Key Takeaway
Court rules insurance company entitled to examine healthcare provider's owner under oath in no-fault benefits case, demonstrating broad discovery rights in medical provider litigation.
In New York no-fault insurance litigation, healthcare providers seeking reimbursement often face extensive discovery demands from insurance companies. These demands can include requests for examinations before trial (EBTs) of key personnel, including business owners. The scope of permissible discovery in these cases is generally broad, allowing insurance companies to investigate the legitimacy of claims and the operations of medical facilities.
When providers file lawsuits to recover assigned first-party no-fault benefits, they open themselves to scrutiny regarding their business practices, billing procedures, and corporate structure. This case demonstrates how courts balance the provider’s right to seek payment against the insurer’s right to conduct thorough discovery.
Jason Tenenbaum’s Analysis:
Dana Chiropractic, P.C. v USAA Cas. Ins. Co., 2017 NY Slip Op 50944(U)(App. Term 2d Dept. 2017)
(1) “In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which granted defendant’s cross motion to dismiss the complaint pursuant to CPLR 3126 or, in the alternative, to compel plaintiff to respond to its discovery demands, to the extent of compelling plaintiff to produce plaintiff’s owner for an examination before trial, and, in effect, continued plaintiff’s motion for summary judgment pending the completion of discovery (see CPLR 3212 ).”
(2) “Contrary to plaintiff’s contention, defendant is entitled to an examination before trial of plaintiff’s owner (see CPLR 3101 ; see also Midwood Acupuncture, P.C. v State Farm Fire & Cas. Co., 21 Misc 3d 144, 2008 NY Slip Op 52468 ; Great Wall Acupuncture v State Farm Mut. Auto. Ins. Co., 20 Misc 3d 136, 2008 NY Slip Op 51529 ). ”
A sufficient showing was made warranting the owner to come in for an EBT
Key Takeaway
Healthcare providers pursuing no-fault reimbursement should expect comprehensive discovery requests, including potential EBTs of business owners. Courts generally favor broad discovery rights for insurance companies in these cases. As seen in similar litigation, summary judgment motions may be denied pending disclosure, emphasizing the importance of completing discovery before seeking final judgment.
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- Appellate Term holds CPLR 3212(f) relief is inappropriate under three separate circumstances
- A plain disaster
- Discovery Violations and Court Sanctions: When New York Courts Strike Back
- New York No-Fault Insurance Law
Legal Update (February 2026): Since this 2017 post, New York’s no-fault insurance regulations and discovery procedures may have been modified through regulatory amendments, updated fee schedules, or changes to CPLR provisions governing examination before trial scope and timing. Additionally, appellate decisions from 2017-2026 may have further clarified the balance between provider payment rights and insurer discovery rights in no-fault litigation. Practitioners should verify current CPLR 3126, 3212, and 3101 provisions and recent case law developments when advising on discovery strategy in no-fault reimbursement cases.
