Key Takeaway
A Plus Medical v Mercury denied the insurer summary judgment in 2009. Read the actual holding beside Jason's original comparison of appellate records.
This article is part of our ongoing medical necessity coverage, with 170 published articles analyzing medical necessity issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
The reported caption is A Plus Medical, P.C. v Mercury Casualty Co.. “A minus” is Jason’s original headline. On April 29, 2009, the Appellate Term, First Department upheld the denial of Mercury’s summary-judgment motion because its medical-necessity submissions were insufficient.
Historical note: A Plus Medical (2009) upheld denial of the insurer’s summary-judgment motion on its submissions; the opinion does not establish a preferred venue or resolve Jason’s comparison of the underlying appellate records.
Last reviewed: September 2026.
What the opinions allow us to compare
A Plus is a short disposition. It does not describe the medical proof in enough detail to establish the broader conflict suggested in the original commentary.
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In A Khodadadi Radiology v New York Central Mutual (2007), the Appellate Term, Second Department upheld denial of the provider’s motion and, on searching the record, granted the insurer’s cross motion. The provider’s business-record foundation was deficient, and the insurer’s medical-necessity proof was unrebutted.
CPT Medical Services (2007) supplies another comparison: competent peer-review evidence met the insurer’s initial burden, while an attorney’s affirmation with an unsworn doctor’s report did not provide adequate opposition.
The record comparisons Jason had in mind cannot be reconstructed from those short opinions alone. The earlier expansion’s claims about favorable Bronx outcomes and maximizing recovery have been removed. A venue recommendation requires the actual procedural rules and case facts.
Jason’s original comment
Jason’s May 2009 reaction follows unchanged in wording, with stray citation-formatting markers removed. It compares appellate records that were not available for this review. The Bronx sentence is historical criticism, not current advice about where a claim may be filed.
I can’t comment much on this matter, but if you read the record on appeal in this matter and the record on appeal in the matter of CPT v. NYCM, then you will see that the Appellate Term, First Department, is having trouble figuring out how to resolve an issue that the Appellate Term, Second Department resolved 2 years ago in A Khodadadi Radiology, P.C. v NY Cent. Mut. Fire Ins. Co., 16 Misc 3d 131(A)(App. Term 2d Dept. 2007).
Lastly, this case only gives a Plaintiff more of a reason to file his or her cases in the Bronx.
Connect to the Encyclopedia
- Medical necessity and peer review: topic hub
- Triangle R: defective DME opposition
- Park Slope: a rebuttal that missed the peer review’s reasoning
- Amherst: identify the missing medical information
- Innovative MR Imaging: unsigned and unsworn opposition
For review of a particular no-fault dispute, contact our office.
Legal Context
Why This Matters for Your Case
New York law is among the most complex and nuanced in the country, with distinct procedural rules, substantive doctrines, and court systems that differ significantly from other jurisdictions. The Civil Practice Law and Rules (CPLR) governs every stage of civil litigation, from service of process through trial and appeal. The Appellate Division, Appellate Term, and Court of Appeals create a rich and ever-evolving body of case law that practitioners must follow.
Attorney Jason Tenenbaum has practiced across these areas for over 24 years, writing more than 1,000 appellate briefs and publishing over 2,353 legal articles that attorneys and clients rely on for guidance. The analysis in this article reflects real courtroom experience — from motion practice in Civil Court and Supreme Court to oral arguments before the Appellate Division — and a deep understanding of how New York courts actually apply the law in practice.
About This Topic
Medical Necessity Disputes in No-Fault Insurance
Medical necessity is the most common basis for no-fault claim denials in New York. Insurers hire peer reviewers to opine that treatment was not medically necessary, shifting the burden to providers and claimants to demonstrate otherwise. The legal standards for establishing and rebutting medical necessity — including the sufficiency of peer review reports, the qualifications of reviewing physicians, and the evidentiary burdens at arbitration and trial — are the subject of extensive case law. These articles provide detailed analysis of medical necessity litigation strategies and court decisions.
170 published articles in Medical Necessity
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Jun 18, 2012Frequently Asked Questions
Common Questions About This Topic
4 answers from the firm's New York personal-injury and employment-law practice. Click any question to expand.
Why do different appellate departments reach different conclusions on the same legal issue?
Different records and procedural postures can produce different results. A Plus Medical's short opinion does not explain enough to establish that its record matched Khodadadi or that the courts adopted conflicting rules.
How does venue selection affect my no-fault insurance case?
Venue must be supported by the applicable procedural rules and facts. Jason's 2009 Bronx comment is an archived reaction, not a finding that Bronx courts currently favor providers or a recommendation to choose an otherwise improper venue.
What should I do if my no-fault claim involves appellate issues?
Have counsel review the actual order, record, service history and preserved issues. This note identifies what the reported decisions resolved; it does not substitute for reviewing the papers in a particular appeal.
How long do appellate proceedings typically take?
A Plus Medical establishes no typical appeal duration. Timing depends on the court and proceeding; this historical case note makes no estimate for a current appeal.
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Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
If you need legal help with a medical necessity matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.
