Key Takeaway
Innovative Chiropractic v Travelers dismissed one claim for conclusory opposition but preserved another because timely denial was not established.
This article is part of our ongoing medical necessity coverage, with 171 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.
A supported medical-necessity motion still has to be read claim by claim. In Innovative Chiropractic v Travelers, the insurer won dismissal of one cause of action, not both causes challenged on appeal.
Last reviewed: September 2026.
Historical note: Innovative Chiropractic separated timely denial from the sufficiency of opposition; the fifth cause of action was dismissed, but the fourth was not. Read the 2009 decision.
What the court decided
In Innovative Chiropractic, P.C. v Travelers Ins. Co., 2009 NY Slip Op 52447(U), decided December 1, 2009, the insurer established timely mailing of the denial for the fifth cause of action. Its chiropractor supplied a peer review and affidavit supporting lack of medical necessity. The treating chiropractor’s response asserted necessity without facts supporting that conclusion. The Appellate Term granted dismissal of that claim.
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The fourth cause of action had a different problem: the insurer had not established a timely denial. Dismissal of that claim remained denied. The opinion therefore does not support treating a persuasive medical report as a substitute for the necessary denial proof.
Read the opposition, not just its label
The decision applied the medical-evidence rule illustrated in Bronze Acupuncture, 2009 NY Slip Op 51219(U). It did not announce a newly mandatory five-part affidavit checklist or make affidavit length the test. Compare the actual conclusion challenged, the facts offered in response and the relief sought.
Frequently Asked Questions
Q: Can a treating provider’s affidavit ever be sufficient to defeat a medical necessity challenge?
Yes. The issue here was unsupported opposition, not a categorical bar on treating-provider evidence.
Q: How detailed must an affidavit be to satisfy Appellate Term requirements?
The response must address the disputed medical reasoning with supporting facts. This opinion supplies no word-count rule.
Q: What happens if my practice has been using template affidavits?
Review the evidence in each case. A template’s format does not answer whether its contents rebut the motion.
Q: Can I use medical literature to support my affidavit?
Its relevance and evidentiary foundation need case-specific review. This decision did not establish a literature requirement.
Q: How does this affect cases already in litigation?
The 2009 holding is not a new filing rule. Current deadlines and the submitted proof need separate review.
Jason’s original 2009 note
Jason’s original 2009 comments are preserved below. The final sentence was already cut off in the archive; no missing words have been invented.
Now, Travelers has joined in the parade to non-suit plaintiffs who put in pro-forma affidavits of medical necessity in an attempt to defeat an insurance carrier’s well support summary judgment motion:
I end this post with the following thought. If you are litigating medical necessity cases against an insurance carrier who makes these types of motions and gears their papers to the eventual trip to the Appellate Term, then you had better make sure that your answering papers not only have affidavits of merit, but have affidavits that are factually detailed and contain a valid medical rationale. The attorney arguments that many times win in Civil Court or District Court, usually do not fly at the Appellate Term. I think the failure to procure affidavit
Connect to the Encyclopedia
Start with the medical necessity and peer-review encyclopedia, then compare these records:
- Bronze Acupuncture: disagreement without supporting facts
- B.Y., M.D.: an incomplete opposing affirmation
- Alur Medical: an unrebutted equipment review
- Five Boro: missing report pages and sufficient opposition
For review of a particular no-fault dispute, contact the firm with the relevant reports and motion papers.
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.
171 published articles in Medical Necessity
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DRD Medical defeated the insurer's motion in 2020. Compare the court's finding of a factual dispute with Jason's original criticism of the affidavit.
Apr 27, 2020
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Huntington Regional Chiropractic: two supported IMEs met medical affidavits that raised a trial issue. Jason's 2015 questions remain distinct from the ruling.
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A copy of a peer report is all that is needed
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Apr 1, 2013
Crazy
Amato's 2010 IME-cutoff ruling was reversed in 2013. Read that result alongside Jason's original criticism, without treating it as current claims advice.
Oct 27, 2010
A Common Sense Approach to Defeating Medical Necessity Motions | Long Island Lawyer | Jason Tenenbaum
Cariddi was a 2007 injury case, not a universal peer-review attachment rule. Read the distinctions involving expert foundations, missing records and IMEs.
Mar 4, 2009Frequently Asked Questions
Common Questions About This Topic
5 answers from the firm's New York personal-injury and employment-law practice. Click any question to expand.
Q: Can a treating provider’s affidavit ever be sufficient to defeat a medical necessity challenge?
Yes. The issue here was unsupported opposition, not a categorical bar on treating-provider evidence.
Q: How detailed must an affidavit be to satisfy Appellate Term requirements?
The response must address the disputed medical reasoning with supporting facts. This opinion supplies no word-count rule.
Q: What happens if my practice has been using template affidavits?
Review the evidence in each case. A template's format does not answer whether its contents rebut the motion.
Q: Can I use medical literature to support my affidavit?
Its relevance and evidentiary foundation need case-specific review. This decision did not establish a literature requirement.
Q: How does this affect cases already in litigation?
The 2009 holding is not a new filing rule. Current deadlines and the submitted proof need separate review.
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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.
