Medical necessity motion wins in a tough venue

Diagnostic Medicine, P.C. v Clarendon Natl. Ins. Co., 2012 NY Slip Op 50102(U)(App. Term 1st Dept. 2012)

What happened to Pomona v. Geico?  Why did A-minus go sour?

“[Defendant] submitt[ed] competent medical evidence, including a sworn peer review report, that the diagnostic testing giving rise to plaintiff’s claims lacked medical necessity (see CPT Med. Servs., P.C. v NY Cent. Mut. Fire Ins. Co., 18 Misc 3d 87, 88 [2007]). Plaintiff’s opposition consisting of an attorney’s affirmation — unaccompanied by any medical evidence or other competent proof — was insufficient to raise a triable issue.”

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