Independent Medical Examinations, West Palm Beach 1-800-74-TRIAL

Dear Adjuster:

This will confirm our agreement to have our client, John Doe, evaluated on an independent basis by Dr. Mary Rowe, an orthopedic specialist with offices in Delray Beach, Florida.
We have agreed as follows:
A. That you will provide me with a copy of your cover letter to the physician including any questions, comments, or other concerns to the doctor. Privilege is hereby waived on the part of both parties for purposes of this examination.
B. You will provide me with a copy of the doctor's complete report, without exception, within two weeks of receiving the report in your office. You will also provide copies of any subsequent report or cover letters relating to this matter. If you anticipate any delay with the above time frame, please let me know.
C. Dr. Rowe may be used by either party at trial or in any deposition proce¬dure. You are also allowed to use any of my client's physicians at trial with appro¬priate notice as provided by the Florida civil rules.
D. The cost of this examination will be absorbed totally by the carrier. The cost of any subsequent deposition or trial testimony will be absorbed by the party calling the witness to testify.
E. The cost of your examination does not have to be disclosed during settle¬ment but is proper for inquiry if this matter proceeds to litigation.
F. It is agreed that the independent medical examination that will take place will be the only such examination the prospective plaintiff will have to undertake. A second independent medical examination, if this matter proceeds to litigation, is hereby precluded.

If any of the above concerns are inaccurate, please let me know at once. It is my request that you sign the copy of this letter enclosed and return it to me in the self addressed envelope provided.

Thank you for your cooperation.

Sincerely,

Seen and agreed to:
BY: ______________________________
Authorized representative
ABCD Insurance Company