On Oct. 4, 2010, claimant Kristy Betz, 35, a home care hospice provider, was driving when she was rear-ended by an underinsured motorist. The collision caused minor damage to both vehicles, and Betz claimed neck and back . Betz filed a claim against the underinsured motorist, alleging the motorist was negligent in the operation of his vehicle by being inattentive. The motorist ultimately agreed to tender his policy limits. Betz then sought further recovery via the supplementary-underinsured-motorist provision of her own insurance policy, which was administered by Arch Insurance Co., Betz claimed she sustained cervical . She initially underwent conservative treatment through November 2011, which provided minor relief. She was advised she was a candidate for cervical disc replacement surgery, but opted to first undergo an epidural injection on Feb. 24, 2012. However, Betz claimed the epidural injection failed to resolve her neck complaints, and she subsequently decided to proceed with surgery. On July 24, 2012, Betz underwent a cervical disc replacement by her treating orthopedic surgeon. Although Betz reported improvement, she still complained of muscle spasms and pain. As a result, in January 2013, she received two series of cervical nerve blocks and underwent radiofrequency ablation. She then received a third series of cervical injections on July 30, 2013, while undergoing chiropractic treatment from February 2013 through October 2013. The claimant’s orthopedic surgeons opined that Betz is a candidate for surgical intervention due to her persistent neck complaints. They recommended a second cervical disc replacement procedure and/or a fusion and sacroiliac joint injections to treat Betz’s persistent lower back complaints. Betz claimed that she became employed part-time as a customer service representative in early 2014 and that she would incur further wage losses, estimated at $8,595.53 if she undergoes the second cervical surgery. Thus, she sought recovery of $77,480 in past wage losses, $8,595.53 in future lost wages, $259,575.25 in past medical expenses, and between $100,000 and $150,000 in future medical costs. Betz’s husband, Richard Betz, 42, a landscaper, presented a derivative claim, seeking recovery of damages for his loss of consortium based on the loss of his wife’s companionship and services, plus emotional related to his wife’s condition. The respondent’s counsel disputed the nature and extent of Mrs. Betz’s and treatment, including the alleged damages related to Mrs. Betz’s past and future surgeries. Counsel asserted that the impact was minor and that Mrs. Betz had pre-existing conditions as the result of three prior motor vehicle accidents. The respondent’s counsel also asserted that Mrs. Betz did not report significant cervical complaints until several months after this accident.