Insurance Australia Limited t/as NRMA Insurance v Cox

[2024] NSWPIC 503

CERTIFICATE OF DETERMINATION OF MEMBER 

CITATION:

Insurance Australia Limited t/as NRMA Insurance v Cox [2024] NSWPIC 503

CLAIMANT:

Pauline Cox

INSURER:

Insurance Australia Limited t/as NRMA Insurance

MEMBER:

Hugh Macken

DATE OF DECISION:

11 September 2024

CATCHWORDS:

MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; settlement approval under section 6.23; left hand injuries; amputation of fingers of the left hand; non-economic loss; partial amputation; limited use of left hand; range of likely assessments of non-economic loss; stabilisation of injuries; Held – settlement approved.

DETERMINATIONS MADE:

CERTIFICATE

SETTLEMENT APPROVAL

Issued under s 6.23 of the Motor Accident Injuries Act 2017

The amount of the claim for damages is approved in the total amount of $300,000.1.     

STATEMENT OF REASONS

INTRODUCTION

1. Pauline Cox (the claimant) is a 63-year-old retired woman who was seriously injured in a motor vehicle accident on 19 August 2023.

2. The claimant is not represented by an Australian Legal Practitioner.

3. The claimant has confirmed that she wishes to accept the insurers offer of $300,000 being compensation for non-economic loss only noting that there is no claim that can be made for economic loss. The claimant has indicated by email dated 9 July 2024 that she accepts the offer of $300,000.

DOCUMENTS CONSIDERED

1. I have considered the documents provided in the application noting that the injury consists primarily of extensive injuries to the claimants left hand which has required complete amputation of one finger and the partial amputation of two others. A photograph of the claimant’s left hand was included in the material.

2. I propose to approve the settlement of this matter.

REASONS

1. The claimant sustained her injures when the vehicle where she was a passenger went off the road striking a rock wall, falling onto its side before eventually becoming completely overturned. The claimant has stated she has no recollection of the matter but assumes her left hand was injured when the front passenger window was broken and her left hand came in contact with the road which had the effect of lacerating and shattering the bones of her left hand which has resulted in the partial amputation and significant damage to it.

2. The claimant’s surgeon Dr Alani performed right fourth metacarpal base ostomy and fourth MC head ray amputation. This aggressive surgery included the revision of RF amputation stump and excision of the end bulb neuroma. This surgery was performed on 14 May 2024 and has stabilised the claimants left hand. Quite clearly, she has very limited use of the left hand although she does still have a capacity for some grasping and capacity for manipulation with her remaining thumb and finger.

3. The claimant resides with her husband. She has three children as well as grandchildren. She previously worked in the education sector, including as a library assistant. She retired in 2016 and has not sought to return to any type of employment since that time.

4. Her husband worked at the Piper Power Station as a Plant Manager and retired in 2020. Other than the injuries she sustained to her left hand, both the claimant and her husband are in good health.

5. The claimant can fairly be described as a remarkably strong and stoic woman. Notwithstanding the devastating injuries she sustained to her left hand she presents as optimistic about her future and accepting of the injuries and disabilities to her left hand.

6. The figure of $300,000 was put by the insurer as an appropriate allowance for non-economic loss noting that this was the only matter which would require assessment given the concession by the insurer that her injuries exceed the 10% whole person impairment (WPI) threshold established by the Motor Accident Injuries Act 2017 which gives rise to the claimant’s entitlement to compensation for non-economic loss.

7. At the assessment conference it was noted that the claimant did have the option of having non-economic loss assessed and the prospect of an assessment of non-economic loss as being higher than that which has been offered by the insurer. This was a figure which she wished to accept so as to conclude the matter and put it behind her.

8. The calculation of non-economic loss is a most in-exact science. The agreed figure of $300,000 for non-economic loss, taking into account, as it does pain and suffering, reduced capacity for pre-accident social sport, domestic and recreational activities and past and ongoing trauma associated with it can, in my view, be fairly described within the range of likely assessments of non-economic loss were the matter to be the subject of an assessment.

9. It follows that I approve the proposed settlement figure of $300,000 noting that the only assessment requiring assessment is non-economic loss and noting that the settlement figure proposed by the insurer and accepted by the claimant is a fair allowance in this matter.

10. I have no hesitation in approving this settlement.

LEGISLATION

1. In making this decision I have considered the following legislation and guidelines:

   ·        Motor Injuries Act 2017, and

   · Motor Accident Injuries Regulation 2017.