Key Takeaway
Innovative MR Imaging rejected unsigned, unsworn opposition in 2015. Separate that Second Department ruling from today's CPLR 2106 affirmation rules.
This article is part of our ongoing evidence coverage, with 277 published articles analyzing evidence 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 insurer won in Innovative MR Imaging v Praetorian because its supported motion went unrebutted. The two opposing medical-necessity letters were neither sworn nor signed. The decision was issued September 16, 2015, by the Appellate Term, Second Department, not the First Department.
Legal Update (September 2026): The any-person affirmation expansion took effect January 1, 2024, as Sweet v Fonvil explains; current CPLR 2106 supplies the form and exceptions, without making the unsigned letters rejected in this 2015 case adequate evidence.
Last reviewed: September 2026.
What the motion record showed
The Civil Court had denied both sides’ motions and limited the trial to medical necessity. On the insurer’s appeal, the Appellate Term reversed the challenged part of the order and granted dismissal. A sworn peer review supplied the medical reasoning; the two letters had no probative value.
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An unsigned letter and a medical report used as the basis for a proper expert affirmation are different submissions. CPT Medical Services v New York Central Mutual (2007) distinguished a physician’s affirmation relying on an unsworn report from an attorney’s affirmation merely attaching one. It also found the report medically unresponsive even if considered.
Form and medical substance remain separate
Today’s CPLR 2106 is not limited to physicians and a short list of professions. A qualifying affirmation must substantially follow the statutory form; the rule also contains exceptions. Neither signing a letter nor choosing the correct form supplies an expert’s missing explanation of the disputed care.
The old advice to obtain a document that is “at minimum, signed” has been removed. For this motion, the insurer’s initial medical showing and the deficiencies in the opposition both mattered.
Connect to the Encyclopedia
- Medical necessity and peer review: topic hub
- Triangle R: defective DME 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
Evidentiary Issues in New York Litigation
The rules of evidence determine what information a court or arbitrator may consider in deciding a case. In New York no-fault and personal injury practice, evidentiary issues arise constantly — from the admissibility of business records and medical reports to the foundation requirements for expert testimony and the application of hearsay exceptions. These articles examine how New York courts apply evidentiary rules in insurance and injury litigation, with practical guidance for building admissible evidence at every stage of a case.
277 published articles in Evidence
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Aug 19, 2010Frequently Asked Questions
Common Questions About This Topic
3 answers from the firm's New York personal-injury and employment-law practice. Click any question to expand.
What is a letter of medical necessity in a no-fault case?
It explains the medical reason for treatment or testing. Innovative MR Imaging decided whether two particular letters answered a supported summary-judgment motion; it did not determine every way medical evidence may be presented.
Can an unsworn doctor's letter defeat an insurer's summary judgment motion?
The two letters here were neither sworn nor signed, and did not rebut the insurer's showing. A signed statutory affirmation is different from an unsigned letter. CPT Medical also distinguished a physician's affirmation based on an unsworn report from an attorney merely attaching that report.
How should a treating doctor's rebuttal be executed?
Current CPLR 2106 permits qualifying affirmations by any person, not just specified professions, and provides form requirements and exceptions. Counsel must also check the signer's knowledge, qualifications and response to the actual medical reasoning; a signature alone does not establish those matters.
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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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