IMR Program

medical insurance review

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An Independent Medical Review (IMR) is a process where expert independent medical professionals are selected to review specific medical decisions made by the insurance company. The California Department of Insurance (CDI) administers an Independent Medical Review program that enables you, the insured, to request an impartial appraisal of medical decisions within certain guidelines specified by the law.

Sections 10169 through 10169.5 of the California Insurance Code (CIC), which became effective January 1, 2001, explain the IMR process in detail. An IMR can be requested only if the insurance company's decision involves:

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