participate in a compulsory conference.

This is a prerequisite to being able to file proceedings in Court.

The compulsory conference is conducted on an agreed date and the Claimant and the Insurer turn up and discuss the merits of the claim and there will be an exchange of offers.

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Written Final Offer

If the matter does not settle at the compulsory conference the parties are required to make Written Final Offers.

This means that the Claimant must make a Written Final Offer and the Insurer must make a Written Final Offer.

Both Written Final Offers are open for a period of 14 days after which they expire.

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Proceedings in Court

As discussed above proceedings cannot be filed in Court until completion of the compulsory conference and further to add onto that the 14 day period during which the Written Final Offers are open.

Proceedings must be filed between the period of the expiration of the Written Final Offers and 60 days from the date of the compulsory conference.

It is important that this new limitation date is understood.

Even if you are within the original 3 year statutory limitation period the effect of holding the compulsory conference is that you have created a new limitation period and the proceedings must be filed within 60 days of that compulsory conference.

Court Proceedings

Once the proceedings are filed in Court the parties come under the provisions of the Uniform Civil Procedure Rules and must comply with those Rules.

Those Rules include participating in a 552 conference which can double as a mediation in a further attempt to resolve the claim.

If the matter does not settle at the 552 conference then the parties can certify that the matter is ready for Trial by completing a Request for Trial Date.

Insurer’s Independent Medical Examination

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.

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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 –

  • Your full particulars;
  • Details of the circumstances surrounding the accident;
  • Details of all motor vehicles involved;
  • Details of Police involvement;
  • Medical Certificate to be complete by your treating doctor;

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 –

Scenario 1

  • Vehicle A comes to a halt at a red light at an intersection.
  • Vehicle B is following and fails to keep a proper lookout and drives into the rear of Vehicle A.
  • In this scenario Vehicle B is clearly responsible for the accident.
  • The claim for damages for personal injuries will be against the Compulsory Third Party Insurer of Vehicle B.

Scenario 2

  • Vehicle A and Vehicle B are travelling in opposite directions and approaching an intersection.
  • Vehicle A is indicating to turn right and fails to give way to Vehicle B and Vehicle B is the through traffic.
  • A collision results.
  • In this scenario Vehicle A is clearly responsible for failing to give way to oncoming tra

The at Fault Driver

  • In both the scenarios listed above we identify the driver who is considered at fault.
  • The Notice of Accident Claim Form is given to the Compulsory Third Party Insurer of the driver at fault.

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.

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