On January 23, 2007, the New York Appellate Division, Second Department issued an opinion in Long Island Radiology v. Allstate Insurance Co., et al., reversing the lower court decision that held that, contrary to express statutory requirements, a radiology group could recover no-fault benefits from the insurers for services provided, even when the tests provided were not medically necessary, because the radiologist was not the physician who prescribed the treatment.
The Appellate Division held that the New York No-Fault Law limits recovery to "necessary expenses." The court noted that an "accident victim may assign his or her no-fault claim to a medical provider who has provided a medical service" and that an assignee "stands in the shoes" of an assignor. The court concluded: "[s]ince the defense of lack of medical necessity may indisputably be raised by the defendants against the injured party, it is available as against radiologists who accept assignments of no-fault benefits."
Wiley Rein insurance partners Craig A. Berrington and Karalee C. Morell submitted an amicus curiae brief in the case on behalf of the American Insurance Association, National Association of Mutual Insurance Companies, Property Casualty Insurers Association of America and New York Insurance Association, Inc.