,

Geico now joins the Mercury and NYCM club in having their medical necesity motions denied based upon boilerplate letters of medical necessity

Park Slope Med. & Surgical Supply, Inc. v GEICO Ins. Co., 2011 NY Slip Op 50188(U)(App. Term 2d Dept. 2011)

“[p]laintiff submitted an affirmation of its doctor which sufficiently demonstrated the existence of a question of fact as to medical necessity (see Quality Psychological Servs., P.C. v Mercury Ins. Group, 27 Misc 3d 129[A], 2010 NY Slip Op 50601[U] [App Term, 2d, 11th & 13th Jud Dists 2010]; Park Slope [*2]Med. & Surgical Supply, Inc. v New York Cent. Mut. Fire Ins. Co., 22 Misc 3d 141[A], 2009 NY Slip Op 50441[U] [App Term, 2d, 11th & 13th Jud Dists 2009])”

Knowing this provider and the citation to Quality Psychological (letter of medical necessity sufficient to defeat LOMN motion), it appears that Plaintiff proffered the Dr. Leonid Shapiro letter of medical necessity.  Please note that I have not reviewed the record and do not have personal knowledge of these facts.  If my facts are wrong, please let me know and I will make the appropriate changes in the post.  History and practices in no-fault practice do not change themselves unless forced upon the dueling parties.

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7 Responses

  1. geico made a motion based on a boilerplate peer review. it only seems fair that it was opposed with a boilerplate letter of medical necessity.

    1. If it is such boilerplate, then why cant Plaintiff win on an affirmative medical necessity summary judgment?

  2. Plaintiff’s affirmation/affidavit was boilerplate too. Both side’s boilerplate canceled each other out.

    Plus, from a judge’s perspective, it’s much less likely that a denial of summary judgment will be reversed.

  3. you mean how do i know that Geico’s peer/IME was boilerplate?

    A combination of experience and speculation.

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