Key Takeaway
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.
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 carrier lost this appeal. DRD Medical’s opposing medical evidence created a factual dispute about physical therapy, even though Jason’s original note was sharply critical of the affidavit.
What the court held
DRD Medical v Global Liberty, 2020 NY Slip Op 50385(U), decided April 3, 2020, affirmed the denial of the insurer’s summary-judgment motion on medical necessity. The Appellate Term, First Department, found the parties’ conflicting medical opinions sufficient to require further resolution of that issue.
The opinion is short. It does not reproduce the affidavit or call it inadequate. It also does not award the provider judgment for payment. A factual dispute defeated this motion.
Reading Jason’s objection alongside the result
Jason’s criticism below is his assessment of the opposition papers, not a finding adopted by the court. His disagreement with the outcome did not change it: the insurer’s motion remained denied.
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Compare Mendoza’s unsuccessful physical-therapy rebuttal and Complete Radiology’s successful treating-physician letter. Those decisions reached different results on their records. DRD does not say that any disagreement between two medical professionals automatically prevents summary judgment.
For a comparison with another file, read the actual motion and opposition where available. The published opinion alone cannot tell us what every sentence of DRD’s affidavit said or establish that it matched the evidence in a different carrier’s winning case.
Jason’s original comment
Jason’s original April 2020 comment is preserved below as his criticism of the affidavit. It is not the court’s description of the evidence.
Amazingly, this is no different than cases where the carrier has won except the affidavit of merit in this case has a bunch of verbiage but no substance
Historical note: DRD Medical’s April 2020 decision left a physical-therapy dispute for further resolution; it did not adopt the criticism in this note or establish that every conflict of opinion defeats summary judgment.
Last reviewed: September 2026.
Connect to the Encyclopedia
Start with the medical necessity and peer review hub.
- Normal range of motion and an inadequate rebuttal: Mendoza
- A treating-physician letter that raised a factual issue: Complete Radiology
- Missing justification for additional studies: Neomy
- An IME rebuttal that did not address the examiner: Eastern Star
For review of a particular no-fault dispute, contact the firm with the denial and supporting medical papers.
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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May 22, 2019Frequently Asked Questions
Common Questions About This Topic
5 answers from the firm's New York personal-injury and employment-law practice. Click any question to expand.
What makes a medical opinion strong enough to defeat a no-fault summary judgment motion in New York?
DRD Medical found a factual dispute in the medical opinions submitted about the physical therapy at issue. The opinion does not reproduce those submissions or supply a universal affidavit checklist.
Can conflicting medical opinions alone prevent summary judgment in a no-fault case?
They did in DRD Medical on the record before the court. The decision does not say that any unsupported disagreement defeats a properly supported motion.
What is an 'affidavit of merit' in a no-fault medical necessity dispute?
The original note uses that phrase for the provider's medical opposition. The published DRD opinion refers to conflicting medical opinions without describing a particular document as an affidavit of merit.
What is a peer review in New York no-fault insurance litigation?
It is a medical review of records used to assess the disputed services. This DRD opinion gives little detail about the individual submissions, so it should not be treated as a description of every reviewer's methods.
What are the practical consequences when a no-fault provider submits a weak affidavit of merit?
Insufficient opposition can result in dismissal of the claims at issue, as the linked Mendoza note illustrates. DRD had the opposite procedural outcome: the insurer's medical-necessity motion remained denied.
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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.
