AAI Limited t/as GIO v Guevarra
[2025] NSWPIC 205
•6 May 2025
| CERTIFICATE OF DETERMINATION OF MEMBER | |
| CITATION: | AAI Limited t/as GIO v Guevarra [2025] NSWPIC 205 |
| CLAIMANT: | Lalaine Guevarra |
| INSURER: | AAI Limited t/as GIO |
| MEMBER: | Michael Inglis |
| DATE OF DECISION: | 6 May 2025 |
CATCHWORDS: | MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; settlement approval; $3,000.00 in respect of future economic loss only; 25-year-old passenger suffered a cracked front tooth; future dental treatment might be required; Held – settlement complies with clause 7.37 of the Motor Accident Injuries Guidelines, Version 9.3. |
| DETERMINATIONS MADE: | CERTIFICATE The certificate issued under section under s 6.23 of the Motor Accidents Injuries Act 2017. 1. The proposed settlement in the sum of $3,000.00 is approved under s 6.23 (2)(b). 2. The proposed settlement complies with cl 7.37 of the Motor Accident Injuries Guidelines Version 9.3. |
STATEMENT OF REASONS
BACKGROUND
Lalaine Guevara suffered injury in a motor accident on 18 January 2024.
The claimant is now aged 25.
On 18 January 2024, the claimant was travelling to work as a passenger in the insured motor vehicle along Smith Street, Parramatta New South Wales near the intersection of George Street, when the driver braked heavily to avoid a collision with another motor vehicle. As a result of the heavy braking, the claimant hit her face on a glass panel near the rear door of the insured vehicle.
The claimant lodged an Application for Damages on 22 January 2025.
By letter dated 30 December 2024, GIO accepted liability for the claim.
THE RELEVANT LAW
Sections 6.23 (2) and (3) of the Motor Accidents Injuries Act 2017 (MAI Act) requires approval of the settlement and I am not to approve the settlement unless I am satisfied it complies with the requirements of the MAI Act or the Motor Accident Guidelines Version 9.3 (Guidelines) which commenced on 6 December 2024.
Clause 7.37 of the Guidelines states I must be satisfied of the following:
(a) the proposed settlement satisfies the timing requirements under s 6.23 (1) of the Act;
(b) the proposed settlement is just, fair and reasonable and within the range of the likely potential damages assessments for the claim were the matter to be assessed by the Personal Injury Commission (Commission), taking into account the nature and extent of the claim and the injuries, disabilities, impairments and losses sustained by the claimant, and taking into account any proposed reductions or deductions in the proposed settlement;
(c) the claimant understands that they are entitled to be represented in respect of the claim by an Australian legal practitioner, and
(d) the claimant understands in nature and effect of the proposed settlement and is willing to accept the proposed settlement.
PRELIMINARY CONFERENCE
The claimant confirmed at the preliminary conference that the only injury she suffered in the motor vehicle accident was a cracked front tooth (tooth 11). That tooth was restored but the claimant said she continued to suffer ongoing tenderness to bite and sensitivity to cold. She was aware that the treatment to resolve those symptoms was either root canal therapy or replacement of the tooth.
She informed me that presently she does not propose to have any further treatment at least in the near future.
She is aware that although the settlement would be a final settlement in relation to her entitlement to damages her right to claim in respect of further dental treatment was not extinguished by the settlement. This was confirmed by the insurer at the settlement conference.
MEDICAL EVIDENCE
On 24 January 2024 the claimant presented to Dr Keerthana Avalur Venkateshwar, dentist, who diagnosed the chipped front tooth (tooth 11) that was treated with restoration.
Dr Venkateshwar reviewed the claimant on 7 February 2025 and noted no concerns and a relatively normal pulpal response. He informed the claimant that she would still need to monitor the tooth.
Dr Venkateshwar reported on 29 January 2025 that the claimant was advised to be careful when eating hard foods on her front tooth and to continue monitoring tooth 11 due to the risk of flare-up that may lead to root canal therapy in the future.
The insurer arranged for the claimant to be examined by Dr Paul Nichols, dental surgeon who examined the claimant on 14 February 2025. He noted that the “tooth 11 with class 11 horizontal incisal fracture success had successfully repaired and with reversible pulpits due to trauma traumatic occlusion”.
Dr Nichols opined that the claimant still had ongoing symptoms in tooth 11 and required assessment by a specialist endodontist. He said further “however the ongoing symptoms iatrogenic, in that the restoration was not it was not adjusted to fit the occlusion”.
SUBMISSIONS
The insurer made an offer to settle the claimant's claim for damages on 10 March 2025 in the sum of $3,000.00. This amount is apportioned to future loss of earnings in the event that the claimant decides to proceed with further treatment either by way of root canal or tooth replacement.
DOCUMENTS CONSIDERED
Certificate of Dr Keerthana Avalur Venkateshwar dated 24 January 2024.
Report of Dr Paul Nichols dated 14 February 2023.
Clinical notes Dr Keerthana Avalur Venkateshwar and in consideration even if the claimant proceeded to other avenue of the proposed future remedial treatment she would not thereby become entitled to non-economic loss. It seems to me that the allowance for $3,000 to compensate the claimant for any time she might have off work if she decides to act to proceed with that treatment is reasonable.
I am mindful that the settlement does not distinguish the claimant's entitlement to statutory benefits for reasonable and necessary treatment and care expenses under Division 3.4 of the MAI Act.
I note further the pursuant to s 3.40(1) of the MAI Act, the claimant will cease to be entitled to claim any weekly payments of statutory benefits as a result of the settlement.
CONCLUSION
I am satisfied that the proposed settlement of $3,000 is just, fair and reasonable and within the range of likely potential damages assessments if the claim was to proceed to assessment by the Commission taking into account the nature and extent of the claim and the losses sustained by the claim of claimant.
I am satisfied the claimant was aware she could seek legal advice and chose not to retain legal representation.
I am satisfied the claimant understands the binding nature of the settlement and that she will be precluded from making a further claim for damages arising out of the subject accident.
I am satisfied the claimant was willing to accept the proposed settlement and her decision to accept was of her own volition.
The proposed settlement complies with cl 7.37 of the Motor Accident Guidelines Version 9.3.
0
0
0