Sparke Helmore's MAD (Motor Accidents Division) Weekly - Issue 3
05 May 2021
The Personal Injury Commission (the Commission) commenced on 1 March 2021, an independent statutory tribunal formed in NSW to resolve disputes between people injured in motor accidents and workplaces, employers and insurers.
To help you navigate the myriad of recent decisions of the Commission, and easily locate those specific to the Motor Accidents Division, each week we are actively reviewing, sourcing from, and providing links to, the case notes on the Australasian Legal Information Institute (AustLII) website.
All legislative provisions are from the Motor Accident Injuries Act 2017 unless otherwise noted.
Merit review
AAI v AAMI Limited [2021] NSWPICMR 4
This dispute concerned whether the issue of impairment of earning capacity was for a merit reviewer to decide or was a medical assessment matter, as well as whether the insurer had given proper notice to the claimant that his benefits would cease.
The Commission confirmed the issue of impairment of earning capacity was a medical assessment matter, and that, based on the evidence before it, the insurer had not given proper notice that benefits would cease. It remitted the matter to a Medical Assessor to decide, but also directed the insurer to consider the issue concerning proper notice.
MOTOR ACCIDENTS - Merit Review – claimant certified fit for pre-injury duties following accident which caused wrist fracture; claimant fell at home, supposedly aggravating injury; claimed statutory benefits following fall; insurer disputed liability for benefits following fall at home and aggravation. Finding: matter of incapacity and whether it relates to injury caused by accident is a medical assessment matter under Schedule 2, Clause 2 of the Act; based on available evidence, insurer may not have given proper notice that benefits would cease; decision set aside, incapacity issue to be determined through medical assessment, insurer to consider whether claimant given proper notice that benefits would cease.
