Key Takeaway
Triangle R reversed denial of the insurer's motion in 2011. Its report defects and current affirmation rules differ from a general rule against DME.
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.
Triangle R v New York Central Mutual changed the result below. On September 9, 2011, the Appellate Term, First Department reversed the Civil Court’s denial of the insurer’s motion and dismissed the complaint.
Legal Update (September 2026): Triangle R (2011) rejected the particular medical report submitted there; today’s execution rules are in CPLR 2106, whose any-person expansion took effect January 1, 2024 (Sweet v Fonvil).
Last reviewed: September 2026.
Two defects in the opposition
The insurer’s submissions established its initial lack-of-medical-necessity showing. The provider relied on an undated report that was not properly sworn. The appellate court also said the report would have been insufficient even if considered.
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The opinion does not identify a new equipment-specific checklist or decide that courts should disfavor DME claims. Jason’s reaction compared outcomes in several cases; it was not the court’s explanation for this ruling.
Do not use the old form advice today
The earlier expansion treated CPLR 2106 as an officer-administered-oath requirement. That description has been removed, along with an unsupported explanation of the opinion’s CPLR 2109 reference. Current CPLR 2106 permits qualifying affirmations by any person, with a prescribed substantial form and exceptions.
CPT Medical Services (2007), cited in Triangle R, also distinguished the form of a submission from its medical sufficiency. It allowed for a physician’s affirmation based on an unsworn report while rejecting an attorney’s affirmation that merely attached one. Correct execution does not guarantee that the medical response answers the insurer’s evidence.
Jason’s original comment
Jason’s September 2011 reaction follows unchanged. His characterization of the court’s attitude is commentary, not a factual finding or a rule disfavoring equipment claims.
It looks to me like the Appellate Term, First Department, is not too fond of durable medical equipment. Enko v. Clarendon and Triangle v. NYCM (Defendant is entitled to summary judgment based upon submissions) and A-plus v. Mercury and Pomona v. Geico (Defendants submissions fail to conclusively establish its prima facie entitlement to summary judgment)
Connect to the Encyclopedia
- Medical necessity and peer review: topic hub
- Innovative MR Imaging: unsigned and unsworn opposition
- Park Slope: a rebuttal that missed the peer review’s reasoning
- Amherst: identify the missing medical information
- A Plus Medical: an insurer’s insufficient summary-judgment showing
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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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.
