This is thе consolidation of Dist./Mun. Cts. R. A. D. A., Rule 8A appeals in two G.L.c. 90, §34M actions to recover Personal Injury Protection (“PIP”) benefits for chiropractic treatment undergone after an independent medical examination (“IME”) had determined that further treatment was unnecessary because the insureds “had reached a medical end result without impairment and without residuals.” Thе appeals present a single issue of law as to whether an insurance carrier may refuse to pay such chiropractic bills on the basis of the IME and without submitting the bills for additional medical review by another chiropractor.
On May 1, 1996, plaintiffs Joyce Miller (“Miller”) and Theodore Kocur (“Kocur”) were involved in an automobile accident in Peabody, Massachusetts as occupants of a vehicle insured by defendant Arnica Mutual Insurance Company (“Arnica”). Both plaintiffs were treated at the North Shore Medical Center emergency room and released. Miller was diagnosed as having a minor head injury with no abnormalities beyond a “minimal tenderness to palpitation on thе right parietal scalp.” Kocur suffered a cervical strain.
Shortly after the accident, both plaintiffs began treatment with two chiropractors, Steven Galina (“Galina”) and Josеph Sabino (“Sabino”). Following receipt of the plaintiffs’ respective PIP claims, Arnica requested independent medical examinations pursuant to G.L.c. 90, §34M.
Miller was examined on Junе 26,1996 by David Quinn, a chiropractor. On the basis of his IME
Similarly, Kocur was examined by Dr. Quinn on June 12, 1996. Kocur had by that date returned to work as a painter. At the conclusion of the IME,
The plaintiffs’ claims for payment of chiropractic expenses incurred after definitive independent mediсal examinations require us once again to review that provision of G.L.c. 90, §34M which states:
[N]o insurer shall refuse to pay a bill for medical services submitted by a practitioner registered or licensed under the provisions of chapter one hundred and twelve, if such refusal is based solely on a medical review of the bill or of the medical services underlying the bill, which review was requested or conducted by the insurer, unless the insurer has submitted, for medical review, such bill or claim to at least one practitioner registered or licensed under the sаme section of chapter one hundred and twelve as the practitioner who submitted the bill for medical services.
The plaintiff-insureds contend that this provision prohibited Arnica frоm refusing to pay Dr. Galena’s and Dr. Sabino’s bills for services rendered after the date Dr. Quinn concluded that a medical end result had been reached unless Arnica first submitted those bills to a сhiropractor for review. We disagree.
“The familiar rule of statutory construction requires us to interpret a law so as to effectuate the intent of the Legislature in enaсting it.” International Org. of Masters, Mates & Pilots v. Woods Hole, Martha’s Vineyard & Nantucket S.S. Auth.,
Such an impact on the cost of insurance in this Commonwealth would have to be tolerated if the statute required it. Section 34M, however, requires no such result. Indeed, the express language of the statute supports Arnica’s contrary position. Section 34M specifically mandates that an injured claimаnt cooperate with the insurer’s request that he undergo an independent examination. The utility of such a medical examination would be unjustifiably minimized if the insurer could not rely on it in deciding whether to pay bills submitted. Although arguing that an IME may not affect the payment of future bills, the plaintiff-insureds in these cases concede that an IME constitutes “a medical review of the bill or of the medical services underlying the bill.” As noted in their brief, “[ojbviously, it would be absurd to argue that a paper review of medical records, without the patient present, would satisfy the statute while a review of records in connection with an exam would not.” However, there is-no basis in the statute to restrict the insurer’s reliance on an IME to only bills for services rendered bеfore the examination. While such a limitation might be appropriate in some instances, it has no place where the IME determines that a medical end result has been reached. Obviously implicit in the medical end result finding is the conclusion that any further medical treatment is unnecessary.
Moreover, Arnica has complied not only with the Legislative intent and рolicy underlying §34M, but also with the letter of that law. The statute bars the insurer from refusing to pay a bill based solely on a medical review “unless the insurer has
Accordingly, the plaintiffs’ requests for rulings of law to the effect that Arnica was obligated to submit, for further review, bills for treatment rendered after the independеnt medical examinations in these cases were correctly denied. The trial court’s judgment for the defendant in each case is affirmed. Appeals dismissed.
So ordered.
Notes
Upon examining Ms. Miller, Dr. Quinn found that she was “not in any acute distress and assume[d] a normal posture in the seated and standing positions.... Her gait and station [were] normal. She [was] able to heel and toe walk without difficulty. There [was] no scoliosis noted on forward bending.” Dr. Quinn also found that Miller’s “[r]ange of motion of the cervical and lumbar spine were full” and that she “moved throughout the examination process in a pain-free manner.”
Quinn’s “sensory, motor and vibratory analysis” of Kocur indicated that he was “within normal physiologic parameters.... His active range of motion of cervical and lumbar spine [was] full.” While Kocur complained of occasional lower back ache, Dr. Quinn found no “areas of appreciable myospasm and joint restriction. ... There was no positive orthopedic test.”