Clarke v. GEICO: New York Civil Rights Law § 70-b Requires Litigation to Be Caused by (and Allegationally About) Protected Medical Care

Introduction

In Clarke v. GEICO (2d Cir. Jan. 5, 2026) (summary order), the Second Circuit affirmed the dismissal of a physician’s New York statutory claim for “unlawful interference with protected rights” under N.Y. Civ. Rights Law § 70-b, a provision enacted as part of New York’s “freedom from interference with reproductive and endocrine health advocacy and travel exercise act” (the FIRE HATE Act).

The dispute arose after GEICO brought two federal civil RICO suits against Colin Clarke and Colin Clarke, M.D., P.C., alleging fraudulent billing practices in New York no-fault insurance claims. Clarke then sued GEICO under § 70-b, asserting that GEICO’s litigation tactics were aimed at harassing and inhibiting his provision of “lawfully provided medical care,” including care for minority patients in the Bronx. The key issue on appeal was whether GEICO’s RICO suits triggered § 70-b’s cause of action.

Summary of the Opinion

The Second Circuit affirmed dismissal, but on narrower grounds than the district court. While the district court held that § 70-b’s “medical care” is limited to reproductive or gender-affirming care, the court of appeals declined to decide the scope of “medical care”. Instead, it held that Clarke failed to state a claim because § 70-b requires that the plaintiff’s exercise of the protected medical-care right “results in litigation”—i.e., that the litigation is actually caused by (and, as reflected in the statutory text, framed in terms of) the provision/access of protected care.

GEICO sued Clarke for alleged false billing schemes, not for providing medical care. Because the alleged wrongdoing that prompted the RICO suits was billing fraud, the provision of medical care was not the required causal trigger.

The court also rejected (at the pleading stage) Clarke’s attempt to recast GEICO’s suits as pretextual “sham” litigation intended to stop him from treating patients. Finally, the court upheld the denial of leave to amend because Clarke’s request was conclusory and did not identify proposed new facts that would cure the defects.

Analysis

Precedents Cited

1) Statutory purpose and the post-Dobbs landscape

• Dobbs v. Jackson Women’s Health Organization, 597 U.S. 215 (2022)
  The panel used Dobbs primarily as context: after the leak and decision, states anticipating interstate conflicts adopted “shield” measures. The FIRE HATE Act is framed as a response to out-of-state attempts to impose civil/criminal liability on people for obtaining or facilitating protected care in New York. The case’s importance here is not doctrinal but explanatory: § 70-b is targeted at retaliatory litigation seeking to punish protected healthcare-related conduct.

2) Causation embedded in “results in litigation”

• Burrage v. United States, 571 U.S. 204 (2014)
  The court treated “results” as a causation term. Quoting Burrage, it held that “results” language “imposes … a requirement of actual causality.” That import—often discussed in criminal-law causation—was imported to interpret § 70-b(1): the protected conduct must be an actual cause of the litigation. Applying this frame, the panel concluded the litigation was caused by alleged fraudulent billing, not by providing medical care.

3) Pleading standards and “sham” litigation theory

• Ashcroft v. Iqbal, 556 U.S. 662 (2009) and Bell Atl. Corp. v. Twombly, 550 U.S. 544 (2007)
  These cases supplied the plausibility framework. The panel held Clarke’s allegations about aggressive discovery tactics were “at least as consistent” with bona fide fraud litigation as with an unlawful effort to inhibit medical care, and thus did not cross the line from possibility to plausibility.

4) Erie prediction and New York interpretive method

• Glob. Reins. Corp. of Am. v. Century Indem. Co., 22 F.4th 83 (2d Cir. 2021) (quoting Van Buskirk v. New York Times Co., 325 F.3d 87 (2d Cir. 2003))
  These cases framed the Second Circuit’s role sitting in diversity: apply New York law as the New York Court of Appeals would.
• E. Fork Funding LLC v. U.S. Bank, N.A., 118 F.4th 488 (2d Cir. 2024) (quoting Khan v. Yale Univ., 27 F.4th 805 (2d Cir. 2022))
  The panel reiterated the “predictive” function where the New York Court of Appeals has not addressed a precise issue, provided there are sufficient indicia.
• Morenz v. Wilson-Coker, 415 F.3d 230 (2d Cir. 2005)
  Cited for the requirement that federal courts interpret state law using the state’s own interpretive rules.
• Windward Bora LLC v. Sotomayor, 113 F.4th 236 (2d Cir. 2024) (quoting Kasiotis v. N.Y. Black Car Operatorsʹ Inj. Comp. Fund, Inc., 90 F.4th 95 (2d Cir. 2024))
  These decisions supplied the New York interpretive baseline: legislative intent is primary; text is the clearest indicator; plain meaning controls when unambiguous. The panel invoked these rules to justify focusing on the “results in litigation” text rather than expanding the statute based on generalized anti-harassment concerns.

5) Standard of review and leave to amend

• Altimeo Asset Mgmt. v. Qihoo 360 Tech. Co., 19 F.4th 145 (2d Cir. 2021) (quoting Henry v. County of Nassau, 6 F.4th 324 (2d Cir. 2021))
  Provided the de novo standard for reviewing a motion-to-dismiss.
• WC Cap. Mgmt., LLC v. UBS Sec., LLC, 711 F.3d 322 (2d Cir. 2013)
  Controlled the leave-to-amend issue. Because Clarke requested leave in a conclusory sentence and offered no proposed facts that would cure the deficiency, the district court acted within its discretion in denying amendment.

6) No-fault insurance uncertainty and plausibility

• GEICO v. Mayzenberg, No. 83, 2025 WL 3259882 (N.Y. Nov. 24, 2025) and GEICO v. Mayzenberg, 121 F.4th 404 (2d Cir. 2024)
  Clarke invoked Mayzenberg to argue GEICO’s conduct was wrongful. The panel used it differently: the “recent legal uncertainty” about no-fault defenses suggested GEICO’s positions could be credible, undermining (rather than supporting) an inference that GEICO was litigating solely to punish protected care.

Legal Reasoning

1. The court centered the claim’s trigger on causation and on what the challenged suit alleges.
   Section 70-b(1) requires that the plaintiff exercised (or attempted/facilitated) a protected right to obtain/provide covered medical care and that this exercise “results in litigation.” The panel read “results” to require actual causation (Burrage). On the pleadings, GEICO’s RICO suits were a response to alleged fraud in billing, not the act of providing medical care; thus, the necessary causal chain was missing.
2. Motive was insufficient where the statute focuses on allegations.
   Clarke argued GEICO’s true purpose was to deter him from treating patients. The panel pointed to § 70-b(2), which frames the claim as arising when an action is commenced “in which the allegations … involve” accessing/providing/facilitating the protected medical care. This “allegations” focus matches the legislature’s identified harm: being sued or charged to punish protected healthcare activity (especially travel-related care) rather than being sued for independent misconduct.
3. Even if a sham-litigation theory could exist under § 70-b, Clarke pleaded too little.
   The complaint’s cited facts—numerous examinations under oath and extensive record demands—were ordinary tools in fraud litigation and did not plausibly suggest an ulterior scheme. Under Twombly/Iqbal, allegations equally consistent with lawful conduct do not establish entitlement to relief.
4. The panel avoided the district court’s narrowing construction of “medical care.”
   The district court limited “medical care” to reproductive or gender-affirming care (relying on ejusdem generis, legislative history, and avoidance of absurd results). The Second Circuit affirmed without reaching that interpretive dispute, instead adopting a causation-and-allegations-based limitation that defeats Clarke’s claim even under a broader reading of “medical care.”

Impact

• Practical narrowing of § 70-b through causation and pleadings.
  Even without defining the outer bounds of “medical care,” the decision makes § 70-b difficult to invoke unless the challenged lawsuit is causally and facially tied to protected care—i.e., litigation that targets healthcare access/provision itself, not collateral disputes (such as billing fraud) involving healthcare businesses.
• Text-first focus on the “allegations” of the underlying action.
  Plaintiffs seeking § 70-b relief should expect courts to examine what the underlying complaint charges, not merely the defendant’s asserted subjective motives.
• Higher bar for “retaliatory” or “sham” theories at the pleading stage.
  The panel’s reliance on Twombly/Iqbal signals that aggressive litigation conduct, without additional concrete facts, will rarely suffice to infer a malicious purpose to inhibit protected medical care.
• Reinforces § 70-b’s intended target: liability-imposing suits aimed at protected care.
  The court’s repeated references to the FIRE HATE Act’s travel-and-punishment rationale indicate that § 70-b is tailored to counteract suits seeking to impose liability for protected healthcare choices or facilitation—especially in interstate conflict settings—rather than to federalize or convert routine insurance fraud disputes into civil-rights retaliation claims.

Complex Concepts Simplified

“Results in litigation” (causation)

The statute requires more than “litigation happened while you are a healthcare provider.” It requires that the litigation happened because of the protected conduct—similar to a “but-for” causation idea: the lawsuit must arise as an effect of exercising the protected medical-care right.

Focus on “the allegations” in the underlying lawsuit

The court read § 70-b as keyed to what the underlying lawsuit claims you did (its pleaded allegations), not just what the plaintiff in that lawsuit privately intended.

Plausibility pleading (Twombly/Iqbal)

A complaint must contain enough concrete facts to make unlawful conduct a reasonable inference, not merely a possibility. If the facts fit lawful and unlawful explanations equally, the claim is typically dismissed at the pleading stage.

Leave to amend

Asking to amend “if the motion is granted” is not enough. Courts generally require some indication of what new facts would be added and how they would fix the problem.

Summary order

The court noted the disposition is a “summary order,” which in the Second Circuit “do[es] not have precedential effect,” though it can be cited under specified rules. Even so, it provides a clear indicator of how the court reads § 70-b’s causal and pleading requirements.

Conclusion

Clarke v. GEICO construes New York Civil Rights Law § 70-b as requiring a concrete causal link between the exercise of a protected medical-care right and the litigation complained of, with special emphasis on whether the allegations in the underlying action involve imposing liability for protected healthcare conduct. Lawsuits centered on alleged billing fraud—without plausible, factually enhanced allegations of a sham designed to punish protected care—do not satisfy § 70-b’s “results in litigation” requirement. The decision thus channels § 70-b toward its core post-Dobbs function: countering liability-imposing actions aimed at deterring protected healthcare access and facilitation in New York.