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Failure To Show For Examination Not Proper Grounds To Withdraw Insurance Coverage

Failure To Show For Examination Not Proper Grounds To Withdraw Insurance Coverage

Posted by on Mar 26, 2014 in Motor vehicle accidents

Failure To Show For Examination Not Proper Grounds To Withdraw Insurance Coverage

It goes without saying that almost nobody reads their automobile insurance policy, and very few people are familiar with all of the terms and fine print.  Nevertheless, many readers of this blog probably realize that almost every car insurance policy sold in Florida contains a provision requiring the complete cooperation of the customer with the insurance company, and that one of the things that the insurance company can require is a medical examination of he customer arranged by the company.

Over time, insurance companies have sometimes used medical examinations as a precursor or excuse to withdraw insurance coverage to their customers.  Companies will almost always hire doctors who have a history of finding that claimants are not seriously injured, if they find them to be injured at all.  Sometimes companies will unilaterally schedule examinations during work hours, or at other times that are clearly inconvenient for the insured.

Last week the Florida Supreme Court issued an opinion that may be helpful to insurance consumers.  In State Farm v. Curran, America’s largest car insurance company was seeking to use an injured person’s refusal to submit to an unrestricted and unlimited medical examination as an excuse to deny Uninsured Motorist insurance coverage altogether.

The Florida Supreme Court ruled that in order for an insurance company to deny coverage to a customer who has refused or failed to attend a medical examination, the insurance company must first carry the burden of proving that the customer’s failure to attend was prejudicial to the company.

In this instance, State Farm would have had to offer some reasonable proof that there was something about Curran’s medical condition that was otherwise hidden to State Farm, but would have been revealed to State Farm had Curran attended the medical examination.

In the Curran case, the Court found that State Farm could not carry its burden of proving prejudice.  However, in light of the holding in Curran, in future disputes like this one, it is very likely that  insurance companies will simply find doctors to review medical records and say that the insurance companies have been prejudiced by the lack of a medical examination.

As a practical matter, we advise our clients to do everything in their power to actually attend reasonable medical examinations so disputes like this don’t happen in the first place.

If you have any questions regarding Florida automobile insurance, or a medical examination following a Florida car accident, call Winter Park personal injury attorneys Kim Cullen and Robert Hemphill at 407-254-4901.  You may also wish to download a FREE copy of our free Florida car insurance book by visiting www.2013PIP.com.

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