Why Trust This Analysis
This article is part of our ongoing 5102(d) issues coverage, with 251 published articles analyzing 5102(d) issues issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
Understanding Medical Expert Requirements in No-Fault Cases
In New York’s no-fault insurance system, establishing whether an injury meets the “serious injury” threshold under Insurance Law § 5102(d) often hinges on competing medical expert opinions. A common defense strategy involves challenging the plaintiff’s injuries by arguing they don’t rise to the statutory serious injury standard. However, plaintiffs frequently counter by claiming the defense expert’s opinion is inadequate because they didn’t review certain medical records like MRIs or EMG studies.
The Brand v Evangelista decision provides important clarity on what constitutes a sufficient prima facie showing by defense experts. This ruling has significant implications for both personal injury cases and medical necessity determinations in no-fault disputes, areas where similar expert witness standards apply.
Jason Tenenbaum’s Analysis:
Brand v Evangelista, 103 AD3d 539 (1st Dept. 2013)
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“efendant’s physicians required to review plaintiff’s medical records, since they detailed the specific tests they used in their personal examination of plaintiff, which revealed full range of motion (see Fuentes v Sanchez, 91 AD3d 418, 419 ; Zhijian Yang v Alston, 73 AD3d 562 ).
…is physicians did not tender any recent quantified range-of-motion measurements to demonstrate any limitations he may have had from his herniated discs, or following his second back surgery.
Point of this case is that the line: “well you did not look at the MRI’s or EMG’s” should not be fatal to an insurance carrier’s expert who opines on the lack of medical necessity, lack of causal relationship or non existence of a statutory serious injury.
Key Takeaway
Defense medical experts can establish a prima facie case for lack of serious injury without reviewing all plaintiff medical records, provided they conduct thorough physical examinations and document specific objective findings. This principle applies equally to medical necessity reversals where similar expert testimony standards govern insurance coverage decisions.
Legal Update (February 2026): Since this 2013 post, New York courts have continued to refine standards for medical expert testimony in serious injury determinations, and Insurance Law § 5102(d) has been subject to ongoing judicial interpretation that may affect the sufficiency requirements for prima facie showings. Practitioners should verify current case law developments and any regulatory updates that may have modified expert witness standards or medical record review requirements in no-fault serious injury cases.
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Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
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Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
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