Key Takeaway
Forest Drugs rejected a particular medical affirmation in 2018. Read the IME evidence and inadequate rebuttal without adding a universal examination rule.
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.
Forest Drugs lost because its opposition did not rebut the insurer’s supported IME opinion. The Appellate Term reversed the partial denial of summary judgment and dismissed the complaint.
Historical note: Forest Drugs (2018) rejected opposition that lacked an examination and a meaningful response to the IME; the decision does not say every records-based medical opinion is inadmissible.
Last reviewed: September 2026.
In Forest Drugs v Global Liberty, decided November 29, 2018, the insurer proved timely denials supported by its orthopedist’s affirmed IME report. The report explained the conclusion that the injuries had resolved and no further treatment was needed.
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The provider’s medical affirmation was not based on an examination and did not meaningfully answer the examining doctor’s findings. The court also found that subjective pain complaints did not overcome the objective tests described in the IME.
Those were the defects in this opposition. The opinion does not announce that every records-based opinion is inadmissible, or that any doctor who personally examines a patient necessarily supplies sufficient rebuttal. The medical explanation still has to address the evidence offered on the motion.
Connect to the Encyclopedia
Start with the medical-necessity and peer-review topic hub.
- Throgs Neck: inadequate opposition to an IME-based motion
- Total Equipment: DME supplied after an IME cutoff
- Hernandez: the surgeon’s claims and summary judgment
- Radiology Today: peer reports and live trial testimony
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
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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.
