One Beacon Ins. Group v. Midland Med. Care, P.C

In One Beacon Ins. Group v. Midland Med. Care, P.C., 54 AD3d 738, 863 NYS2d 728 [2008]), the court affirmed the lower court's decision to grant that branch of the plaintiffs' cross motion which was for disclosure of certain financial documents holding that the plaintiffs were not required to make a showing of good cause for such disclosure as the documents were material and necessary in the prosecution of the action. (See One Beacon Ins. Group at 740.) In One Beacon, the plaintiffs commenced an action against numerous professional medical service corporations, management companies, individuals who owned them, and licensed health care professionals alleging that the P.C.s were fraudulently incorporated in names of licensed healthcare professionals while, in fact, the P.C.s were owned, operated and controlled by unlicensed persons and their management companies in violation of applicable statutes and regulations. (Id. at 739.) The plaintiffs, inter alia, sought repayment of no-fault claims already paid to the P.C.s and a judgment declaring they were not obligated to pay outstanding claims. (Id.) The court held that the regulation, which permits carriers to withhold reimbursement from fraudulently licensed medical corporations to which patients have assigned their claims, allows carriers to look beyond the face of licensing documents to identify willful and material failure to abide by state and local laws. (Id. at 740.)