MONTGOMERY and INSURANCE AUSTRALIA LIMITED ACN 000 016 722 TRADING AS NRMA (Motor Accident Injuries)

The case involved the applicant, Montgomery, and the respondent, Insurance Australia Limited, trading as NRMA, concerning a dispute over motor accident injuries. Montgomery sought external review of the respondent's decision to reject liability for defined benefits under the Motor Accident Injuries Act 2019 (MAI Act). The applicant argued that the respondent's decision was flawed and sought reconsideration of the matter. The court had to determine whether evidence admitted under section 197(3) of the MAI Act could be used in the same way as evidence considered by the internal reviewer. The respondent contended that such evidence should only be used for limited purposes, while the applicant argued for broader use. The court examined the statutory framework and found that the review process under the MAI Act was not a judicial review but rather a review on a question of law or fact. The court concluded that evidence admitted under section 197(3) had the same status as evidence considered by the internal reviewer and could be used in the same way.

The court held that the respondent's argument regarding the use of evidence admitted under section 197(3) was misconceived. The court reasoned that the review process was statutory in nature, and the statute determined the scope of the review. The court noted that the MAI Act allowed for additional evidence to be presented in strictly limited circumstances but that such evidence had the same status as evidence considered by the internal reviewer. The court found that there was nothing in the statute that would lead to a different conclusion and that the review process was not a judicial review but rather a review on a question of law or fact. The court also noted that the Explanatory Statement indicated that the review was not a review on the merits, but it did not provide much guidance beyond that. The court concluded that the review process was governed by the phrase "on a question of law or fact" in section 193 of the MAI Act.

The court set aside the respondent's decision to reject liability for defined benefits and remitted the matter to the respondent for reconsideration in accordance with the MAI Act and the relevant Guidelines. The court also ordered that the same provisions of the MAI Act and Guidelines applied to the reconsideration referred to in order 1 and that the same time periods for making the reconsideration decision applied as if order 1 were an application for internal review of the decision to reject liability received on the day after the date of these orders. The court's decision provided clarity on the use of evidence in the review process under the MAI Act and ensured that the review process was conducted in accordance with the statutory framework.