Dr. Isaac

The applicant was injured in a motor vehicle accident and sought statutory accident benefits, including income replacement benefits, supplementary medical benefits, and attendant care benefits.

The insurer terminated income replacement benefits, alleging the applicant failed to attend a medical examination and was malingering.

The arbitrator found that the insurer improperly terminated benefits before obtaining a Designated Assessment Centre report, entitling the applicant to benefits until the report's release.

However, the arbitrator concluded the applicant grossly exaggerated his physical and cognitive symptoms, relying on surveillance evidence and medical inconsistencies, and denied ongoing income replacement benefits.

The arbitrator also awarded limited supplementary medical and attendant care benefits, and a special award due to the insurer's unreasonable delay in initial payments and refusal to fund certain treatments.