AAI Limited t/as GIO v Morgan
[2024] NSWPIC 86
•27 February 2024
| CERTIFICATE OF DETERMINATION OF MEMBER | |
| CITATION: | AAI Limited t/as GIO v Morgan [2024] NSWPIC 86 |
| CLAIMANT: | Jennifer Morgan |
| INSURER: | AAI Limited t/as GIO |
| MEMBER: | Elyse White |
| DATE OF DECISION: | 27 February 2024 |
| CATCHWORDS: | MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; claimant involved in an accident whilst entering an intersection and sustained injuries to her ribs and back; whole person impairment assessment not greater than 10%; claimant developed anxiety; otherwise made a good recovery from injuries; ongoing back and psychological symptoms; proposed settlement includes past and future economic loss; claimant been retired for years and in receipt of disability benefit; proposed settlement will net the claimant $20,000 subject to a Centrelink clearance; ongoing entitlement to reasonable future treatment for accident-related injuries; Held – proposed settlement approved under section 6.23(2)(b); proposed settlement complies with clause 7.38 of the Motor Accident Injuries Guidelines 2017. |
| DETERMINATIONS MADE: | CERTIFICATE 1. The propsoed settlement is approved under s 6.23(2)(b) of the Motor Accident Injuries Act 2017. 2. The proposed settlement complies with cl 7.38 of the Motor Accident Guidelines 2017. |
STATEMENT OF REASONS
INTRODUCTION
The claimant, Ms Jennifer Morgan, was involved in a motor vehicle crash on 6 July 2019. Amongst other minor injuries, she sustained fractured ribs and developed psychological symptoms.
Ms Morgan has made a claim against AAI Limited t/as GIO, the insurer.
The insurer wholly admitted liability for the claim for common law damages.
Pursuant to the Motor Accident Injuries Act 2017 (MAI Act), the insurer has accepted that
Ms Morgan is entitled to the payment of reasonable treatment and care for the rest of her life for her accident caused injuries.
Ms Morgan and the insurer have reached agreement as to settlement of the claim for damages.
Because Ms Morgan is not legally represented, her settlement must be approved in accordance with the MAI Act.
The insurer lodged the application for approval of the settlement, and it was referred to me for consideration.
The insurer has conceded Ms Morgan is entitled to damages for past and future economic loss.
THE RELEVANT LAW
Section 6.23(2) and (3) of the 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 (Guidelines).
Clause 7.37 of the Guidelines states I must be satisfied that the proposed settlement is just, fair and reasonable and within the range of likely potential damages that would be assessed by a member taking into account the nature and extent of the claim having regard to the claimant’s injuries, disabilities, impairments, and losses sustained taking into consideration any deductions in the proposed settlement. Also, the claimant must understand the nature and effect of the settlement.
DOCUMENTS CONSIDERED
I have considered the totality of the material contained in the insurer’s submission and attachments. These included but not limited to medical reports by Drs Giblin, Newlyn and Meakin. I have also considered the clinical records, ambulance report, certificates of capacity and settlement documentation.
REVIEW OF THE EVIDENCE
At the time of this accident, Ms Morgan was 61 years old. She is now 65 years old. She is retired leaving her job at Coles in 2001. She has been in receipt of a disability pension from around 2012 to 2013, due to a low back injury.
The accident occurred at the intersection of Spencer and Alice Streets in Rooty Hill. The insured driver collided with Ms Morgan’s vehicle trapping her inside for over half an hour.
The ambulance attended the scene and transported her to Westmead Hospital where she was admitted for a couple of days. She was treated for severe pain from rib fractures and non-displaced right L4 transverse process fracture.
She was discharged from Westmead Hospital with pain medication and into the care of her general practitioner.
As part of her treatment she consulted with Dr Matthew Giblin, orthopaedic surgeon. The doctor arranged for her to undergo lumber facet blocks and encouraged her to reduce the medication and increase her exercise program.
As Ms Morgan developed a post-traumatic stress disorder, she underwent counselling from psychologist Dr Bandaranayake.
The insurer arranged for Ms Morgan to be assessed by psychiatrist Dr Thomas Newlyn. The doctor diagnosed post-traumatic stress disorder which was in partial remission. Dr Newlyn expected a complete recovery. The doctor assessed whole person impairment (WPI) at 3%.
Orthopaedic surgeon Dr Ian Meakin was briefed by the insurer to provide an opinion on the claimant’s accident-related injuries and assessment of WPI. The doctor found the rib and neck injuries had resolved and the WPI of Ms Morgan’s lumber spine he assessed as 5%.
THE PROPOSED SETTLEMENT
The proposed settlement is made up of a buffer allowance of $10,000 for past economic loss of earning capacity and a buffer allowance of $10,000 for future economic loss of earning capacity.
Subject to a clearance from Centrelink, there are no deductions from these sums.
As Ms Morgan has not been assessed for a WPI greater than 10%, she is not entitled to damages for non-economic loss.
During the preliminary conference with Ms Morgan and Ms Hill, I asked Ms Morgan if she understood the consequences of the approval. She confirmed she did and accepted if approved, the settlement amount is final, and she cannot lodge a future claim for damages for accident-related injuries.
I reminded her she is entitled to reasonable treatment expenses for accident-related injuries. She shared with me her anxiety when driving and felt further counselling may assist her.
I encouraged her to seek medical advice and follow any recommendations made for treatment.
SHOULD I APPROVE THE PROPOSED SETTLEMENT
I am satisfied the proposed settlement should be approved.
The amount is within the likely range of potential damages that would be assessed by a member considering the nature and extent of Ms Morgan’s claim.
The proposed settlement is just, fair and reasonable. I have had regard to Ms Morgan’s injuries, disabilities, impairments and losses and I have taken into consideration that there are no deductions, subject to the Centrelink clearance.
Ms Morgan understood the nature and effect of the settlement.
I approve the proposed settlement of this claim in the sum of $20,000 and I am satisfied that the settlement complies with the applicable requirements of the MAI Act and Guidelines.
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