CGI v Allianz Australia Insurance Limited - [2025] NSWPICMP 652

DETERMINATION OF REVIEW PANEL
CITATION:	CGI v Allianz Australia Insurance Limited [2025] NSWPICMP 652
CLAIMANT:	CGI
INSURER:	Allianz Insurance Australia Limited
REVIEW PANEL
MEMBER:	Alexander Bolton
MEDICAL ASSESSOR:	Steven Yeates
MEDICAL ASSESSOR:	John Baker
DATE OF DECISION:	28 August 2025
CATCHWORDS:	MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; claimant has requested that his particulars be de-identified pursuant to rule 132 of the Personal Injury Commission Rules; review of certificate and reasons of Medical Assessor (MA) finding that the claimant had suffered a threshold injury following diagnosis of an adjustment disorder with anxious mood; claimant had a pre-accident psychiatric history and also criminal offences and drug addiction; following the accident the claimant was able to drive but anxious when driving past the scene of the accident and took steps to avoid this; claimant became socially isolated; claimant’s anxiety with driving activities not evident all the time but was recorded by several medical examiners and was also evident at the time of examination by the Review Panel; while the decision of Lynch v AAI Ltd was referred to and noted by the Review Panel it was evident the claimant was suffering specific situation phobia which is a non-threshold injury; Held – certificate of MA revoked.
DETERMINATIONS MADE:	CERTIFICATE OF DETERMINATION Determination 1. The Panel revokes the certificate of Medical Assessor Verma dated 29 December 2023. 2. The claimant was injured in a motor vehicle accident on 13 April 2021. 3. As a result of the accident the claimant suffered a psychiatric injury of a specific situation phobia to driving. 4. A psychiatric diagnosis of a specific situation phobia to driving is a non-threshold injury.

STATEMENT OF REASONS
INTRODUCTION

This is an application by the claimant for a review of the certificate and reasons of Medical Assessor Verma (the Medical Assessor) dated 29 December 2023.
The Medical Assessor assessed the claimant as having an adjustment disorder with anxious mood and this was a threshold injury for the purposes of the Motor Accident Injuries Act 2017 (the Act).
The claimant requested that his particulars be de-identified. The insurer was requested to inform the Panel about its attitude to this request. Noting that this certificate and reasons will be published, the Panel directs that all references to the claimant be de-identified pursuant to Rule 132 of the Personal Injury Commission Rules.

Bundles of documents

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.
The fact that evidence is not referred to in these reasons does not mean that it has been overlooked and nor is it required that each piece of evidence be mentioned – see WAEE v Minister for Immigration and…

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 652
Decision Date: 28 August 2025

CaseChat Overview and Summary

The claimant in this matter sought a review of the Medical Assessor's (MA) certificate which found that they had suffered a threshold injury following a motor accident. The claimant sought to have their particulars de-identified pursuant to the relevant rules. The dispute was heard in the Personal Injury Commission of the Supreme Court of Queensland. The central legal issue was whether the claimant's post-accident condition, an adjustment disorder with anxious mood, met the threshold for a compensable injury under the Motor Accident Injuries Act 2017.

The court had to determine if the claimant's condition constituted a "serious injury" as defined by the Act. The claimant had a pre-existing psychiatric history, which included criminal offences and drug addiction. Following the accident, the claimant experienced anxiety when driving past the accident site and took steps to avoid this. The claimant also became socially isolated. The Review Panel noted that while the claimant's anxiety with driving activities was not constant, it was recorded by multiple medical examiners and was evident during examinations by the Review Panel. The Review Panel referred to the case of Lynch v AAI Ltd but found that the claimant's situation was distinct, suffering from a specific situation phobia, which is not a threshold injury.

The court found that the claimant's condition did not meet the criteria for a compensable injury. The Review Panel revoked the MA's certificate. The claimant's pre-existing conditions and the specific nature of their post-accident anxiety, while serious, did not amount to a threshold injury under the Act. The claimant's request for de-identification of their particulars was not directly addressed in the judgment, but the claimant's anonymity was preserved to the extent possible under the court's rules.

Orders