Key Takeaway
Court examines how plaintiff's own hospital records contradicted expert testimony in no-fault threshold case, creating triable issues of fact.
When Medical Records Contradict Expert Testimony
In New York’s no-fault insurance system, plaintiffs seeking to recover damages beyond basic economic losses must prove they sustained a “serious injury” under Insurance Law § 5102(d). This threshold requirement typically involves expert medical testimony to establish the nature and extent of injuries. However, what happens when a plaintiff’s own medical records directly contradict their expert’s conclusions?
A recent Appellate Division case demonstrates how hospital records from the day of an accident can undermine an otherwise strong expert affirmation, creating factual disputes that prevent summary judgment. This scenario highlights the critical importance of thoroughly reviewing all medical documentation before advancing threshold arguments, as inconsistencies in medical records can prove fatal to a case.
The intersection of medical evidence and legal strategy becomes particularly complex when dealing with diagnostic imaging and contemporaneous medical assessments versus later expert interpretations.
Jason Tenenbaum’s Analysis:
In support of the plaintiff’s cross motion, she relied upon, inter alia, Dr. Westreich’s affirmation, which was sufficient to meet her prima facie burden of showing that she sustained a serious injury within the meaning of Insurance Law § 5102(d) as a result of the subject accident, inasmuch as she sustained a fractured nose. In opposition, the appellants raised a triable issue of fact as to the existence of a fracture on the day of the accident and, thus, whether the accident caused a fractured nose. In this respect, the appellants relied upon, inter alia, the plaintiff’s hospital records, which revealed that the CT scan of her head on the day of the accident was “unremarkable.”
This case is interesting because the Appellate Division, in a 5102(d) matter, looked to see if the injured persons medical records contradicted the affirmation of the injured person’s expert. This does not happen too frequently in no-fault practice, as we learned in Co-Op City Chiropractic, P.C. v. Mercury Ins. Group, 26 Misc.3d 145(A)(App. Term 2d Dept. 2010) and Infinity Health Products, Ltd. v. Mercury Ins. Co., 26 Misc.3d 142(A)(App. Term 2d Dept. 2010).
Key Takeaway
This case serves as a crucial reminder that expert affirmations must be supported by, not contradicted by, contemporaneous medical records. When hospital records from the accident date directly conflict with expert testimony, courts will find triable issues of fact that prevent summary judgment motions from succeeding, regardless of how well-credentialed the expert may be.
Legal Update (February 2026): Since this post’s publication in 2010, New York’s serious injury threshold standards under Insurance Law § 5102(d) may have evolved through appellate decisions and regulatory interpretations, particularly regarding the weight given to contemporaneous medical records versus expert testimony. Practitioners should verify current case law developments and any amendments to threshold analysis standards when evaluating medical record inconsistencies in no-fault cases.
