Park v QBE Insurance (Australia) Ltd - [2025] NSWPICMP 463

DETERMINATION OF REVIEW PANEL
CITATION:	Park v QBE Insurance (Australia) Ltd [2025] NSWPICMP 463
CLAIMANT:	Park
INSURER:	QBE Insurance (Australia) Limited
REVIEW PANEL
MEMBER:	Montgomery-Hribar
MEDICAL ASSESSOR:	Dr Ankur Gupta
MEDICAL ASSESSOR:	Dr Christopher Canaris
DATE OF DECISION:	30 June 2025
CATCHWORDS:	MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); threshold injury dispute; consideration of impact of previous head injury; claimant examined; Held – no previous psychological symptoms or injuries; major depressive disorder with anxious stress caused by the accident; non-threshold injury; MAC confirmed.
DETERMINATIONS MADE:	The Review Panel confirms the certificate of Medical Assessor Samson Roberts dated 14 April 2024.

STATEMENT OF REASONS

INTRODUCTION

On 5 January 2023, Seonyi Park (claimant) was a passenger in a vehicle that was stopped at traffic lights. It was rear ended by another vehicle, causing her vehicle to be pushed into the vehicle stopped in front (accident).
The claimant made a claim for statutory benefits under the Motor Accident Injuries Act 2017 (MAI Act) on QBE Insurance (Australia) Limited (insurer).
A dispute has arisen between the insurer and the claimant as to whether the claimant’s psychological injuries are “threshold injuries” within the meaning and for the purposes of the MAI Act.
The dispute was referred to Medical Assessor Samson Roberts. On 20 March 2024 the claimant was assessed by Medical Assessor Roberts, who issued a certificate on 14 April 2024. The Medical Assessor certified that the injury caused by the accident, being Major Depressive Disorder, is not a threshold injury for the purposes of the MAI Act.
The insurer lodged an application with the Personal Injury Commission (Commission) seeking a review of Medical Assessor Roberts’ assessment under s 7.26 of the MAI Act. On 17 June 2024, a delegate of the President determined there was reasonable cause to suspect that the medical assessment was incorrect in a material respect and referred the application to a review panel.
This review panel (the Panel) has been constituted to conduct a review of Medical Assessor Roberts’ certificate dated 14 April 2024.

LEGISLATIVE FRAMEWORK

Review procedure

Pursuant to Schedule 2 cl 2(e) of the MAI Act, whether the injury caused by the accident is a threshold injury for the purposes of the Act is a medical assessment matter. A medical assessment matter is determined in accordance with Division 7.5 of the MAI Act, at first instance by a Medical Assessor,[1] and on review by a review panel.[2]
[1] Section 7.20, MAI Act.
[2] Section 7.26, MAI Act.
Section 7.26(5A) of the MAI Act provides that a review panel consists of two Medical Assessors and a Member assigned to the Motor Accidents Division of the Commission.
The review of the medical assessment is not limited to a review of only that aspect that is alleged to be incorrect and is to be by way of a new assessment of all matters with which the medical assessment is concerned: s 7.26(6) of the MAI Act. The function of the Medical Assessor…

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: [2025] NSWPICMP 463
Decision Date: 30 June 2025

CaseChat Overview and Summary

The parties in the case were Park and QBE Insurance (Australia) Ltd, where the dispute centred around the classification of an injury sustained by Park in a motor accident and its eligibility under the Motor Accident Injuries Act 2017. The case was heard in a court of relevant jurisdiction. The central issue before the court was whether Park's psychological injury, specifically a major depressive disorder with anxious distress, met the threshold criteria under the Act for compensation. The court had to determine if the injury was severe enough to warrant compensation, considering Park's previous head injury history and the impact it might have on the current injury.

The court considered the statutory framework provided by the Motor Accident Injuries Act 2017, focusing on the criteria for a threshold injury. It examined the nature and extent of Park's psychological injury, the causation of the injury from the motor accident, and the absence of any previous psychological symptoms or injuries. The court also reviewed the Medical Assessment Certificate (MAC) provided by the examining medical practitioner. In doing so, it assessed the impact of the previous head injury on the current psychological condition. After thorough analysis, the court concluded that Park's major depressive disorder with anxious distress was caused by the accident and did not have any significant exacerbation from the previous head injury.

Based on the evidence and the statutory criteria, the court ruled that Park's psychological injury met the threshold for compensation under the Act. The court confirmed the MAC, affirming that the injury was non-threshold and thus eligible for compensation. This decision recognised the severity of Park's current condition, which was a direct result of the motor accident, and rejected any significant influence from the previous head injury on the current psychological state.

Orders