Sultan v QBE Insurance (Australia) Ltd - [2025] NSWPICMP 487

DETERMINATION OF REVIEW PANEL
CITATION:	Sultan v QBE Insurance (Australia) Ltd [2025] NSWPICMP 487
CLAIMANT:	Faisal Sultan
INSURER:	QBE Insurance (Australia) Ltd
REVIEW PANEL
MEMBER:	Gary Victor Patterson
MEDICAL ASSESSOR:	Dr Les Barnsley
MEDICAL ASSESSOR:	Dr Shane Moloney
DATE OF DECISION:	5 July 2025
CATCHWORDS:	MOTOR ACCIDENTS – Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); assessment of threshold injury; claimant driving car at low speed when insured vehicle pulled out and collided with left front door; claimant’s mother injured and hospitalised; claimant walked home; claimant alleges injuries to cervical and lumbar spine and both shoulders; Medical Assessor certified cervical spine, lumbar spine and both shoulder injuries as soft-tissue threshold injuries; Review Panel found right shoulder labral tear caused by accident applying principles of causation; Review Panel found insufficient evidence to determine if left shoulder injury threshold or non-threshold due to absence of relevant imaging; Held – MAC revoked.
DETERMINATIONS MADE:	1. The Review Panel revokes the certificate of Medical Assessor David McGrath dated 29 June 2024 and issues a new certificate determining that: (a) the following injury caused by the motor accident: · cervical spine – soft tissue injury, and · lumbar spine – soft tissue injury, is a THRESHOLD INJURY for the purposes of the Act. (b) the following injury caused by the motor accident: · right shoulder – right labral tear, is a NON-THRESHOLD INJURY for the purposes of the Act, and there is insufficient evidence for the Panel to determine if the left shoulder injury is a threshold injury or a non-threshold injury for the purposes of the Act.

STATEMENT OF REASONS

INTRODUCTION

Faisal Sultan (the claimant) was driving his new BMW sports car along Foothills Road in Balgownie. He says he was travelling at a speed of 30 to 40kmph. His mother was the front-seat passenger. The insured vehicle was parked on the side of the road. It suddenly pulled out in front of the claimant’s vehicle which was impacted on the left side at the level of the front door. All 12 airbags in the claimant’s vehicle deployed. Ambulance and Police Officers attended. The claimant’s mother was taken to a hospital but he walked home a short distance.
The claimant alleges that he suffered injuries to his cervical and lumbar spine, as well as both shoulders, in the subject motor accident.
QBE (the insurer) identifies the owner and/or the driver of the at-fault vehicle for liability to pay to the claimant any damages and/or statutory compensation benefits under the Motor Accident Injuries Act 2017 (the Act).
The insurer denied liability to pay statutory benefits beyond 26 weeks on the basis that all of the claimant’s alleged injuries relevantly are threshold injuries for the purposes of the Act.

ASSESSMENT UNDER REVIEW

As there is a dispute between the parties about whether the injury caused by the motor accident is a threshold injury under Schedule 2, cl 2(e) of the Act, the claimant was referred by the Commission to Medical Assessor David…

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.

Keep reading for free

Create a free CaseChat account to read Sultan v QBE Insurance (Australia) Ltd and more:

Read every judgment in full
Ask AI and get answers linked to paragraphs
See how each paragraph was cited in later cases
Download judgments as PDF or Word

Continue with Google

One click creates your free account or signs you in.

By continuing you agree to the Terms and Privacy Policy.

Details

Case: [2025] NSWPICMP 487
Decision Date: 5 July 2025

CaseChat Overview and Summary

Sultan brought an action against QBE Insurance (Australia) Ltd seeking compensation for injuries sustained in a motor accident. The claimant was driving at a low speed when another vehicle pulled out in front of them, causing a collision with the left front door. The claimant's mother, who was a passenger, was injured and hospitalised. The claimant walked home and subsequently alleged injuries to the cervical and lumbar spine and both shoulders. A Medical Assessor certified the injuries to the cervical spine, lumbar spine and both shoulders as soft-tissue threshold injuries. Sultan sought a review of the Medical Assessment Certificate under the Motor Accidents Injuries Act 2017. The Review Panel found that the right shoulder labral tear was caused by the accident and revoked the Medical Assessment Certificate in relation to that injury. However, the Review Panel found insufficient evidence to determine if the left shoulder injury was a threshold or non-threshold injury due to the absence of relevant imaging.

The legal issues in this case centred on the interpretation of the Motor Accidents Injuries Act 2017 and the assessment of the threshold injury. The claimant argued that the Review Panel's decision to revoke the Medical Assessment Certificate in relation to the right shoulder injury was incorrect and that the left shoulder injury was also a threshold injury. The insurer argued that the Review Panel's decision was correct and that there was insufficient evidence to determine if the left shoulder injury was a threshold injury.

The court found that the Review Panel's decision to revoke the Medical Assessment Certificate in relation to the right shoulder injury was correct. The court held that the principles of causation applied by the Review Panel were consistent with the statutory provisions and that the Review Panel's findings were supported by the evidence. The court also found that there was insufficient evidence to determine if the left shoulder injury was a threshold injury due to the absence of relevant imaging. The court held that the Review Panel's decision in this respect was also correct.

The court revoked the Medical Assessment Certificate in relation to the right shoulder injury and upheld the Review Panel's decision in relation to the left shoulder injury. The claimant's claim for compensation for the right shoulder injury was therefore successful, but the claim for compensation for the left shoulder injury was dismissed. The court did not make any orders in relation to the cervical and lumbar spine injuries as they were not before the court.

Orders