Key Takeaway
Court rules defendant's summary judgment motion premature when plaintiff lacks discovery needed to oppose medical necessity denial in no-fault insurance case.
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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”
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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.
Legal Context
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.
About This Topic
Discovery Practice in New York Courts
Discovery is the pre-trial process through which parties exchange information relevant to the dispute. In New York, discovery practice is governed by CPLR Article 31 and involves depositions, interrogatories, document demands, and physical examinations. Disputes over the scope of discovery, compliance with demands, and sanctions for noncompliance are frequent in both no-fault and personal injury cases. These articles analyze discovery rules, court decisions on discovery disputes, and strategies for effective discovery 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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