Key Takeaway
Glenn Segal's 2014 physical-therapy claim failed on two supported IME reports and inadequate rebuttal. Read the holding beside Jason's cross-specialty question.
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.
The provider lost its physical-therapy claim in Glenn Segal PT v GEICO, 2014 NY Slip Op 51301(U). The insurer supplied two supported IME reports, and the opposing doctor’s affidavit did not adequately answer either. Jason’s original question about the two examiners remains worth distinguishing from what the court actually decided.
Historical note: Glenn Segal (August 12, 2014) found the provider’s response inadequate to two IME reports; the opinion does not decide a general licensing or cross-specialty competency rule.
Last reviewed: September 2026.
The evidence and the result
The IMEs preceded the services in dispute. One submission came from a chiropractor; the other was a doctor’s affirmed report. The Appellate Term found both supported by medical reasoning and facts.
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The provider’s response did not meaningfully address the chiropractor’s conclusions and did not sufficiently rebut the doctor’s conclusions. On August 12, 2014, the court reversed the denial of GEICO’s cross-motion, vacated the findings previously made in the provider’s favor and granted dismissal.
What the case does not answer
The opinion does not select one examiner as the sole basis for the cutoff. Nor does it announce that every practitioner may give an opinion on every specialty. The earlier expansion’s broad instruction to rebut every discipline in every case went beyond this record.
The cited Pan Chiropractic v Mercury (2009) supplies a closer comparison: its opposing affidavit merely disagreed with a reasoned peer review instead of engaging with the medical determination. Keep that evidentiary issue separate from any question about an expert’s qualifications.
Jason’s original comment
Jason’s August 2014 questions follow unchanged. They identify an uncertainty in the opinion; they do not answer which examiner’s view controlled or establish the qualifications required in other cases.
Was the cut-off based upon the chiro or the physician? Has to be the latter you would think since it is PT services? Yet, the court commented on the chiro IME. Interesting.
Connect to the Encyclopedia
Start with the medical necessity and peer-review topic hub for the archive’s case directory. Compare these related records:
- Huntington Regional Chiropractic: medical affidavits answered two IMEs
- Hunt City: competing chiropractic opinions left a trial issue
- Amato: reversal after trial on post-IME treatment
- Arnica: an IME rebuttal that missed objective findings
- Promed: two equipment claims, two different results
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.
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