Peer report is sufficient to prima facie prove lack of serious injury (Ins Law Sec. 5102[d])

In New York no-fault insurance litigation, defendants often rely on expert medical opinions to challenge whether a plaintiff sustained a “serious injury” under Insurance Law Section 5102(d). A key question that frequently arises is what type of expert evidence is sufficient to make a prima facie showing that no serious injury occurred.

The Fourth Department’s decision in Fisher v Hill provides important guidance on this issue, particularly regarding the use of peer review experts who examine medical records without conducting independent medical examinations. This approach is common in personal injury defense work, where insurance companies retain medical experts to review existing documentation and provide opinions on causation and injury severity.

Understanding the evidentiary standards for expert testimony in serious injury threshold cases is crucial for both plaintiffs and defendants. The courts have generally been receptive to various forms of expert evidence, as seen in cases involving biomechanical evidence and other specialized expert opinions.

Jason Tenenbaum’s Analysis:

Fisher v Hill, 2014 NY Slip Op 00830 (4th Dept. 2014)

It is infrequent that I post on the serious injury threshold. But a Plaintiff on a PI case that I am handling rejected a 3101(d) based upon the fact that our expert will be the classic peer reviewer. He will look at the EBT testimony, medical records, Bill of Particulars and testify that Plaintiff did not sustain a “serious injury” since the injuries were not causally related to the loss.

“In support of their motion, defendants submitted medical records and the affirmed report of a neuroradiologist who examined plaintiff’s medical records at defendants’ request. The neuroradiologist concluded that the objective medical findings related only to a preexisting condition in plaintiff’s spine. “ith persuasive evidence that plaintiff’s alleged pain and injuries were related to a preexisting condition, plaintiff had the burden to come forward with evidence addressing defendant claimed lack of causation” and, here, plaintiffs failed to meet that burden”

Key Takeaway

The Fisher v Hill decision demonstrates that a peer review expert’s report, based solely on examination of medical records, can be sufficient to establish a prima facie defense to serious injury claims. When defendants present persuasive evidence that injuries relate to preexisting conditions, the burden shifts to plaintiffs to provide contradictory evidence on causation.

Legal Update (February 2026): Since this 2014 post, New York’s serious injury threshold jurisprudence under Insurance Law Section 5102(d) has continued to evolve through appellate decisions that may have refined the standards for peer review expert testimony and prima facie showings. Additionally, procedural rules governing expert disclosure and the admissibility of records-based medical opinions may have been updated through court rule amendments or statutory changes. Practitioners should verify current evidentiary standards and recent appellate precedent regarding peer review experts in no-fault threshold cases.