West Tremont Med. Diagnostics, P.C. v. GEICO

In West Tremont Med. Diagnostics, P.C. v. GEICO (8 Misc 3d 423, 795 NYS2d 840 [Civ Ct, Richmond County, McMahon, J.]), which was decided after trial, the court found that the defendant's expert testified unequivocally that "the MRIs were performed unnecessarily." (West Tremont at 425.) Notwithstanding that finding, the court held that defendant had not met its burden of proof to establish that the MRIs were medically unnecessary. In reaching this anomalous conclusion, the court cited the testimony of defendant's expert who testified that plaintiff diagnostic center was "not the entity that determines what test is necessary for the patient to undergo." (Id. at 427.) The court then went on to hold that the defense of medical necessity "should not be available" against the plaintiff since it "does not make an independent medical evaluation of the patient." (Id.) The court held that this result is consistent with "the purpose and intent of the no-fault benefits statute which is expedient payment of benefits to automobile accident victims." (Id.)