Key Takeaway
Radiology Today ordered a new no-fault trial in 2017. Separate the peer report's evidentiary role, expert testimony and the provider's scope objection.
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.
The insurer obtained a new trial in Radiology Today, not a judgment establishing its defense. The trial judge had stopped the insurer before it called witnesses because the peer review report could not first be admitted for its truth.
Historical note: Radiology Today (2017) separates a peer report’s limited trial use from expert testimony, as A-Quality (2013) had explained; it does not dispense with the insurer’s medical proof.
Last reviewed: September 2026.
Radiology Today v GEICO, decided December 15, 2017, rejected that premise. The report could not itself prove lack of medical necessity, but the insurer could present medical expert testimony without first admitting the report as substantive proof.
Free Consultation · No Fee Unless We Win
Does this apply to your situation?
Every case is different. Get a free, confidential case review from an experienced attorney who can tell you exactly where you stand.
The report still had a role if testimony exceeded the denial’s basis. The provider had to make an appropriate objection and, if necessary, produce the report. The court’s warning about possible bolstering did not create a numerical rule against two experts.
A-Quality Medical Supply (2013) distinguishes the copy supplied during claims handling, sworn or affirmed motion evidence, and testimony at trial. Radiology Today’s footnote separately explains that the insurer has an initial trial burden; the provider ultimately must prove necessity by a preponderance of the evidence. The remand concerned the first cause of action.
Connect to the Encyclopedia
Start with the medical-necessity and peer-review topic hub.
- Mollo: competing MUA experts at trial
- All-In-One: stipulated post-IME records at trial
- Hernandez: the surgeon’s claims and summary judgment
- Forest Drugs: an affirmation that did not answer the IME
For review of a particular New York 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
Keep Reading
More Medical Necessity Analysis
MUA is dangerous
Mollo's 2020 MUA ruling turned on competing expert testimony. Read the actual trial result without treating an expert's safety concerns as a universal rule.
Mar 17, 2021
Another Medical Necessity?
DRD Medical defeated the insurer's motion in 2020. Compare the court's finding of a factual dispute with Jason's original criticism of the affidavit.
Apr 27, 2020
A prima facie case of medical necessity?
Understanding medical necessity proof standards in NY personal injury and no-fault cases. Expert legal analysis from Long Island attorneys. Call 516-750-0595.
Nov 22, 2009
Much ado over something?
Dayan's 2015 surgery appeal required a new trial under the proper burden of proof. It did not direct dismissal or find that the insurer had already prevailed.
Dec 7, 2015
That the testing was necessary to rule out herniations is sufficient to warrant a trial on medical necessity
AP Diagnostic's 2013 MRI ruling: pain, restricted cervical motion and a diagnostic explanation defeated summary dismissal, not established a right to payment.
Oct 20, 2013
A 2007 causation case – affidavit insufficient
Selective's insurer submitted the deficient affidavit; the hospital won. A corrected account of the 2007 no-fault causation and payment ruling.
Apr 27, 2011Frequently Asked Questions
Common Questions About This Topic
4 answers from the firm's New York personal-injury and employment-law practice. Click any question to expand.
Can an insurer admit a peer review report into evidence at a no-fault trial in New York?
Radiology Today bars using the report to prove the truth of the insurer's medical opinion. It separately contemplates producing the report when needed to support an objection that testimony exceeds the denial's basis.
How can an insurer prove lack of medical necessity without the peer review report?
The insurer may present medical expert testimony. Radiology Today required a new trial because the judge stopped the insurer before witnesses testified, based on the mistaken premise that the report first had to be admitted for its truth.
What is the scope of permissible expert testimony at a no-fault trial?
The opinion limits testimony to the denial's basis. It places responsibility on the provider to make an appropriate objection if testimony goes further and, if necessary, produce the peer report.
What is impermissible bolstering in the context of peer review evidence?
Radiology Today says offering the report as proof of lack of necessity may impermissibly bolster the expert's testimony. It does not establish a numerical rule against two experts or make the report inadmissible for every purpose.
Was this article helpful?
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.
