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Lynch v AAI Limited t/as AAMI

Lynch v AAI Limited t/as AAMI

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Case Copied 13 January 2022 29 min read

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DETERMINATION OF REVIEW PANEL
CITATION:	Lynch v AAI Limited t/as AAMI [2022] NSWPICMP 6
CLAIMANT:	Marina Lynch
INSURER:	AAI Limited t/as AAMI
REVIEW PANEL:	Principal Member John Harris Dr Brian Parsonage Dr Michael Hong
DATE OF DECISION:	13 January 2022
CATCHWORDS:	MOTOR ACCIDENTS- This was a dispute about whether the claimant suffered a non-minor psychological injury in the motor accident; the claimant was re-examined by both Medical Assessors on the Panel who found that the DSM-5 criteria for a Specific Phobia of Driving was satisfied; a diagnosis of an Adjustment Disorder is not made if the stress related disturbance meets the criteria for another mental disorder, which in this case it does i.e. Specific Phobia of Car Travel; for that reason, the Panel did not consider that Ms Lynch was suffering from an ‘Other Specified Trauma and Stressor Related Disorder’ because her ‘Adjustment-like Disorder’ with anxiety satisfied DSM-5 criteria for a Specific Phobia of Driving; the Panel otherwise did not make a diagnosis of adjustment disorder because Ms Lynch’s depressive symptoms satisfied DSM-5 criteria for Major Depressive Disorder at that time and therefore an Adjustment-like Disorder would not be made; secondly, Ms Lynch’s depressive disorder is now in remission; observations that the onus lay on the injured person to establish that they suffered from a non-minor injury for the purposes of an ongoing entitlement to statutory benefits and an entitlement to recover damages; Vines v Djordjevitch applied; observations that the relevant onus was established if the psychological injury (other than an adjustment disorder) was present at any time; Held- the claimant suffered from a Major Depressive Disorder in remission and suffers from a Specific Phobia of Driving; both psychological injuries were a non-minor injury within the meaning of the Motor Accident Injuries Act 2017 and the Regulations.

Medical Assessment – Minor injury

Review Panel Assessment of Minor Injury
Replacement Certificate issued under section 7.23(1) of the Motor Accident Injuries Act 2017

The Review Panel revokes the certificate dated 3 May 2021 and issues a new certificate determining that:

The claimant suffered from a Major Depressive Disorder in remission.
The claimant suffers from a Specific Phobia of Driving.
The psychological injury is a NON-MINOR INJURY for the purposes of the Motor Accident Injuries Act 2017.

REASONS

Background

Ms Marina Lynch (the claimant) suffered injury in a motor accident on 5 June 2019 when another vehicle collided with the claimant’s vehicle.
The insurer insured the owner and driver of the other motor vehicle for liability to pay to Ms Lynch any damages and/or statutory compensation entitlements under the Motor Accident Injuries Act 2017 (the MAI Act).

The present issue is whether the claimant’s injury is classified as a “minor injury” within the meaning of the MAI Act. Pursuant to Schedule 2, clause 2 of the MAI Act, various matters are declared to be a medical assessment matter including whether “the injury caused by the motor accident is a minor injury for the purposes of the Act”.

A medical assessment matter is determined…

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: [2022] NSWPICMP 6
Decision Date: 13 January 2022

CaseChat Overview and Summary

In Lynch v AAI Limited t/as AAMI, the claimant sought to establish that she had suffered a non-minor psychological injury from a motor accident, which would entitle her to ongoing statutory benefits and damages. The dispute was primarily about the nature and existence of these psychological injuries, as well as their classification and impact. The matter was heard in the Civil and Administrative Tribunal of New South Wales.

The central legal issues revolved around whether the claimant, Ms Lynch, had sustained a non-minor psychological injury within the meaning of the Motor Accident Injuries Act 2017. Specifically, the court needed to determine if Ms Lynch's conditions met the criteria for a non-minor injury, and if so, what those conditions were. The Tribunal also had to consider whether these injuries were present at any time post-accident to establish an ongoing entitlement to benefits and damages.

The Tribunal concluded that Ms Lynch suffered from a Major Depressive Disorder that was in remission at the time of the hearing. Additionally, she had a Specific Phobia of Driving, which satisfied the DSM-5 criteria. The Tribunal noted that an adjustment disorder diagnosis was not applicable because Ms Lynch's symptoms met the criteria for a Specific Phobia of Driving. Consequently, the Tribunal found that both conditions constituted non-minor injuries under the Act and Regulations. The decision emphasised that the onus was on the claimant to establish the presence of a non-minor psychological injury, which was successfully demonstrated in this case.

The final orders of the Tribunal confirmed that Ms Lynch was entitled to ongoing statutory benefits and damages for her non-minor psychological injuries. The Tribunal's decision hinged on the clear evidence presented that both the Major Depressive Disorder in remission and the Specific Phobia of Driving were non-minor injuries.

Orders