SK Med. Servs., P.C. v. New York Cent. Mut. Fire Ins. Co

In SK Med. Servs., P.C. v. New York Cent. Mut. Fire Ins. Co., 12 Misc. 3d 686, 818 N.Y.S.2d 430, 2006 NY Slip Op 26227, 1 (NY Civ. Ct. 2006), a lower court case, the parties stipulated that the peer report was in evidence and the court held that the substitute peer was permitted to testify. The substitute peer was limited to testifying to the facts and opinions contained in the peer review report. Id. The decision was based on the rationale that an insurer may not assert new grounds for its refusal to pay a claim and must adhere to the defense as stated in its denial. Id. Permitting a substitute peer to testify does not violate these principles as long as the substitute peer doctor is limited to the basis for the denial as set forth in the original peer report. Id.