Stephens v Insurance Australia Limited t/as NRMA Insurance

In the case of Stephens v Insurance Australia Limited t/as NRMA Insurance, the claimant sought to challenge the insurer’s decision to cease weekly benefits under s 3.13(1) of the Motor Accident Injuries Act 2017. The claimant, who had been receiving weekly benefits following a motor accident, reached the age of 66 years and 6 months in May 2023, and 12 months later, the insurer decided to cease her weekly payments as of 20 June 2024. The claimant argued that she had not reached her “retiring age” for the purposes of s 3.13(1) because she would not satisfy the means test for the aged pension. The insurer maintained that the cessation of payments was mandatory once the claimant reached the qualifying age. The dispute centered on whether the insurer was entitled to stop weekly payments under s 3.13(1) once 12 months had elapsed since the claimant reached the age of 66 years and 6 months.

The court had to determine the proper interpretation of the term “retiring age” in s 3.13(1) of the MAI Act and whether it required an assessment of all other qualifying requirements for the aged pension, as the claimant argued, or merely the meeting of the qualifying age as the insurer contended. The court also considered whether the insurer had to provide advice on the potential impact of s 3.13(1) on the claimant’s benefits before ceasing payments. The court concluded that the definition of “retiring age” under s 3.13(1) was solely concerned with the claimant meeting the qualifying age requirement for the age pension, without considering other qualifying criteria. Additionally, the court found that the insurer was not obligated to provide advice on statutory provisions that might affect the claimant’s entitlement to benefits. The court further held that the wording of s 3.13(1) was mandatory, imposing an obligation on the insurer to cease payments once the specified period had elapsed.

The court confirmed the insurer’s decision to cease weekly benefits under s 3.13(1) of the MAI Act. The court found that the insurer was not required to consider all other qualifying requirements for the aged pension when determining “retiring age” for the purposes of the MAI Act. It was sufficient that the claimant met the qualifying age. The court also held that the insurer was not under an obligation to provide advice on the impact of s 3.13(1) on the claimant’s entitlement to benefits. The claimant was, however, entitled to an additional four weeks of benefits due to the insurer issuing the notice of cessation of benefits late.