On Dec. 7, 2009, claimant Donald Ricci, 75, a retiree, was a back seat passenger in a sport utility vehicle traveling south on Lynn Road in Thousand Oaks. The SUV, which was owned and operated by Charles Bartolotta, was rear-ended by a vehicle operated by Crystal Alvarez. Ricci claimed the accident caused neck and back . Ricci sued Alvarez, alleging for negligence. Alvarez ultimately tendered her policy. Ricci then sought further recovery via the supplementary-underinsured-motorist provision of the insurance policy held by the driver of his vehicle, Charles Bartolotta. The policy was administered by State Farm Mutual Automobile Insurance Co. State Farm initial denied the claim, and the matter proceeded to arbitration., Ricci was taken by ambulance to an emergency room, where he underwent a cervical MRI. The results revealed cervical disc bulges with spondylosis at C5-6 and C6-7, unstable spondylolisthesis with disc bulging and severe stenosis at L4-5, and a bulging disc at L2-3. The plaintiff’s treating surgeon recommended that Ricci undergo an anterior lumbar discectomy and fusion at L4-5, which could then complete the stabilization, and a posterior fusion with internal fixation across L4-5. However, Ricci sustained a heart attack post-accident, which prevented him from undergoing the surgical procedures. Ricci claimed he continues to experience lumbar pain, but is focused on recovery from the heart attack. Thus, he claimed he will still require the surgeries at a cost of $60,000 to $70,000, when combined with a two-day hospitalization. Ricci also sought recovery of damages for his pain and suffering. His wife, Mary Cay Ricci, presented a derivative claim, seeking recovery of damages for her loss of consortium. The respondent’s counsel asserted that Mr. Ricci suffered only a cervicothoracic strain and a lumbar strain and that any need for surgical intervention was not caused by sustained in the underlying accident. Thus, counsel contended that the only treatment required for the sustained in the accident consisted of the emergency service evaluation, the emergency room evaluation (with imaging studies), subsequent physician visits, and a course of physical/chiropractic therapy that would not have exceeded a total of 24 visits. Counsel for State Farm did not dispute the claim that the automobile collision was sufficient to cause physical injury, nor did she dispute the claim that Mr. Ricci may be a candidate for lumbar surgery. However, counsel did assert that Mr. Ricci has pre-existing lumbar and that Mrs. Ricci was already reasonably compensated for her loss of consortium claim.