Sam v QBE Insurance (Australia) Limited - [2025] NSWPICMP 722

DETERMINATION OF REVIEW PANEL
CITATION:	Sam v QBE Insurance (Australia) Limited [2025] NSWPICMP 722
CLAIMANT:	Sam Sam
INSURER:	QBE Insurance (Australia) Limited
REVIEW PANEL
MEMBER:	Gary Victor Patterson
MEDICAL ASSESSOR:	Ronald Gill
MEDICAL ASSESSOR:	Christopher Rikard-Bell
DATE OF DECISION:	18 September 2025
CATCHWORDS:	MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; threshold injury disputes; claimant was stationary waiting for a vehicle in front to park; insured vehicle collided with the rear of the claimant’s vehicle; claimant went to hospital later that day initially with few complaints; diagnostic scans were performed and he was sent home for treatment by his GP; claimant was complaining of severe neck pain, pain between his shoulders, and severe lower back injury with numbness/pins and needles extending down both arms; claimant was working as a cleaner; claimant ceased work about two months after the subject accident after suffering a fall at work; Medical Assessor certified that claimant did not suffer a psychological/psychiatric injury as a result of the accident; Held – Review Panel found claimant suffered chronic adjustment disorder secondary to chronic pain with anxiety and depression; certificate revoked.
DETERMINATIONS MADE:	CERTIFICATE REVIEW PANEL ASSESSMENT OF THRESHOLD INJURY *Certificate issued under s 7.23(1) of the Motor Accident Injuries Act2017* (the Act)** 1. The Review Panel revokes the certificate dated 11 April 2024 and issues a new certificate determining that: (a) The following injury caused by the motor accident: (i) chronic adjustment disorder secondary to chronic pain with anxiety and depression, is a THRESHOLD INJURY for the purposes of the Act.

(a)

STATEMENT OF REASONS

INTRODUCTION

On 25 September 2018, Sam Sam (the claimant) was driving home from the RTA office in Bankstown. He was stationary on Belmore Road at Riverwood waiting for a vehicle in front to park. The insured vehicle collided with the rear of the claimant’s vehicle. The accident happened near his home. The other driver said that he would lose his licence if police were called. The vehicle being driven by the claimant was leased by his son. It subsequently was repaired with the bumper bar being replaced.
The claimant went to St George Hospital later that day initially with few complaints. Diagnostic scans were performed, and he was sent home for treatment by his general practitioner. Within six months, the claimant was complaining of severe neck pain, pain between his shoulders, severe lower back injury with numbness/pins and needles extending down both arms. He may have consulted a psychiatrist.
The claimant was born in Beirut of Kuwaiti extraction. His family fled the civil war in Lebanon. The claimant lived in several countries before coming to Australia in 1991/1992. He has been in receipt of the disability support pension for many years. At the time of the subject accident, he was also working as a cleaner. He ceased work about two months after the subject accident after suffering a fall at work.
QBE Insurance (Australia) Limited (the insurer) indemnifies the owner and/or the driver of the at-fault vehicle for liability to…

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 722
Decision Date: 18 September 2025

CaseChat Overview and Summary

Sam brought a claim against QBE Insurance (Australia) Limited under the Motor Accident Injuries Act 2017, following a motor accident in which the insured vehicle collided with the rear of his vehicle. Sam was stationary waiting for a vehicle in front to park at the time of the accident. Initially, Sam went to hospital later that day with few complaints. Diagnostic scans were performed and he was sent home for treatment by his GP. Over time, Sam developed severe neck pain, pain between his shoulders, and a severe lower back injury with numbness and pins and needles extending down both arms. Sam, who was employed as a cleaner, ceased working about two months after the accident following a fall at work. A Medical Assessor certified that Sam did not suffer a psychological or psychiatric injury as a result of the accident.

The Review Panel, however, found that Sam did suffer a chronic adjustment disorder secondary to chronic pain with anxiety and depression. The Panel revoked the certificate issued by the Medical Assessor. The Panel's findings were based on evidence that Sam's psychological condition was a result of the motor accident, despite the initial absence of such complaints. The Panel considered the progression of Sam's symptoms and his cessation of work due to the fall, which was influenced by the injuries sustained in the accident.

The Review Panel carefully weighed the evidence and determined that the claimant's psychological injury was indeed a consequence of the accident. The claimant's initial presentation with few complaints did not negate the eventual development of a chronic adjustment disorder secondary to chronic pain, anxiety, and depression. This finding was pivotal in the Panel's decision to revoke the earlier certification. The decision underscores the importance of ongoing medical assessment and the potential for delayed onset of psychological injuries following motor accidents.

Orders