Tuesday, February 11, 2014

Production of Entire Claims File Ordered

Heimbach v. State Farm Ins.
(4th Dept., decided 2/7/2014)

Pay attention insurers.  It has been the case decisional law in New York for some time that reports prepared by insurance investigators, adjusters, or attorneys before the decision is made to pay or reject a claim are not privileged and are discoverable.  Here is another case decision holding the same thing.

Plaintiff sued State Farm for SUM coverage benefits and served a discovery demand for State Farm's entire claims file.  She also sought to depose various representatives of State Farm, including the claim representative who had been handling her SUM claim.  State Farm apparently declined to produce the entire claims file and the handling claim rep for a deposition, and plaintiff moved to compel such discovery.  The motion court denied plaintiff's motion insofar as it sought the entire claims file and the handling claim rep's deposition.

In MODIFYING the order appealed from to grant plaintiff's motion to compel production of the entire claims file and the handling claim rep's deposition, the Fourth Department held:
Given the scope of the liability and damages issues framed by the pleadings, we conclude that plaintiff's request for the entire claim file was not palpably improper and that the disclosure was "material and necessary" for the prosecution of plaintiff's action (CPLR 3101 [a]; see generally Cain v New York Cent. Mut. Fire Ins. Co., 38 AD3d 1344, 1344; Gibson v Encompass Ins. Co., 23 AD3d 1047, 1047-1048). Furthermore, defendant failed to meet its burden of establishing that those parts of the claim file withheld from discovery by the court contain material that is privileged or otherwise exempt from discovery (see Gibson, 23 AD3d at 1048; Bombard v Amica Mut. Ins. Co., 11 AD3d 647, 648). Inasmuch as plaintiff established that defendant's claim representative directly responsible for handling plaintiff's claim possesses "material and necessary" information regarding the action (CPLR 3101 [a]), that part of plaintiff's motion seeking to compel his deposition also should have been granted.
Be advised.

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