Insurer medical examinations

March 31, 2014

Can the insurer make me undergo a medical examination?

As part of any Personal Injury Claim, your solicitor will arrange for you to meet with and be examined by a doctor. This doctor is usually a specialist. The purpose of the appointment if to obtain a medico/legal opinion (i.e. not for treatment). This doctor will, after meeting with you, provide a report about your injury. This report will include:


  • the effects the injury has on your day-to-day life;

  • any further treatment or rehabilitation to help improve your condition; and

  • how your injury is likely to impact on your working life.


The law also allows the Insurer (or other party) to obtain their own medico/legal opinion from a doctor of similar specialty (e.g. orthopaedic surgeon, neurosurgeon, etc). In most cases this opinion is sought.


If the Insurer intends to have you examined by their own specialist, they will usually provide your solicitor with a panel of 3 specialists of similar areas of practice. Your solicitor will then choose one of those doctors on your behalf. The Insurer will then arrange an appointment with that chosen doctor.


You must attend the appointment, unless you can successfully argue that the appointment is “unreasonable or unnecessarily repetitious”. This prevents the Insurer from organising multiple medical examinations or to go “doctor shopping”.


The Insurer is required to cover the cost of your attendance at the appointment, including:


  • the cost of the doctor’s assessment;

  • travel costs (eg. flights, taxis, fuel, etc); and

  • accommodation (where necessary).


What if I can’t make the appointment?

If you are unable to attend the appointment because of unexpected circumstances, you must tell your solicitor at the earliest opportunity. This is especially relevant as the Insurer may ask you to pay the doctor’s cancellation fee where insufficient notice has been given.


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