Independent Medical Examinations (IMEs) are supposed to be objective assessments requested by insurance companies during the PIP claims process. In reality, many IMEs are far from independent and often lead to premature denial of payment for necessary treatment. For medical providers, this results in unpaid claims, frustrated patients, and a disrupted revenue cycle.
That’s where IME Denial Disputes come in. At The Massachusetts Personal Injury Protection Lawyers, we challenge these denials and fight to reinstate or recover payment for the care you rightfully provided. With years of experience handling PIP disputes, we’ve seen insurers misuse IMEs to delay or deny compensation, and we know exactly how to respond.
An insurance company orders an IME when they want a second opinion on whether treatment should continue. These exams are conducted by physicians hired and paid by the insurer—not your clinic, and not your patient. Unsurprisingly, IMEs frequently result in reports that state treatment is “no longer necessary.”
Once that report is submitted, the insurer stops paying. They may also deny any outstanding claims tied to services rendered after the IME date. This blanket denial is rarely based on a thorough review and often contradicts the treating provider’s clinical opinion.
IME Denial Disputes exist to push back against these unjust practices and ensure providers aren’t financially penalized for continuing medically necessary care.
IME-based denials put providers in a difficult position. You’re faced with choosing between halting treatment prematurely or continuing care without guaranteed payment. In many cases, the patient is still recovering, and stopping therapy could cause setbacks. But for the provider, unpaid work adds up quickly.
These denials:
Interrupt the treatment plan
Delay or eliminate compensation
Strain provider-patient relationships
Increase administrative burden
Challenging IME decisions is not just your right—it’s a necessary step in protecting your practice’s financial health and your patient’s well-being.
At The Massachusetts Personal Injury Protection Lawyers, we work exclusively with healthcare providers who bill under Massachusetts PIP insurance.
At The Massachusetts Personal Injury Protection Lawyers, we work exclusively with healthcare providers who bill under Massachusetts PIP insurance. We understand how insurers operate and know how to respond quickly when IMEs are used as a blanket excuse to cut off payment.
We support:
Physical therapy clinics
Chiropractic practices
MRI and imaging centers
Orthopedic offices
Pain management specialists
Hospitals and urgent care facilities
Community health centers
If you’ve received one or more denials following an IME report, we can help you recover the compensation you’ve earned.
Not all IME reports are created equal. Many contain vague language, lack direct patient evaluation, or fail to reference key records. These flaws can be grounds for overturning a denial if challenged properly.
The IME doctor never physically examined the patient
The denial occurred suddenly with no written explanation
The report ignores imaging results or objective findings
Denial was based solely on the IME with no provider consultation
Insurer used the same IME physician for multiple denials
These issues can be leveraged as part of an effective IME Denial Dispute strategy.
Challenging an IME denial takes more than a phone call. Our legal team builds strong, evidence-based cases that show your treatment was medically necessary—and that the insurer’s decision was flawed.
Here’s how The Massachusetts Personal Injury Protection Lawyers approach these disputes:
Review the IME report and identify inconsistencies
Collect detailed medical records and supporting documentation
Draft a legal demand challenging the denial
Escalate to litigation when necessary
Represent you in court or arbitration as needed
We don’t just question the IME—we dismantle its credibility using objective evidence and legal leverage.
Under Massachusetts General Law Chapter 90, Section 34M, insurers must pay for all reasonable and necessary treatment related to a motor vehicle accident. IMEs are not automatic justification to stop payments. They must be based on thorough evaluation and aligned with the facts of the case.
Many insurers abuse the IME process by:
Scheduling them prematurely
Using the same doctors repeatedly
Applying the findings across all future claims
Ignoring the treating provider’s medical opinion
Our firm uses this law to hold insurers accountable and reverse unfair IME-related denials.
We are not a general law firm—we are a focused team with decades of combined experience handling Massachusetts PIP claims.
Claim & IME Review
We start by examining the denial, the IME report, and your billing records.
Evidence Collection
We gather your notes, diagnostic images, and treatment rationale to build the case.
Demand Letter Issued
A formal legal demand is submitted to the insurer outlining the dispute.
Litigation Filed (if needed)
If the insurer fails to respond or comply, we initiate legal proceedings.
Resolution & Payment
Upon success, you receive full or partial reimbursement—plus interest if applicable.
Our team keeps you updated while handling all legal communications and filings on your behalf.
IME denials are difficult to reverse through billing appeals alone. Insurers typically double down on the IME report and ignore new information unless legal pressure is applied. A formal dispute backed by attorneys is often the only way to compel a re-evaluation or payment.
Working with The Massachusetts Personal Injury Protection Lawyers gives your claim weight. We speak the insurer’s language—and we fight with the law on your side.
Choosing not to challenge an IME denial means leaving money on the table. In contrast, legal disputes lead to stronger collections, improved insurance relationships, and better patient outcomes.
Faster resolution of denied claims
Higher likelihood of full payment
Deterrence of future unfair denials
Legal precedent for future claims
No risk (we only get paid if you do)
When your practice is facing unjust IME-based denials, a legal partner can help you turn losses into recovered revenue.
IME denials are not the end of the road. With the right legal team, you can challenge these decisions and recover what you’re owed for the care you provided. At The Massachusetts Personal Injury Protection Lawyers, we make the process simple, efficient, and low-risk.
Our job is to handle the insurer. Your job is to keep delivering great care.
Contact our legal team today for a free case evaluation and start recovering your unpaid PIP claims. No upfront fees — just results.
We handle the legal heavy lifting so your team doesn’t have to. From identifying violations of PIP law to aggressively pursuing litigation when needed, we tailor our strategy to fit your goals. And because we operate on a no recovery, no fee basis, there’s no financial risk to your practice.
At The Massachusetts Personal Injury Protection Lawyers, LLC, we focus solely on helping medical providers recover what they’re owed — quickly and effectively. Our firm covers all filing costs upfront and never charges a fee unless we win your case. With personalized legal strategies and statewide service, we make PIP collections simple and stress-free.
We exclusively serve hospitals, clinics, and healthcare professionals across Massachusetts, giving us unmatched insight into PIP law and provider rights.
From claim review to litigation and appeals, we handle everything — so your staff doesn’t have to deal with paperwork, insurers, or court filings.
Our services are contingency-based — you pay nothing unless we recover funds for you. No upfront costs, no hidden fees, just results.
