AAI Limited t/as GIO v Dordevic - [2025] NSWPICMP 677

DETERMINATION OF REVIEW PANEL
CITATION:	AAI Limited t/as GIO v Dordevic [2025] NSWPICMP 677
CLAIMANT:	Snezana Dordevic
INSURER:	AAI Limited t/as GIO
REVIEW PANEL
MEMBER:	Maurice Castagnet
MEDICAL ASSESSOR:	Mohammed Assem
MEDICAL ASSESSOR:	David Gorman
DATE OF DECISION:	5 September 2025
CATCHWORDS:	MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; claimant’s review of Medical Assessment Certificate (MAC) under section 7.26; permanent impairment dispute; claimant was thrown off her pushbike after being struck by the insured vehicle; referred injuries include cervical spine, thoracic spine, lumbar spine, both shoulders, left wrist, left knee, right hip, and right ankle; claimant was involved in multiple prior and subsequent motor accidents and work injury incidents; complex pre-existing and subsequent history of musculoskeletal injuries; prior cervical spine and lumbar spine pathology; subsequent lumbar spine pathology; assessment of permanent impairment complicated by pre-existing and subsequent impairments in some of the same body regions; clauses 6.31 and 6.34 of the Motor Accident Guidelines considered; re-examination by the Review Panel; Held – original MAC (finding permanent impairment of 14%) revoked; permanent impairment assessed at 9%.
DETERMINATIONS MADE:	CERTIFICATE OF DETERMINATION Issued under s 7.23(1) of the Motor Accident Injuries Act 2017 The issue determined by the Review Panel is whether the degree of permanent impairment of the injured person as a result of the injury caused by the motor accident is greater than 10%. Determination 1. The Review Panel revokes the certificate of Medical Assessor Alan Home dated 14 April 2023. 2. The Review Panel issues a new certificate determining that the following injuries caused by the motor accident give rise to a permanent impairment that is not greater than 10% (9%): · cervical spine; · thoracic spine – resolved; · lumbar spine; · right shoulder; · left shoulder; · left wrist; · left knee; · right hip – resolved, and · right ankle – resolved.

STATEMENT OF REASONS

BACKGROUND

On 19 February 2019, the claimant, Snezana Dordevic, was involved in a motor accident when the bicycle she was riding was hit by a vehicle insured by AAI Limited t/as GIO.
As a result of the accident, the claimant claimed that she sustained physical injuries. She also claimed that she developed psychological injury, although this aspect of her injuries is not the subject of this dispute.
The insurer accepted liability to pay the claimant statutory benefits and damages under the Motor Accident Injuries Act 2017 (the MAI Act). As part of her claim for damages, the claimant pursued damages for non-economic loss. According to s 4.11 of the MAI Act, no damages for non-economic loss may be awarded in respect of injury unless the degree of permanent impairment of the injured person as a result of the injury caused by a motor accident is greater than 10%.
The insurer did not concede that the threshold for permanent impairment of the claimant’s physical injuries caused by the accident, was crossed.
To resolve the dispute, the claimant made an application for a medical assessment by the Personal Injury…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

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Details

Case: [2025] NSWPICMP 677
Decision Date: 5 September 2025

CaseChat Overview and Summary

AAI Limited trading as GIO brought an action against Dragica Dordevic, a claimant who had been injured in a motor accident. The dispute centred on the assessment of Dordevic's permanent impairment following the accident, which involved her being thrown from her bicycle after being struck by GIO's insured vehicle. Dordevic appealed against a Medical Assessment Certificate (MAC) issued under the Motor Accident Injuries Act 2017, which had initially assessed her permanent impairment at 14%. Dordevic argued that this assessment did not adequately account for the full extent of her injuries and the impact of her pre-existing and subsequent injuries. Dordevic's injuries included cervical spine, thoracic spine, lumbar spine, both shoulders, left wrist, left knee, right hip, and right ankle. Dordevic's complex medical history involved multiple prior and subsequent motor accidents and work injury incidents, which complicated the assessment of her permanent impairment.

The court was required to decide whether the original MAC appropriately assessed Dordevic's permanent impairment and whether the Review Panel's re-assessment, which found a permanent impairment of 9%, was more accurate. The court had to consider the statutory framework provided by the Motor Accident Injuries Act 2017, particularly section 7.26, which governs the review of MACs, and the Motor Accident Guidelines, specifically clauses 6.31 and 6.34, which pertain to the assessment of permanent impairment. The court needed to weigh Dordevic's pre-existing and subsequent injuries against the injuries caused by the relevant motor accident to determine the appropriate percentage of permanent impairment.

The court examined the evidence presented by Dordevic and the reasoning behind the original MAC and the Review Panel's findings. The court found that the original MAC did not adequately account for all of Dordevic's injuries and their cumulative impact, particularly in light of her complex medical history. The court accepted the Review Panel's re-assessment, which had considered the entirety of Dordevic's injuries and concluded that her permanent impairment was 9%. The court held that the original MAC was revoked and replaced with the Review Panel's assessment. The court thus determined that Dordevic's permanent impairment was appropriately assessed at 9%.

Orders