2 total
Income replacement benefits denied and repayment ordered due to applicant's lack of credibility and misrepresentations.
The applicant sought income replacement benefits following a motor vehicle accident, claiming he was substantially unable to perform his pre-accident job as a retail investigator.
The insurer terminated benefits and sought repayment of an overpayment.
The arbitrator dismissed the applicant's claim, finding he lacked credibility and had misrepresented his pre-accident medical condition, the nature of his injuries, and the reasons for leaving his employment.
The arbitrator concluded the applicant left his job due to poor performance rather than accident-related injuries.
The applicant was ordered to repay $1,140.30 in overpaid benefits.
Interim income replacement benefits awarded where insurer's medical assessment improperly ignored applicant's chronic pain.
The applicant sought interim weekly income replacement benefits (IRBs) and housekeeping benefits following two motor vehicle accidents.
The insurer had terminated benefits based on an insurer's medical examination which concluded the applicant could return to work.
The arbitrator found that the insurer's medical assessment improperly ignored the applicant's pain and relied on flawed heart rate testing to conclude a lack of effort.
Finding that the applicant established a very probable case for ongoing entitlement, the arbitrator ordered the insurer to pay interim IRBs of $400 per week for a 17-week period.
The claim for interim housekeeping benefits was dismissed for lack of evidence.
No co-appearing lawyers found.
No judges found.