AAI Limited t/as AAMI v Noun

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DETERMINATION OF REVIEW PANEL

CITATION:

AAI Limited t/as AAMI v Noun [2025] NSWPICMP 763

CLAIMANT:

Noaman Noun

INSURER:

AAI Limited trading as AAMI

REVIEW PANEL

MEMBER:

Alexander Bolton

MEDICAL ASSESSOR:

Himanshu Singh

MEDICAL ASSESSOR:

Christopher Canaris

DATE OF DECISION:

3 October 2025

CATCHWORDS:

MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; review of certificate and reasons of Medical Assessor (MA) diagnosing the claimant with a post-traumatic stress disorder which was a non-threshold injury; claimant injured on 23 March 2023 suffering physical and psychiatric disabilities; claimant not being treated at the time of the accident for any psychiatric disability; Review Panel not satisfied that on the day of examination the claimant demonstrated all of the criterion for post-traumatic stress disorder; Held – Review Panel satisfied that the claimant was suffering a persistent depressive disorder; certificate of MA revoked; Review Panel determined the claimant was suffering a non-threshold injury.

DETERMINATIONS MADE:  

CERTIFICATE OF DETERMINATION

Determination

1.     The Panel revokes the certificate of Medical Assessor Sidorov dated 7 May 2024.

2.     As a result of the accident on 23 March 2023, the claimant suffered a persistent depressive disorder.

3.     The claimant has suffered a non-threshold injury.

STATEMENT OF REASONS

INTRODUCTION

  1. This is an application for review by the insurer of a certificate and reasons of Medical Assessor Sidorov (the Medical Assessor) dated 7 May 2024.

  2. The following injuries were referred by the Personal Injury Commission (Commission) for assessment:

    (a)    anxiety;

    (b)    depression, and 

    (c)    post-traumatic stress disorder.

  3. There is a dispute between the claimant and the insurer about whether the injury is a threshold injury under Schedule 2, s 2(e) of the Motor Accident Injuries Act 2017 (the Act).

  4. The Medical Assessor initially found by certificate dated 2 December 2023 the following injury caused by the motor accident:

    (a)    adjustment disorder with mixed anxiety and depressed mood,

    was a threshold injury for the purposes of the Act.

  5. The claimant sought review of that certificate and while the review application was dismissed, the matter was remitted back to the Medical Assessor as an ‘incomplete’ certificate, for him to consider additional clinical records.

  6. By way of further assessment and review of additional clinical records, the Medical Assessor found, by certificate dated 7 May 2024, that the following injury caused by the motor accident:

    (a)    post-traumatic stress disorder,

    was a non-threshold injury for the purposes of the Act.

  7. It is from this certificate that a review is sought by the insurer.

Bundles of documents

  1. The parties have each presented their respective bundles of documents upon which they rely. The Panel have read all the documentation. If a particular document is not referred to by the Panel, this does not mean that the Panel or a Panel Member has not read it, in much the same manner as parties not referring to or not specifically relying on a document in their own bundle and submissions.

  2. The fact that evidence is not referred to in these reasons does not mean it has been overlooked and nor is…

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Details
Case
[2025] NSWPICMP 763
Decision Date

CaseChat Overview and Summary

AAI Limited, trading as AAMI, brought a case against Mr Noun regarding a motor accident that occurred on 23 March 2023. Mr Noun, the claimant, was diagnosed with both physical and psychiatric disabilities following the incident. The primary dispute centred around a certificate issued by a Medical Assessor (MA) that diagnosed the claimant with a post-traumatic stress disorder, classified as a non-threshold injury under the Motor Accident Injuries Act 2017. The claimant had not been undergoing treatment for any psychiatric condition prior to the accident. The Review Panel was tasked with determining the validity of the MA’s diagnosis and whether the claimant genuinely suffered from a non-threshold injury.

The court was required to assess the credibility of the MA’s diagnosis and the claimant's psychiatric condition at the time of the accident. Specifically, the Review Panel had to determine if the claimant met all the criteria for post-traumatic stress disorder during the examination and if the MA's certificate should be upheld. Additionally, the court needed to ascertain whether the claimant suffered from a persistent depressive disorder, which would also qualify as a non-threshold injury under the Act.

Upon review, the Panel found that the claimant did not demonstrate all the necessary criteria for post-traumatic stress disorder on the day of examination, leading to the revocation of the MA’s certificate. However, the Panel concluded that the claimant was indeed suffering from a persistent depressive disorder, which qualified as a non-threshold injury under the Motor Accident Injuries Act 2017. This conclusion resulted in the claimant's entitlement to compensation for his injuries.

The court ordered that the MA's certificate be revoked due to insufficient evidence of post-traumatic stress disorder. Instead, the Review Panel affirmed that the claimant was suffering from a persistent depressive disorder, satisfying the criteria for a non-threshold injury. This determination granted the claimant the right to compensation for his injuries as per the Act.

Orders

Orders of the court

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Background

Background to the litigation

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Evidence

Evidence Before The Court

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Decision

Reasons for decision

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Ratio Decidendi

Legal Principle Established

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