The decision concerned whether the plaintiff's injury met criteria laid out in the Motor Accidents Injuries Act 2017
The NSW Supreme Court recently quashed the decision of a medical assessor's review on the grounds that errors were discovered in the panel's assessment of a personal injury claim.
The proceedings in Adam Briggs v IAG Limited t/as NRMA Insurance [2024] NSWSC 3 stemmed from the pursuit of damages under the Motor Accidents Injuries Act 2017 (NSW) by the plaintiff, Adam Briggs. Briggs had sustained injuries in a 2018 motor vehicle accident.
The central dispute revolved around whether the plaintiff's injury met the "threshold injury" criteria defined by section 1.6 of the act. The court noted that injuries involving the "complete or partial rupture of tendons, ligaments, menisci, or cartilage" are not classified as threshold injuries.
The plaintiff underwent an assessment by a medical assessor, who initially determined the injury to be minor. However, a subsequent review panel concluded that while an annular tear was present, it was not causally linked to the accident. Consequently, the review panel deemed the injuries minor under the act.
Upon judicial review, the first review panel decision was overturned due to procedural fairness concerns. The matter was then assigned to a newly constituted review panel, the second review panel, which reaffirmed the classification of the injuries as "minor." However, a second judicial review quashed the second review panel's decision. The court found that the panel had failed to conduct a fresh assessment and apply the correct causation test.
The matter was allocated again to a newly constituted third review panel. The plaintiff asserted several judicial grounds of review, including the panel's misapplication of the Motor Accident Guidelines and its failure to consider all relevant evidence regarding causation.
The NSW Supreme Court, in its analysis, concurred with the plaintiff on several points. The court noted that the third review panel applied a permanent impairment guideline irrelevant to threshold injury disputes. The court identified this as a jurisdictional error and emphasised the need to adhere to the correct guidelines.
The court also supported the plaintiff's argument that the third review panel asked the wrong question regarding causation, applying an incorrect test that deviates from the balance of probabilities standard required by law.
Furthermore, the court found that the third review panel failed to provide procedural fairness by not notifying the parties before redefining the claimed injury and conducting a selective meta-analysis of scientific studies without allowing the parties to be heard.
Ultimately, the court ruled in favour of the plaintiff, finding errors of law on the face of the record and jurisdictional errors. Accordingly, the court set aside the review panel's decision and remitted the matter to the Personal Injury Commission to be dealt with according to law.
