The applicant was injured in a motor vehicle accident and sought statutory accident benefits for caregiving, housekeeping, attendant care, and medical treatments.
The insurer denied most of the claims, citing discrepancies in the evidence and surveillance footage that contradicted the applicant's reported limitations.
The arbitrator found the applicant and her husband lacked credibility, noting significant inconsistencies between their testimony, the submitted invoices, and the surveillance evidence.
The claims for caregiver, housekeeping, and attendant care benefits were dismissed due to insufficient reliable evidence that the expenses were incurred or that the applicant met the test for substantial inability.
The arbitrator partially allowed the claim for medical benefits, awarding $2,384.59 for treatment plans that were deemed reasonable and necessary or were deemed approved due to the insurer's failure to respond.
The claim for a special award was dismissed as the insurer did not unreasonably withhold payments.
