2 total
Accident benefits claims dismissed entirely due to applicant's lack of credibility and unproven treatment attendance.
The applicant sought statutory accident benefits, including medical, attendant care, and housekeeping benefits, following a motor vehicle accident.
The insurer denied the benefits, arguing the treatments were not reasonable, necessary, or actually incurred.
The arbitrator dismissed the applicant's claims in their entirety, finding her testimony lacked credibility and was inconsistent with the clinical notes of her regular treating physicians.
The arbitrator drew adverse inferences from the applicant's failure to call treating practitioners or her son, who allegedly provided care, and concluded the claimed services were either not provided or not reasonably required.
Accident benefits application dismissed entirely due to applicant's lack of credibility and material misrepresentations.
The applicant sought various statutory accident benefits, including income replacement, medical, attendant care, and housekeeping benefits, following a motor vehicle accident.
The arbitrator dismissed the application in its entirety, finding the applicant lacked credibility due to numerous inconsistencies, deliberate misrepresentations about his living arrangements, and evidence of symptom exaggeration.
The arbitrator also found that the applicant made a material misrepresentation by failing to notify the insurer that he was residing and working in Illinois, which voided his entitlement to income replacement and housekeeping benefits under section 30(2) of the Schedule.
No co-appearing lawyers found.
No judges found.