Insurance Australia Limited t/as NRMA Insurance v BKA

In the case of Insurance Australia Limited trading as NRMA Insurance v BKA, the parties were involved in a dispute regarding compensation for a claimant who experienced two motor accidents ten months apart. The claimant had a pre-existing psychiatric condition and was diagnosed with chronic and severe post-traumatic stress disorder and major depressive disorder following the first accident. The Motor Accidents Compensation Act 1999 provided the legislative framework for the dispute. The central legal issues revolved around the extent to which the claimant's psychological injuries were caused by the first accident or the subsequent near miss, and the necessity and reasonableness of the treatments and care provided.

The court was required to decide whether the claimant's psychiatric condition and psychological injury were caused by the first accident, and if so, the degree of permanent impairment attributable to that accident. The court also had to determine whether the treatments and care provided to the claimant were reasonable and necessary consequences of her psychological injury. The court reviewed the evidence and submissions, including the claimant's evidence at the re-examination, the Occupational Therapist report, and other relevant evidence. The court found that the claimant's psychological condition and injury were caused by the first accident, and that the degree of permanent impairment was 26%.

In its determination, the court followed the principles set out in the cases of Slade v Insurance Australia Ltd trading as NRMA and State Government Insurance Commission v Oakley. The court found that the injury or impairment resulting from the subsequent incident (the near miss) was treated as caused by the first motor accident. The court also found that all previous psychiatric, psychological, pharmacological and general practitioner treatments did relate to the first motor accident and were reasonable and necessary. The court determined that varying hours of past and future personal and domestic assistance have been and continue to be reasonable and necessary as a consequence of the claimant's psychological injury.

The court's final orders set aside the original medical certificate and the previous Medical Review Panel certificate, and remitted the case to the Commission for reconsideration. The court also reviewed the reconsideration and determined that ongoing psychiatric review will be required on a 6 monthly basis, and that ongoing weekly psychological consultations are not necessary. The court found that admission to an inpatient PTSD treatment program is not necessary due to the time that has elapsed since the subject motor accident. The court also found that gratuitous personal and domestic assistance is necessary, but that the hours claimed were excessive. The court ordered that BKA would require less personal and domestic assistance for a period between the first and second accident.