Automobile insurance policy provisions requiring a first-party inured to undergo an IME in order to seek first party benefits is against public policy, absent a court order.

All Pennsylvania automobile insurers are required to provide a minimum medical benefit of $5,000. Insurers will often seek to determine whether the claim and medical treatment of their insured is medically necessary by utilizing an independent medical exam (IME). The issue becomes when the insured is not willing to submit to their carrier’s requested IME (possible issues with inconvenience and invasion of privacy on the part of the insured). Insurance carriers have in the past used the “non-cooperation” to terminate their insured’s medical benefits, even when a court order was not obtained necessitating the IME. The Supreme Court decided the provision requiring an IME without good cause was void against public policy. (An insurer could always seek a court order, provided there is sufficient good cause as to why the IME is necessary.)

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