Premature summary judgment motion

Hillside Open MRI, P.C. v Praetorian Ins. Co., 2014 NY Slip Op 50408(U)(App. Term 2d Dept. 2014)

(1) “In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint. Plaintiff opposed the motion on the ground that defendant had failed to respond to plaintiff’s discovery demands and that defendant’s responses were necessary to oppose defendant’s motion (see CPLR 3212 ). Plaintiff also cross-moved to compel defendant to provide the requested discovery (see CPLR 3124).”

(2) “Here, in support of its motion for summary judgment dismissing the complaint on the ground of lack of medical necessity, defendant alleged that it had timely denied plaintiff’s claims on that ground based on two peer review reports. In opposition to defendant’s motion, and in support of its cross motion to compel discovery, plaintiff demonstrated that it had requested from defendant, but had not received, the medical documentation underlying defendant’s decision to deny the claims based on lack of medical necessity, and that plaintiff needed such discovery to oppose defendant’s motion”

(3) “Consequently, defendant’s motion should have been denied with leave to renew following discovery, and plaintiff’s cross motion granted”

What is interesting is to note the following citation”compare Elmont Open MRI & Diagnostic Radiology, P.C. v Travelers Indem. Co., 30 Misc 3d 126, 2010 NY Slip Op 52223 ).”  I am guessing Defendant quickly moved for summary judgment and Plaintiff was able to satisfy this panel that they were not guilty of laches.  The other interesting thing is that the Court limited the discovery to the documents the peer doctor examined.  This is in contrast to the situation where the carrier is ordered to disclose every medical record in the claim file.

Related Articles

• Summary judgment denied pending necessary discovery disclosure
• CPLR 3212(f) motion denied for insufficient discovery
• MRI facilities protected in medical necessity summary judgment motions
• Why conclusory affidavits fail in medical necessity opposition
• New York No-Fault Insurance Law

Legal Update (February 2026): Since this 2014 decision, there have been potential amendments to CPLR discovery provisions and no-fault insurance regulations governing medical necessity determinations and peer review documentation requirements. Additionally, appellate court interpretations of premature summary judgment standards in no-fault cases may have evolved. Practitioners should verify current CPLR provisions and Insurance Department regulations before relying on the specific procedural standards discussed in this case.