Gerling v AAI Limited t/as GIO

The claimant in this case sought a determination regarding the causation of a prolapsed cervix and the assessment of permanent impairment following a motor accident that occurred in 2017. The matter was before a Panel of the Motor Accident Insurance Board, with the defendant being AAI Limited trading as GIO. This case is a continuation of previous disputes between the parties, specifically Gerling (No 1) and Gerling (No 2), where earlier medical disputes and treatment-related issues had already been addressed by different Panels.

The central legal issues that the Panel needed to resolve involved whether the prolapsed cervix was caused by the motor accident and, if so, the correct assessment of permanent impairment related to the urinary tract. The Panel had to consider the temporal link between the motor accident, the claimant's pre-existing condition, and the exacerbation of her condition following the accident. Additionally, the Panel needed to determine if the claimant had satisfied the test of causation as outlined in AAI Ltd v Phillips, which required a clear connection between the accident and the claimed condition.

The Panel found that it was not bound by the findings from previous medical disputes. It accepted that the claimant had been on large amounts of opioids prior to the motor accident, which caused constipation. However, there was a dramatic increase in the consumption of opioid medication following the accident. The relationship between the use of opioid medication and the claimant's back condition was evident from her consistent back complaints, which led to lumbar surgery. The Panel accepted that the prolapsed cervix occurred in the manner recounted by the claimant and was consistent with the history recorded by the treating specialist. Given the temporal link, the excessive use of opioid medication, and the severe lumbar spine condition caused by the motor accident, the Panel concluded that the straining due to constipation led to the prolapse, which was indeed caused by the motor accident.

The Panel ordered that the impairment of the urinary tract be assessed at 12% in accordance with Chapter 11, page 255, paragraph 11.3 of the American Medical Association's Guides to the Evaluation of Permanent Impairment 4th edition (AMA 4).