Wannous v QBE Insurance (Australia) Limited

The case of Wannous v QBE Insurance (Australia) Limited involves a dispute concerning the payment of weekly benefits under the Motor Accident Injuries Act 2017. The claimant, Wannous, sought merit review of the defendant's decision to determine her entitlement to weekly benefits. The primary issue before the court was the calculation of the claimant's pre-accident weekly earnings (PAWE) and the interpretation of certain provisions of the Act, specifically Schedule 1, Clause 4. The court had to decide whether there was a change in the claimant's earning circumstances and, if so, when that change occurred. This determination hinged on the interpretation of Clause 4(3), Clause 4(2)(b), and Clause 4(2)(a) of the Act, particularly in relation to the commencement of continuous earnings for a sole trader and the deductibility of business expenses, including GST.

The court considered the evidence presented regarding Wannous's income, including her income as a sole trader, and the impact of the COVID-19 lockdown on her business. It was necessary to ascertain when Wannous began earning continuously and whether her income fluctuations warranted a change in her PAWE calculation. The court also had to determine if the business expenses, including GST, were appropriately deducted in calculating her earnings. The decision hinged on a detailed analysis of the statutory provisions and their application to the facts of Wannous's case.

The court found that the reviewable decision made by QBE Insurance was flawed. The determination of Wannous's PAWE did not correctly apply the statutory provisions. Specifically, the court held that the change in her earning circumstances should have been identified earlier, and the calculation of her PAWE should have accounted for the continuous nature of her earnings from her business. The court also found that the deduction of business expenses, including GST, was not appropriately considered. Consequently, the reviewable decision was set aside, and the matter was remitted for reconsideration in light of the court's findings.

The final orders of the court were to set aside the decision of QBE Insurance regarding the claimant's PAWE and to remit the matter back to the insurer for reassessment in accordance with the court's findings. The court's decision provided clear guidance on the application of the statutory provisions to the specific facts of the case, ensuring that Wannous's entitlement to weekly benefits would be accurately determined upon reassessment.