New Federal Court Disability Medical Exam Opinion

court opinion disabilityLast month, in Curry v. Trustmark Insurance, a Maryland District Court judge made an interesting ruling in a breach of contract case involving disability payments. The judge granted summary judgment for the defendant. While not a tort claim, this opinion deals with a lot of issues we face as personal injury lawyers regarding disability and the contractual obligation to submit to an IME in uninsured motorist cases.

Facts of Curry v. Trustmark Insurance

Here are the basic facts: Plaintiff, a chiropractor, is injured as he is attempting to perform an adjustment on one of his patients. He suffers, ironically I guess, a lower-back injury that he claims causes a permanent disability.

On the face, arguably that is a tough make, right? You were just performing an adjustment, and now you are disabled? Possible? Sure. But unbelievably unlikely.

Still, he makes a claim and the insurance company makes payments to the Plaintiff in the amounts that were predetermined in the policy. After the plaintiff cannot show for an IME, the insurance company says enough is enough and discontinues the payments. Plaintiff files for breach of contract lawsuit claiming $1.5 million dollars in damages.

The district court judge grants Trustmark Insurance’s motion for summary judgment because the Plaintiff failed to appear for an IME that was a requirement in the insurance contract.

From here, we learn an important fact:  Plaintiff must be acting as their own disability lawyer. A week and a half after the entry of summary judgment, Plaintiff asks the judge to reconsider the decision to grant summary judgment, arguing that there was a dispute of material fact between the parties that makes summary judgment improper. Plaintiff claims that in his answers to Defendant’s interrogatories, he agrees to appear for an IME evaluation. Plaintiff further argues that this admission “saves” his claim for the disability payments. This argument fails because it is really dumb. Judge Bredar notes that the ruling has no bearing on Plaintiff’s ability to sue for breach of contract between July 27, 2011 (the date he filed his complaint) and the present.

Do You Have to Give a Medical Exam When You Bring a UM Claim?

When the insurance company demands a recorded statement or a medical exam in an uninsured or underinsured motorist case in Maryland, almost every accident attorney in Maryland assumes that this means that you are required to do so or you lose your coverage. I am not so sure.

I know the contract is clear on this point. But the Maryland UM endorsement does not say that and, arguably, that rewrites the policy’s language.

No one knows for sure, which is why few tort lawyers in Maryland will push the envelope because the juice may not be worth the squeeze. But it is a good thing to keep in mind, particularly in fact patterns like this one.

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