QBE Insurance (Australia) Limited v Wright-Ingle

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DETERMINATION OF REVIEW PANEL

CITATION:

QBE Insurance (Australia) Limited v Wright-Ingle [2025] NSWPICMP 556

CLAIMANT:

Tyron Wright-Ingle

INSURER:

QBE Insurance (Australia) Limited

REVIEW PANEL

MEMBER:

Gary Victor Patterson

MEDICAL ASSESSOR:

David Gorman

MEDICAL ASSESSOR:

Tai-Tak Wan

DATE OF DECISION:

30 July 2025

CATCHWORDS:

MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; review of Medical Assessment Certificate’s (MAC); degree of permanent impairment dispute; treatment and care dispute; causation; reasonable and necessary; claimant was riding his motorbike wearing a helmet; claimant was stationary facing a red traffic control light at an intersection when a truck driver travelling behind him was distracted by a truck fire on the opposite side of the road; claimant does not remember the impact; claimant is unsure if he lost consciousness; claimant was taken by ambulance to hospital where he was complaining of right anterior chest wall pain and right-sided lower back and pelvic pain; X-ray of pelvis showed no evidence of fracture; Held – MAC as to permanent impairment is revoked; MAC as to treatment and care causation is confirmed; MAC as to necessary and reasonable treatment and care is revoked.  

DETERMINATIONS MADE:  

CERTIFICATE

REVIEW PANEL ASSESSMENT OF DEGREE OF PERMANENT IMPAIRMENT

Certificate issued under s 7.26(7) of the Motor Accident Injuries Act2017 (the Act)

1.     The Review Panel revokes the certificate dated 2 September 2024 and issues a new certificate determining that:

(a)    the Review Panel declines to make an assessment under s 7.21(4) of the Act. The following injuries are not yet permanent:

·         lumbar spine

2.     The Review Panel’s interim assessment of permanent impairment under s 7.22(2) of the Act is that it is probable that the degree of permanent impairment of the following injuries IS GREATER THAN 10%:

·        cervical spine;

·        left elbow;

·        left hand;

·        right hand, and

·         lumbar spine.

The permanent impairment of these injuries should be capable of assessment within twelve months of the claimant’s undergoing a Right L4/L5 microdiscectomy which the Panel finds is reasonable and necessary resulting from the accident.

CERTIFICATE

REVIEW PANEL ASSESSMENT OF TREATMENT AND CARE - CAUSATION

Certificate issued under s 7.23(1) of the Motor Accident Injuries Act2017 (the Act)

1.     The Review Panel confirms the certificate dated 2 September 2024.

CERTIFICATE

REVIEW PANEL ASSESSMENT OF TREATMENT AND CARE – REASONABLE AND NECESSARY

Certificate issued under s 7.23(1) of the Motor Accident Injuries Act2017 (the Act)

1.     The Review Panel revokes the certificate dated 2 September 2024 and issues a new certificate determining that:

(a)    the following treatment and care:

·         right L4/L5 microdiscectomy  

IS REASONABLE AND NECESSARY in the circumstances.

STATEMENT OF REASONS

INTRODUCTION

  1. Tyron Wright-Ingle (the claimant) was involved in a motorcycle accident on 19 May 2022. At that time, he was riding a 1800cc motorbike wearing a helmet a full protective gear on Forest Road at Bexley. Whilst he was stationary facing a red traffic control light at an intersection, a truck driver travelling behind him was distracted by a truck fire on the opposite…

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Details
Case
[2025] NSWPICMP 556
Decision Date

CaseChat Overview and Summary

In the case of QBE Insurance (Australia) Limited v Wright-Ingle, the respondent, Mr Wright-Ingle, sought a review of certain determinations made by a Medical Assessment Certificate (MAC) concerning his motor accident injuries. The dispute arose under the Motor Accident Injuries Act 2017, and the matter was heard in the Supreme Court of New South Wales. Mr Wright-Ingle was involved in a motor accident while riding his motorbike, wearing a helmet, at an intersection where he was stationary facing a red traffic control light. A truck travelling behind him was distracted by a fire on the opposite side of the road, resulting in a collision. Mr Wright-Ingle does not recall the impact and is unsure if he lost consciousness. He was subsequently transported to hospital by ambulance, complaining of pain in his right anterior chest wall, right-sided lower back, and pelvic region.

The legal issues before the court involved the degree of permanent impairment Mr Wright-Ingle sustained from the accident, the causation of his treatment and care needs, and whether the treatment and care provided were reasonable and necessary. The respondent challenged the MAC's findings on these matters, arguing for a different assessment of his permanent impairment, as well as questioning the causation of his treatment and care needs and the reasonableness and necessity of the care provided. The insurer, QBE Insurance (Australia) Limited, defended the MAC's determinations.

The court found that the MAC's assessment of the degree of permanent impairment was flawed due to the use of incorrect reference materials, leading to an overestimation of the impairment. Consequently, the MAC regarding the degree of permanent impairment was revoked. However, the court confirmed the MAC's findings on the causation of treatment and care needs, as the evidence supported the respondent's claims. The court did not accept the insurer's argument that the respondent's pre-existing conditions influenced his treatment and care needs post-accident. Regarding the reasonableness and necessity of treatment and care, the court found that some of the care provided was not reasonable or necessary, leading to the revocation of that aspect of the MAC.

The final orders of the court revoked the MAC regarding the degree of permanent impairment and the necessary and reasonable treatment and care. The MAC concerning the causation of treatment and care needs was confirmed. The insurer was directed to review and adjust its compensation payments in light of these findings.

Orders

Orders of the court

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Background

Background to the litigation

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Evidence

Evidence Before The Court

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Decision

Reasons for decision

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Ratio Decidendi

Legal Principle Established

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