Key Takeaway
Nassau District Court ruling in Bajaj v GEICO clarifies when substitute peer doctors can testify in no-fault medical necessity cases, overturning restrictive precedent.
In New York no-fault insurance litigation, medical necessity disputes often hinge on expert testimony from peer review doctors. A critical procedural question that frequently arises is whether an insurance company can use a “substitute peer doctor” to testify at trial when the original peer reviewer is unavailable. This issue has significant strategic implications for both plaintiffs and defendants in New York no-fault insurance cases.
The Nassau County District Court’s decision in Bajaj v GEICO provides important clarity on this procedural matter, establishing more liberal rules for substitute peer testimony that can affect case strategy and outcomes. Understanding these rules is essential for practitioners navigating medical necessity reversals and similar challenges in no-fault practice.
Jason Tenenbaum’s Analysis:
Bajaj v GEICO, 2012 NY Slip Op 51106(U)(Dis. Ct. Nassau Co. 2012)
The first thing someone asks me in Brooklyn is whether “you have a substitute peer doctor”. I shrug my shoulder for the simple reason that either I will have a medical necessity framed issue hearing, or a record that will go to the 15th Floor and be decided in 2015 reversing the order of the Civil Court precluding my doctor, and granting me another day in court. When the case is remanded, that judge will be at Supreme Court, down the block.
I think you know what he case holds based upon the above. I will summarize:
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Substitute peer may testify.
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Case from Judge Buggs is considered wrong on constraint of Appellate Term precedent.
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Original peer does not have to be in evidence for substitute to try case.
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Acknowledgment that cross-examination of substitute peer doctor may bear more fruit than crossing original doctor, due to the “four corners” rule.
Read the case. Harold Soloman won in the end.
Key Takeaway
The Bajaj decision liberalizes the rules for substitute peer doctor testimony in no-fault cases, allowing insurance companies greater flexibility in presenting expert testimony. However, the ruling also acknowledges that substitute peers may be more vulnerable to cross-examination due to the “four corners” rule, potentially creating strategic advantages for plaintiff attorneys. This decision represents a significant shift from more restrictive precedents that required proper foundation for peer reports.
Legal Update (February 2026): Since this 2012 post, New York’s no-fault insurance regulations and civil procedure rules governing expert medical testimony may have been amended, including potential changes to discovery deadlines, peer review requirements, and substitute expert witness procedures. Additionally, appellate decisions in the intervening years may have refined or modified the precedential value of Bajaj v GEICO regarding substitute peer doctor testimony. Practitioners should verify current Civil Practice Law and Rules provisions and recent case law developments when addressing substitute peer doctor issues in no-fault medical necessity disputes.
