Insurance Australia Limited t/as NRMA Insurance v Taylor
[2024] NSWPIC 301
•6 June 2024
| CERTIFICATE OF DETERMINATION OF MEMBER | |
| CITATION: | Insurance Australia Limited t/as NRMA Insurance v Taylor [2024] NSWPIC 301 |
| CLAIMANT: | Marion Taylor |
| INSURER: | IAG Limited t/as NRMA Insurance |
| MEMBER: | Elyse White |
| DATE OF DECISION: | 6 June 2024 |
| CATCHWORDS: | MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; settlement approval; claimant T-boned in left passenger’s door when insured driver exited a driveway failing to give way; liability wholly admitted; entitlement only to past and future economic loss and superannuation; claimant 71 years old, was working full time at the date of accident as a textile machinist; total incapacity to work for three months; work capacity limited to one day a week before increasing until forced retirement in June 2023; claimant intended to retire age 75 years; statutory benefits paid; Held – settlement approved in the sum of $115,000; insurer entitled to credit for statutory benefits paid; issued pursuant to section 6.23. |
| DETERMINATIONS MADE: | CERTIFICATE 1. Issued pursuant to 6.23 of the Motor Accident Injuries Act 2017 settlement is approved in the sum of $115,000. 2. The insurer is to receive a credit for $19,821.89. |
STATEMENT OF REASONS
INTRODUCTION
The claimant Ms Marion Taylor was involved in a motor vehicle crash on 18 March 2021.
Ms Taylor as made a claim for common law damages pursuant to the Motor Accident Injuries Act 2017 (Act).
The insurer IAG Limited t/as NRMA Insurance has wholly admitted liability and there is no allegation of contributory negligence.
The damages claim is limited to past and future economic loss.
Ms Taylor and the insurer have reached agreement as to the settlement of the claim for damages.
Because Ms Taylor is not represented by a lawyer, her settlement must be approved in accordance with the Act.
The insurer lodged the application for approval of the settlement, and it was referred to me for consideration.
Ms Taylor was assessed by Dr Andrew Keller, occupational physician on 8 March 2024 for the purpose of a whole person impairment (WPI) assessment. His final assessment was 0% WPI. Both the claimant and insurer have agreed there are no damages for non-economic loss.
RELEVANT LAW
Section 6.23(2) and (3) of the Act requires that the proposed settlement must be approved and, I am not to approve the settlement unless I am satisfied it complies with the requirements of the Act and/or the Motor Accident Guidelines (Guidelines).
Clause 7.37 of the Guidelines states I must be satisfied the proposed settlement is just, fair and reasonable. The proposed settlement must be within the likely potential damages assessment for the claim were the matter to be assessed by a Member of the Personal Injury Commission (Commission). The matters to be taken into account include the nature and extent of the claim and the injuries, disabilities, impairments and losses sustained by
Ms Taylor. I also must take into account any proposed reductions or deductions in the proposed settlement.
Ms Taylor also must understand the nature and effect of the proposed settlement and is willing to accept the amount.
DOCUMENTS CONSIDERED
I have considered the documents provided by the insurer including but not limited to submissions, claim form, correspondence between the claimant and insurer, report by Dr Keller, and clinical notes, imaging, and Prince of Wales Hospital records. Included in the documents are wage payments, payslips, and certificates of fitness. In addition, the insurer provided a deed of release and submissions.
REVIEW OF THE EVIDENCE
Ms Taylor was driving her vehicle south along Bunnerong Road in Kingsford when the insured driver exited his driveway, t-boning the passenger’s side door of Ms Taylor’s car.
Her vehicle was not fitted with airbags and was written off by the insurer.
Although she was able to exit her car, she immediately felt severe pain in her chest region.
She consulted her general practitioner’s medical centre and was referred to Prince of Wales Hospital. They arranged for an X-ray of her chest which was normal. However, on 26 March 2021 a CT scan confirmed a comminuted fracture of the sternum and prior asbestos related pleural disease.
A month later, an ultrasound of her left breast showed a reducing haematoma.
She developed neck pain and attended physiotherapy sessions for six months.
The insurer arranged for Ms Taylor to be examined by Dr Keller. He diagnosed resolved sternal fracture, left breast haematoma and cervical spine soft tissue strain. His concern was although she had made a good recovery physically, development of psychological symptoms meant she could no longer drive to her employment.
At the time of the accident, Ms Taylor was 71 years old. She was working full time as a machinist sewing textiles. She relied on her car to convey her to and from work.
She told me during the preliminary conference that she had lost all confidence to drive. She said she felt her personality had changed.
Her support person during the preliminary conference was Linda. Linda told me, before the accident, her friend was confident, with no issue driving herself around. In particular, she had lost the capacity to drive herself to and from work.
I asked Linda if her observations of Ms Taylor were present all the time or only when she drove. She said her lack of confidence was only present when she was required to drive to or from work.
I was satisfied with this answer that there was not a need to refer Ms Taylor for WPI assessment of her psychological symptoms.
Ms Taylor was earning $729.38 gross per week working 30 hours a week for Moyes Delta Gliders. She was able to work standing 50% and sitting 50% with lifting restriction of up to 8kg. Her role was making gliding harnesses.
She was totally incapacitated to work for three months post-accident. She returned after three months starting with eight hours one day a week.
By January 2022, she had increased her hours to four days a week, eight hours a day.
In order to get to and from work, she relied on fellow workers to transport her. This situation became impossible, and she was too anxious to drive herself. She was forced to retire in June 2023.
She told me the insurer had arranged driving lessons in an attempt to assist her overcome her anxiety when driving. However, she told me although she appreciated the treatment, she felt she has lost confidence and prefers now not to drive.
She told me, but for the accident, she had intended to work to age 75 years when she intended to retire.
I discussed at length with her and Linda the importance of accessing any recommended treatment for both her physical and emotional injuries sustained in the accident. She clearly was unaware of her entitlement and confirmed with me, she would discuss with her doctor the need for reasonable treatment as a result of accident-related injuries.
The insurer has calculated a past and future economic loss based on Ms Taylor’s loss of $752 net per week. They have divided the periods for past loss from the date of the accident to the date of the proposed settlement offer on payments made by her employer for loss of earnings. The amount submitted is round up to $88,492 which includes paid taxes and superannuation.
For the future loss, the calculation is $25,267 to the date of Ms Taylor’s intended retirement in November 2024.
The proposed offer of settlement is $115,000 and a claim is made by the insurer for a credit of $19,821.89 for paid statutory benefits.
SHOULD I APPROVE THE PROPOSED SETTLEMENT
The proposed settlement offered by the insurer for economic loss is $115,000. From this sum, the insurer is entitled to a credit of $19,821.89 for paid statutory benefits.
I am satisfied the proposed settlement offer should be approved.
I am satisfied Ms Taylor will be aware of her rights, once the insurer advises her in writing as to her entitlement to have reasonable treatment expenses paid for the remainder of her life. Whilst the insurer is only liable to pay treatment expenses for five years, thereafter the claim is transferred to Lifetime Care and Support who will be liable for ongoing reasonable treatment expenses and care.
The insurer will not deduct and pay monies to Medicare under the Health and Other Services (Compensation) Act, 1995 (Cwlth) from the settlement sum. In the event a Notice of Charge is raised by Medicare for reasonable and necessary treatment expenses the insurer will pay the charge in addition to the settlement sum.
I am satisfied the proposed settlement is just, fair, and reasonable and within the range of likely potential damages assessments if the claim was to proceed to assessment taking into account the nature and extent of the claim, the injuries, disabilities, impairments, and losses sustained by Ms Taylor.
I am satisfied the amount of $115,000 is fair and just amount and reflects the loss of past and future economic loss. I am satisfied the statutory benefits to be credited to the insurer is reasonable.
I am satisfied Ms Taylor is aware she can seek legal advice but does not wish to do so.
I am satisfied Ms Taylor understands the binding nature of the settlement and that she will be precluded from making a further claim for damages arising out of the accident. I am satisfied Ms Taylor is willing to accept the proposed settlement.
Accordingly, pursuant to s 6.23(2)(b) of the Act I approve the settlement of Ms Taylor’s claim for damages in the sum of $115,000.
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