McCabes News
A claimant suffers psychological injury when he is threatened by a would be thief of his motor bike. Whether the medical assessor was justified in concluding that this was not a motor accident was answered by the Supreme Court in Bell v Allianz Insurance Australia Ltd.
Judgment date: 18 August 2022
Citation: Bell v Allianz Insurance Australia Ltd [2022] NSWSC 1108
Jurisdiction: Supreme Court of NSW
Before: Basten AJ
On 11 July 2018, a man attempted to steal a Harley-Davidson motorcycle belonging to the Plaintiff in broad daylight from a carpark where it had been temporarily parked while the Plaintiff went into nearby commercial premises.
The Plaintiff heard the person try to start the motorcycle and ran after him. The man was unable to start the engine and was wheeling the motorcycle away. As the Plaintiff closed in, the man saw him and pushed the motorcycle towards the Plaintiff, so that it fell on him, with the foot peg causing a flesh wound to his leg.
A medical dispute came before the Personal Injury Commission and a Certificate was issued on 28 February 2021, determining that of the psychological injuries referred for assessment, “none was related to the motor accident”. The medical assessor’s reasoning was that the threats and intimidatory conduct by the would-be thief did not satisfy the definition of a motor accident. The President’s Delegate dismissed the Plaintiff’s application for review of the decision, not being satisfied that there was reasonable cause to suspect that the medical assessment was incorrect.
The Plaintiff brought proceedings for judicial review of the delegate’s decision.
Basten AJ, found that the delegate failed to address a clearly articulated proposition put forward by the Plaintiff, based on the finding of fact which the delegate accepted, namely that the assessor had failed to complete the exercise of his statutory function. By failing to address that proposition in those circumstances, the delegate had himself failed to exercise the statutory function. That function does not extend to determining the scope of a motor accident, as explained by the Court of Appeal in AAI Limited v State Insurance Regulatory Authority of NSW [2016] NSWCA 368, where McColl stated:
“If, however, in a matter referred to a medical assessor, it is apparent that doubt about whether an incident falls within the statutory definition exists, the medical assessor should make findings about causation by reference to the physical event or events and leave it to the court to determine whether or not the events constitute a “motor accident”.
The court further determined that it is not the delegate’s function to approach the issues raised by the Plaintiff as if determining the correctness or otherwise of the medical assessment. The delegate’s function was only to consider whether there was reasonable cause to suspect error.
The Court set aside the decision of the delegate of the President of the Personal Injury Commission for refusing to refer the Plaintiff’s application for review and directed the President to determine the Plaintiff’s application according to law.
This case reminds us that the function of the delegate of the Personal Injury Commission, when considering applications for review, is to consider whether there is a reasonable cause to suspect error in a medical certificate rather than reach a conclusion by assessing the correctness or otherwise of the medical assessment itself. It also highlights the need for caution on the part of a medical assessor when confronted with issues of causation. It is for the court or a claims assessor, not a medical assessor, to determine, for example, whether certain events constitute a motor accident.