- The medical examination describes your injuries and gives a medical assessment of your losses: it is the basis of your compensation.
- It is insurer-led (amiable) when it is organised by the insurer, and court-ordered (judiciaire) when it is ordered by a judge and entrusted to an independent expert.
- You have the right to be assisted by a medical adviser of your choice and by a lawyer. I strongly recommend that you never attend alone: you risk not being taken seriously by the expert, or ending up with a report that undervalues your losses.
What is the medical examination for?
Since your accident caused you injuries, you must be examined by a doctor (not a lawyer or a judge). Only a doctor has the expertise to record your injuries and determine their consequences. The medical examination meeting allows the doctor to examine you, study your medical file and answer a series of questions. In particular, the doctor must determine:
- the injuries caused by the accident and the treatment they required;
- how long you were off work and how long your everyday life was disrupted;
- the date of your consolidation, that is, the point at which your condition stabilises and no longer changes;
- the extent of your suffering, your disfigurement and your permanent after-effects;
- your need for human assistance, medical devices or adaptations;
- the impact on your working life, your leisure activities and your intimate life.
Each of these findings will then be converted into euros: see the guide which losses can you claim compensation for?
What is an insurer-led (amiable) examination?
It is the examination organised by the insurer responsible for compensating you. It is carried out by a doctor whom the insurer has chosen and pays, often called the “insurer’s medical adviser” (médecin conseil de l’assureur).
After a road traffic accident, the insurer must summon you at least 15 days in advance, telling you the doctor’s identity, the purpose, date and place of the examination, and informing you of your right to be assisted by the doctor of your choice. The report must be sent to you within 20 days of the examination.
The insurer’s doctor is not your doctor: they act on behalf of the company that is going to compensate you. That is why it is essential to be accompanied by your own medical adviser, who will defend your medical point of view. The examination can then be carried out jointly by both doctors: this is known as a joint insurer-led examination (expertise amiable contradictoire).
What is a court-ordered (judiciaire) examination?
It is an examination ordered by a judge, at your request or at the insurer’s. It can be requested before any trial, through a fast-track procedure (summary proceedings, or “référé”), in particular when the insurer disputes your injuries or when the insurer-led examination has not led to an outcome.
The judge appoints a court expert (expert judiciaire), listed on an official register and independent of both parties. The examination is adversarial: each party is summoned to it, may be assisted, and may send the expert written observations, which the expert must take into account.
A sum intended to pay the expert (the expert’s fee deposit, or “provision”) must in principle be advanced by the party requesting the examination. It may later be charged to the opposing party.
Insurer-led or court-ordered: what are the differences?
| Insurer-led examination | Court-ordered examination | |
|---|---|---|
| Who organises it? | The insurer | The judge, at the request of a party |
| Who examines you? | A doctor chosen and paid by the insurer | An independent court expert |
| Timeframe | Generally quicker | Longer: the case must be brought before the judge, then the examination takes place |
| Cost to you | The fees of your own medical adviser, which can later be claimed from the insurer | The expert’s fee deposit if you are the claimant, and your medical adviser’s fees |
| Safeguards | Relies on the balance between the two doctors | Independence of the expert, adversarial debate overseen by the judge |
There is no single right answer: in many cases, an insurer-led examination that is well prepared and conducted with your medical adviser leads to an outcome more quickly. When the stakes are high or the positions are too far apart, a court-ordered examination offers better safeguards.
Only a lawyer can help you decide whether a court-ordered examination is necessary or whether an insurer-led examination may be acceptable.
What is the role of your medical adviser?
The victim’s medical adviser (médecin conseil de victime) is a doctor specialising in the assessment of personal injury, whom you choose and who works for you. They:
- study your medical file before the examination and examine you;
- assist you during the examination and discuss each finding with the insurer’s doctor or the expert;
- make sure that no after-effect or need is overlooked;
- where necessary, draft written observations challenging the report’s findings.
Their fees are part of your expenses: they can be claimed from the insurer as part of your compensation.
What is the role of your lawyer?
Before the examination
- checking the brief given to the doctor and that the summons is in order;
- putting together a complete file with you: medical records, supporting documents, written statements from your loved ones;
- referring you to a victim’s medical adviser and preparing the examination with them;
- requesting a court-ordered examination when it is in your interest.
During and after the examination
- ensuring that your rights and the adversarial process are respected;
- putting forward the non-medical elements: impact on your career, help provided by your loved ones, activities you have had to give up;
- analysing the report, putting a figure on each of your losses and negotiating the insurer’s offer, or bringing the case before the judge.
How should you prepare?
Before the appointment, gather:
- the initial medical certificate drawn up just after the accident;
- hospital, surgery and imaging reports (X-rays, MRI scans…);
- your prescriptions, your sick-leave certificates and the reports from your rehabilitation sessions;
- written statements from your loved ones about the help they give you;
- a list of your day-to-day difficulties: movements you cannot make, pain, sleep, activities you have had to give up.
On the day of the examination, describe all your difficulties precisely and without playing them down, even those that seem minor to you. And do not sign any offer before having the report reviewed.
What if you disagree with the report?
An examination report is not a final decision. Depending on the situation, it is possible to send written observations to the doctor, to produce the opinion of another doctor, or to ask the judge for a court-ordered examination, or even a new examination. The earlier and the better argued the challenge, the greater its chances of success.
Do you have to attend a medical examination and would like to be accompanied by a lawyer?
This guide sets out general rules. It is no substitute for an analysis of your personal situation by Maître Victoria LECLERC.