The applicants, a husband and wife, claimed statutory accident benefits following three motor vehicle accidents in late 1992.
The insurer terminated benefits and sought repayment, alleging the claims were fraudulent and the symptoms exaggerated.
The arbitrator found the applicants were not credible, noting significant inconsistencies in their evidence regarding their business, prior medical history, and post-accident activities.
Medical and surveillance evidence demonstrated that the husband was malingering and his psychological issues predated the accidents, while the wife had concealed her ongoing college attendance and prior accident history from her doctors.
The arbitrator dismissed the applicants' claims for ongoing weekly income benefits, housekeeping, and visitor expenses, and ordered both applicants to repay all benefits previously received, with interest, pursuant to section 27 of the Schedule.
