Massachusetts Appellate Court Upholds Summary Judgment for Insurer in Dispute Regarding the Requirement that Physicians Perform Medical Examinations in PIP Insurance Claims

If you are injured in a motor vehicle accident in Massachusetts, you may be able to seek compensation through the at-fault driver’s Personal Injury Protection (PIP) auto insurance policy. In order to receive benefits, there are several procedures and rules that you may be required to follow, including those surrounding medical examinations. As dedicated Boston car accident lawyers, we have guided numerous injured persons through the claims process while helping them protect their rights.Legal News Gavel

Recently, a Massachusetts appellate court considered a case in which the plaintiff was injured in a car crash during 2009. The woman filed a claim with her auto insurer, pursuant to her PIP policy. Next, the insurer arranged for a medical examination of the plaintiff, pursuant to the PIP statute. The heart of the plaintiff’s lawsuit against the insurer was based on the notice that the insurer sent to the plaintiff regarding the examination. It stated that she would be examined by a physician of the insurer’s choosing. According to the record, however, the selected person was not a medical doctor but a doctor of physical therapy. The insurer sent the plaintiff a copy of his report regarding his examination, which identified him as a doctor of physical therapy and a licensed physical therapist.

The plaintiff’s lawsuit was dismissed on the basis that she did not file it within the appropriate statute of limitations. According to the judge, the plaintiff was on notice as of the date that the notice was sent listing the individual as a doctor of physical therapy. This gave the plaintiff sufficient awareness that the insurer had not complied with the statute’s requirement that a physician conduct the exam.

Additionally, the appellate court pointed out that the plaintiff did not make any allegations that the physical therapist conducted the examination in an improper or unprofessional manner, or that his participation in the exam somehow caused her to suffer an injury or loss. Nor did the plaintiff testify that she would have refused to undergo the examination had she been aware at the time that he was not a physician. Reviewing the statutory rule, the appellate court stated that the plaintiff would have needed to show that the deception caused her to suffer an identifiable loss. To have prevailed, the plaintiff would have needed to first file her claim within the appropriate statute of limitations and then provide evidence showing that the insurer’s failure to use an appropriately licensed physician caused her to suffer an identifiable harm.

If you were hurt in a car accident, you probably have questions regarding your legal rights and how you should go about securing the compensation that you deserve. At the Law Offices of Michael O. Smith, we dedicate our practice to handling personal injury cases, including motor vehicle accidents and related insurance disputes, on behalf of Massachusetts residents. We provide a free consultation to help you learn more about our legal team and how we can help you during this stressful and confusing time. Contact us at 617-263-0060 or contact us online to get started.

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