Burden rests on medical provider to show that defense is palpably improper

Understanding Discovery Burdens in No-Fault Insurance Cases

In no-fault insurance litigation, discovery disputes frequently arise when insurance companies seek information from medical providers to investigate potential billing fraud. A critical question emerges: who bears the burden of proving whether discovery demands are appropriate? The Appellate Term’s decision in All Boro Psychological Services provides important clarification on this procedural issue.

Under New York’s no-fault insurance regulations, insurers must raise defenses like billing fraud in timely NF-10 denial forms. However, when discovery disputes arise, the burden of proof becomes more nuanced. Medical providers cannot simply assume that an insurer’s discovery demands are improper - they must affirmatively demonstrate why those demands should be rejected.

This ruling has significant implications for no-fault discovery motions and the strategic considerations medical providers must weigh when opposing insurance company investigations. The decision reinforces that procedural defenses require active proof, not passive assumptions.

Jason Tenenbaum’s Analysis:

All Boro Psychological Servs., P.C. v Allstate Ins. Co., 2013 NY Slip Op 23043 (App. Term 2d Dept. 2013)

“Thus, in the case at bar, defendant was not required to demonstrate that its discovery demands were not palpably improper. Rather, in order to successfully oppose defendant’s cross motion to compel, plaintiff would have had to show that defendant’s defense of billing fraud was precluded because it was not asserted in a timely NF-10 denial of claim form, which plaintiff did not do.”

This is rough.

Key Takeaway

Medical providers facing discovery demands in no-fault cases cannot rely on passive opposition. They must actively prove that the insurance company’s defense is procedurally barred - such as by demonstrating the insurer failed to raise billing fraud defenses in timely NF-10 forms. The burden rests squarely on the provider to establish that discovery demands are “palpably improper,” not on the insurer to justify their appropriateness.

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