The Applicant was injured in a motor vehicle accident and received weekly income benefits until the Insurer terminated them.
The Applicant sought ongoing benefits, while the Insurer sought repayment of benefits paid, alleging fraud.
The arbitrator found that the Applicant was capable of working in his family cleaning business and had exaggerated his injuries, as evidenced by surveillance video and inconsistent testimony.
The arbitrator concluded the Applicant did not suffer a substantial inability to perform his essential tasks and ordered him to repay $36,474.84 in benefits obtained through fraud.
