CTP Insurance, Insurance

Claim Lacking Substance Dismissed

13 May, 2024

In Brief

  • Section 54(b) of the Personal Injury Commission Act 2020 (PIC Act) empowers a PIC Member to dismiss PIC proceedings where they are frivolous or vexatious or otherwise misconceived or lacking in substance“.
  • Proceedings may be “lacking in substance” where the evidence does not support the claims being made.

Facts

The PIC published its decision in Park v Insurance Australia Limited t/as NRMA Insurance [2024] NSWPIC 225 on 10 May 2024.

The Claimant was injured in a motor accident when he was 74 years of age.

His whole person impairment (WPI) was assessed below 10%. As such, he was not entitled to damages for his non-economic loss.

The Claimant made a belated claim for economic loss based on a claim that he continued to work part-time after his retirement. He provided a supplementary statement saying that he performed casual work in a restaurant and at a mechanical shop. He also stated that he performed handyman work for his friends. He estimated being paid $150 to $200 in cash at the restaurant and $200 in cash at the mechanical shop.

The Claimant’s claim for economic loss was, however, inconsistent with other evidence including the following:

  • The Claimant stated in his Application for Personal Injury Benefits that he was not working.
  • The Claimant stated in his primary statement that he retired in 2014 and received the aged pension.
  • The Claimant provided no supporting documents to corroborate his alleged post-retirement income.
  • The Claimant provided no statements from the restaurant, the mechanical shop or his friends to confirm that they paid him cash in return for his services.
  • The Claimant did not give any history of ongoing work to the medical experts who examined him.
  • The Claimant failed to respond to the insurer’s request for information about his alleged post-retirement income.
  • No records were available to show that the Claimant had disclosed to Centrelink that he was receiving income whilst receiving the aged pension.

The Member’s Reasons

Given the facts outlined above, the PIC Member resolved to dismiss the damages dispute pursuant to s 54(b) of PIC Act 2020 because the claim was lacking in substance.

Key Learnings

The decision in Park is interesting because the PIC Member reviewed the evidence relevant to the belated claim for economic loss and determined that the claim was lacking in substance.

If you have a query relating to any of the information in this case note, or would like to discuss a similar matter of your own, please don’t hesitate to get in touch with CTP Insurance Principal, Peter Hunt, today.

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