Earlier this week, in the cases of Sayles v. Allstate and Scott v. Travelers, the Pennsylvania Supreme Court ruled that such strict language in auto policies purporting to required insureds to attend medical exams conflicted with Section 1796 which is entitled “Mental or Physical Examinations of a Person”.

The Supreme Court, in a 6 to 1 decision, authored by Justice Debra Todd, ruled that insurance policies which require policyholders to undergo potentially unlimited medical exams (by insurance company selected physicians) to preserve insurance benefits are not binding in the Commonwealth of Pennsylvania. In fact, the Pennsylvania
Supreme Court found that such provisions in auto policies “manifestly conflict with, and are repugnant to” Pennsylvania law.

Only Courts have the authority to order “first party” medical exams, if justified, and only after the policy holders refuse. And a Court may order an insured to attend a medical examination only “upon motion for good cause shown.”

The Pennsylvania Supreme Court expressly rejected the current practice of insurers compelling insureds to attend “independent” medical examinations on the basis of the policy provision only. Instead, an insurer must petition the Court and demonstrate “good cause”. And most importantly, the Court will select the medical examiner — and
not the insurance carrier.

Know your rights. Call us with any questions.

Comments are closed.