Key Takeaway
Promed's 2013 equipment ruling split two claims and invited submissions on possible sanctions. The decision did not itself impose those sanctions.
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.
Promed Durable Equipment v GEICO, 2013 NY Slip Op 23283 involved two equipment claims with different outcomes. The same decision criticized the respondent’s appellate brief and required submissions about possible sanctions. That invitation to be heard should not be reported as a completed sanctions award.
Historical note: Promed (August 16, 2013) reached different results for two equipment claims and directed submissions on possible sanctions; this note does not establish the outcome of that later sanctions process.
Last reviewed: September 2026.
Separate the two supply dates
On August 16, 2013, the Second Department’s Appellate Term left the October 23, 2008 claim for trial: the medical response sufficiently contested the peer review. For the December 16, 2008 claim, the response failed to address the reviewer’s explanation that the supplies duplicated benefits of an existing therapy and rehabilitation plan. The insurer obtained dismissal of that claim.
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This was a comparison of the particular reports and rebuttals, not a rule that equipment is unnecessary whenever a patient receives physical therapy.
What happened about the brief?
The court directed submissions on whether sanctions and costs should be imposed. Its criticism concerned a brief that did not meaningfully address the facts or explain why the appealed order should stand. The reported decision leaves the sanctions question for that process; no later disposition is established here.
The opinion also cites Pan Chiropractic v Mercury (2009) on a medical affidavit that merely disagreed with the peer reviewer. That is the useful connection between the medical and procedural parts of this note: identify the argument being answered rather than leaving the court to supply it.
Jason’s original comment
Jason’s August 2013 aside follows unchanged. It is his reaction to the brief, not a statement that sanctions were ultimately imposed.
What’s a boy to do? Well, “Girls just want to have fun”.
Connect to the Encyclopedia
Start with the medical necessity and peer-review topic hub for the archive’s case directory. Compare these related records:
- Devonshire: a conclusory peer review could not defeat the providers’ motion
- Glenn Segal: inadequate opposition to two IME reports
- Hunt City: competing chiropractic opinions left a trial issue
- Huntington Regional Chiropractic: medical affidavits answered two IMEs
For review of a particular no-fault dispute, contact the firm with the relevant reports, submissions and orders.
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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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.
