Legal Bulletin No. 252
This bulletin was issued on 20 March 2026
Issued 20 March 2026
Welcome to the two hundred and fifty-second edition of the Personal Injury Commission’s Legal Bulletin. Please see here for details about the legal citations used for the Commission’s decisions. The decisions listed below are now available on AustLII and will be available shortly, on Jade and Lexis Nexis. Any legislative updates are provided at the base of the Bulletin.
Presidential Member Decisions
Workers compensation; application for redaction or de-identification under rule 132 of the Personal Injury Commission Rules 2021; pursuant to rule 6 of the Personal Injury Commission Rules 2021, I dispense with the requirement in rule 132(3)(c) that this application be made within seven days of the decision being issued; I extend time for the applicant to make an application under rule 132 to Friday 6 March 2026; pursuant to rule 132, I direct that the names of the appellant, the respondent and the Director of the Respondent referred to in Decisions No 1 and No 2 be de-identified.
Decision date: 10 March 2026| Before: President Judge Phillips
Motor Accidents non-Presidential Member Decisions
Botros v Allianz Australia Insurance Limited [2026] NSWPIC 72
Motor Accident Injuries Act 2017; application for damages; claimant’s application for exemption under section 7.34(1)(b); late claim pursuant to section 6.14; the Personal Injury Commission’s (Commission) earlier decision determined that the claimant did not have a full and satisfactory explanation for the delay; Gudelj v Motor Accidents Authority of New South Wales considered; consideration and application of rule 99 of the Personal Injury Commission Rules 2021 and objects as set out in section 3 of the Personal Injury Commission Act 2020; Held – claim is not suitable for assessment by Commission based on preliminary assessment; recommendation that claim be exempt; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 6 February 2026 | Member: Bianca Montgomery-Hribar
Reischl v AAI Limited t/as GIO [2026] NSWPIC 74
Motor Accident Injuries Act 2017; claimant’s application for exemption from assessment under section 7.34(1)(b) consented to by insurer; factual and legal issues relating to Part 3 of the Civil Liability Act 2022; complex legal issues; multiple lay and expert witnesses likely to be required to give evidence; hearing will take a number of days; potential for duplication of work and costs; Held – claim not suitable for assessment by the Personal Injury Commission; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 9 February 2026 | Senior Member: Brett Williams
Shears v QBE Insurance (Australia) Limited [2026] NSWPIC 110
Motor Accident Injuries Act 2017; discretionary exemption application by claimant and insurer consented; basis not suitable; liability denied; claim involves complex liability, fault and causation, factual issues; SafeWork concurrent Industrial Court proceedings; multiple non CTP- parties proceedings likely, Government Information (Public Access) Act 2009 request refused until Industrial Court of NSW proceedings are concluded; multiple proceedings against three non-CTP parties be heard together; rules 99(3)(a), (b) and (d) of the Personal Injury Commission Rules 2021; other factors include length of hearing, number of witnesses to be called and subpoena likely, one forum for all matters; Held – claim not suitable for assessment at the Personal Injury Commission pursuant to section 7.34 (1)(b); recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 19 February 2026 | Member: Shana Radnan
Insurance Australia Limited t/as NRMA Insurance v Habibi [2026] NSWPIC 119
Motor Accident Injuries Act 2017; insurer’s application for exemption under section 7.34(1)(b) opposed by the claimant; insurer alleges claimant made false and misleading statements about the circumstances in which accident occurred; lay and expert witnesses likely to be required to give evidence; hearing will take a number of days; potential for duplication of work and costs; IAG Limited t/a NRMA Insurance v Khaled & Ors, Insurance Australia Limited t/as NRMA Insurance v Banos, Insurance Australia Limited t/as NRMA Insurance Limited v Milton, and Nguyen v Tran applied; Held – evidence of witnesses should be tested under oath in a forum in which they will have all the rights and protections afforded by the Evidence Act 1995; claim should be determined in a forum in which the parties can compel witnesses to give evidence; real prospect that the proceedings would, if assessed by the Personal Injury Commission (Commission), be heard again in the District Court, with associated delay and expense; claim not suitable for assessment by the Commission; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 25 February 2026 | Senior Member: Brett Williams
Camacho v AAI Limited t/as GIO [2026] NSWPIC 131
Motor Accident Injuries Act 2017; application of section 7.34(1)(b) and(c); correction of misidentified defendant in proceedings; matter previously exempted but requiring further recommendation to correct technical error; proceedings against third-party; claim of negligence against operator of building site; injury caused by forklift pushing gate against claimant; Held – recommendation that matter is not suitable for assessment by the Personal Injury Commission; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 2 March 2026| Member: Hugh Macken
Solomon v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 150
Motor Accident Injuries Act 2017; sections 3.11 and 3.28; claimant riding motorcycle on country road behind Toyota Hilux and trailer; claimant no recollection of accident; Hilux slowed and stopped to avoid approaching unidentified vehicle which swerved to avoid goanna; claimant collided with trailer; AAI Limited t/as GIO v Evic applied; claimant failed to maintain a safe distance, to keep a proper lookout and failed to take evasive action; unidentified driver failed to take reasonable care in swerving onto incorrect side of road; driver of Hilux failed to take reasonable care in failing to move vehicle off the road before stopping; Podrebersek v Australian Iron and Steel considered; contributory negligence of claimant assessed at 60%; Held – claimant not wholly or mostly at fault for the accident.
Decision date: 4 March 2026 | Senior Member: Susan McTegg
Park v Allianz Australia Insurance Limited [2026] NSWPIC 152
Motor Accident Injuries Act 2017; miscellaneous claims assessment; pedestrian struck by passing vehicle after exiting parked car and attempting to cross residential street; claimant suffered fracture to base of left fifth metatarsal; insurer determined claimant wholly at fault and statutory benefits would cease after 52 weeks; dispute as to whether the motor accident was caused wholly or mostly by the claimant’s fault for the purposes of sections 3.11 and 3.28; competing accounts; insured driver gave oral evidence treated with caution due to internal inconsistencies in driver’s account; mechanism of injury and side-impact evidence supported inference that claimant entered the vehicle’s path as it was already passing; comparative responsibility assessed having regard to culpability and causal potency; Held – claimant’s conduct constituted the dominant cause of the accident; contributory negligence assessed at 70%; accident caused wholly or mostly by the fault of the claimant within the meaning of sections 3.11 and 3.28.
Decision date: 5 March 2026 | Member: Bridie Nolan
Petkovic v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 153
Motor Accident Injuries Act 2017; miscellaneous claims assessment; single vehicle motorcycle accident; rider approached crest of hill and encountered banked traffic beyond crest; claimant braked heavily causing front wheel to lock and motorcycle to skid and overturn; claimant contended restricted visibility and road configuration prevented earlier perception of the hazard; restricted visibility required a reasonable rider to moderate speed and maintain control so as to respond safely to foreseeable traffic conditions beyond the crest; accident caused by claimant’s failure to regulate speed and control before reaching the crest; no evidence of involvement or fault of another road user; Held – motor accident caused wholly by the fault of the claimant for the purposes of sections 3.11 and 3.28.
Decision date: 5 March 2026| Member: Bridie Nolan
Cox v The Nominal Defendant by its agent Allianz Australia Insurance Limited [2026] NSWPIC 154
Motor Accident Injuries Act 2017; miscellaneous claims assessment dispute; statutory benefits; whether accident caused wholly or mostly by the fault of the claimant for the purposes of sections 3.11 and 3.28; unidentified vehicle; conflicts in evidence; assessment of relative culpability of driver of unidentified vehicle and claimant; whether claimant’s contributory negligence greater than 61%; application for exceptional costs; Podrebersek v Australian Iron & Steel Pty Ltd, AAI Limited t/as GIO v Evic, Verryt v Schoupp, and AAI Limited t/as GIO v Moon & Ors considered and applied; Held – claimant wholly or mostly at fault for the purposes of sections 3.11 and 3.28; exceptional circumstances found permitting the payment of legal costs pursuant to sections 8.3(4) and 8.10(4).
Decision date: 5 March 2026| Member: Bianca Montgomery-Hribar
Allianz Australia Insurance Limited v Chalise [2026] NSWPIC 156
Motor Accident Injuries Act 2017; settlement approval; damages limited to past and future economic claimant sustained a fracture to her left clavicle; certified unfit for work duties for 15 weeks at which time she was paid statutory benefits; certified fit for light duties before certified fit for full-time work; past loss for a closed period, buffer for future loss for flare-ups or aggravation; Held – settlement approved under section 6.23(2)(b) in the sum of $44,200 within the range of settlement expected if assessed by a Member in the Commission, satisfied the settlement is just, fair and reasonable.
Decision date: 6 March 2026| Member: Elyse White
Ouzounian v Allianz Australia Insurance Limited [2026] NSWPIC 157
Motor Accident Injuries Act 2017; claim for statutory benefits; assessment under section 3.38 of claimant’s contributory negligence; all traffic stopped at traffic lights; claimant wanted to merge from one lane to her right, indicator on; vehicle behind and to the right did not move when lights turned green; claimant saw the driver of that vehicle had not seen her and was not looking at her; claimant moved into gap; insured driver moved forward and looked up before collision occurred; insurer argued 50% contributory negligence; self-represented claimant argued no fault at all; evidence taken at telephone conference; Held – claimant departed from the standard of care, having seen the other driver not looking she should not have merged; claimant’s contribution minor and assessed at 25%; Podrebersek v Australian Iron & Steel Pty Limited applied for the apportionment of culpability.
Decision date: 6 March 2026| Member: Belinda Cassidy
Romeo v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 158
Motor Accident Injuries Act 2017; claimant injured in a motor vehicle accident when he was riding his bicycle and struck a pothole/divot in the road causing him to lose his balance and collide with the motor vehicle being driven by the insured driver; claimant sustained fracture of the right elbow, fracture of the right proximal humerus, multiple soft tissue injuries, and traumatic ulceration to both knees; insurer has conceded claimant’s injuries are non-threshold but has disputed liability; TransportNSW and ConnectSydney Pty Ltd were responsible for the maintenance of the road; statement of claim has been issued in the District Court upon both those parties seeking damages; claimant submits the matter be exempted in the interests of justice in order for both claims to be determined concurrently in the jurisdiction of the District Court; submitted on behalf of the claimant the matter should be exempted on discretionary grounds; insurer consents to the application; Held – the matter be exempted under section 7.34 (1)(b) on the grounds a claimant or insurer seeks to proceed against one or more non-CTP parties; rule 99(3) (d) of the Personal Injury Commission Rules 2021; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 9 March 2026 | Member: David Ford
Allianz Australia Insurance Limited v Garigali [2026] NSWPIC 160
Motor Accident Injuries Act 2017; claimant was a rear seat passenger in a stationary motor vehicle; alighted from the vehicle to adjust his seat; insured driver moved the car forward resulting in claimant's right foot crushed by the rear driver’s side tyre; claimant sustained serious injury to his right foot being a Lisfranc fracture dislocation, and multiple fractures to the foot; underwent open reduction and internal fixation of the right foot; claimant off work for a period of 5 months and then returned to work on restricted hours; insurer conceded non-threshold injury; insurer admitted liability; no entitlement to non-economic loss; claim for past and future economic loss; total amount proposed is $200,000 less statutory benefits paid to date; Held – the proposed settlement is just, fair and reasonable; proposed settlement is approved under section 6.23 (2)(b).
Decision date: 11 March 2026| Member: David Ford
Pinarbasi v AAI Limited t/as GIO [2026] NSWPIC 148
Motor Accident Injuries Act 2017; Motor Accidents Compensation Act 1999; discretionary exemption application by claimant; claim not suitable for assessment at the Personal Injury Commission pursuant to section 7.34 (1)(b); Held – basis not suitable; claim involves complex legal and factual issues pursuant to rule 99(3)(a) of the Personal Injury Commission Rules 2021; privately operated buses operating on public transport route; dispute as to which Act should apply to assessment of damages; other factors include costs of single hearing; recommendation subsequently approved by the Division Head, as the President’s delegate.
Decision date: 18 March 2026 | Member: Shana Radnan
Workers Compensation non-Presidential Member Decision
Aneska v State of New South Wales (South Western Sydney Local Health District) [2026] NSWPIC 159
Workers Compensation Act 1987; claim for proposed right lumbar sympathetic nerve blocks at L3 and L4 for treatment of right knee pain and symptoms and for further physiotherapy treatment pursuant to section 60; Held – the respondent is to pay the costs of and incidental to the proposed right lumbar sympathetic nerve blocks at L3 and L4 at SIRA gazetted rates; award for the respondent for further physiotherapy treatment costs at this time.
Decision date: 10 March 2026| Member: Fiona Seaton
Motor Accidents Medical Review Panel Decisions
CED v Gordian RunOff Ltd [2026] NSWPICMP 172
Motor Accident Compensation Act 1999; claimant suffered injury in a motor vehicle accident when he was struck by a car whilst walking at a pedestrian crossing; original Medical Assessor (MA) determined the claimant’s whole person impairment (WPI) as a result of the accident was 8%; claimant made an application under section 63 for referral of assessment to the Review Panel; Review Panel conducted its own examination and found as a result of psychiatric injuries sustained in the accident the claimant suffered a total WPI of 5%; Held - Certificate of original MA was revoked; de-identification direction made pursuant to rule 132 of the Personal Injury Commission Rules 2021.
Decision date: 4 March 2026| Panel Members: Member Terence Stern OAM, Dr Gerald Chew, and Dr Samson Roberts| Injury module: Mental and Behavioural
Chidiac v AAI Limited t/as GIO [2026] NSWPICMP 167
Motor Accident Injuries Act 2017; review of medical assessment of single Medical Assessor; assessment of whole person impairment (WPI); prior lumbar spine surgery giving rise to pre-existing impairment; re-examination for Review Panel revealed examination equivalent to DRE category I impairment; shoulder movements inconsistent, assessed by analogy; Held – found to have 4% WPI which is not greater than 10% WPI; certificate revoked.
Decision date: 4 March 2026| Panel Members: Member Elizabeth Medland, Dr Margaret Gibson, and Dr Rhys Gray | Injury module: Spine, and Upper Limb
Searle v AAI Limited t/as GIO [2026] NSWPICMP 173
Motor Accident Injuries Act 2017; claimant passenger in vehicle which left road and overturned; assessment of whole person impairment for physical injuries for hand, brain and C2 fracture; agreement that matter could be assessed on the papers; previous motor accident in 2014 causing brain injury, C5 fracture and various orthopaedic injuries; assessment of head injury; mild brain injury with reduced GCS of 14/15 at scene; subsequent records show reduced level of consciousness due to other causes including illicit drug use; claimant passed post-accident amnesia assessment and CT scan showed no abnormality; mild brain injury resolved; hand fracture; no loss of movement; not otherwise assessable; C2 fracture; Medical Assessors reviewed CT and MRI scans and subsequent x-ray; discussion of uniqueness of C2 vertebrae and application of the Motor Accident Guidelines (Guidelines); conclusion that C2 fracture caused canal deformity and assessed as DRE category III; no deduction for C5 fracture in 2014 as that fracture is unrelated to the C2 fracture in accordance with clause 6.33 of the Guidelines; Held – original assessment revoked; certificate issued for physical injury greater than 10%.
Decision date: 5 March 2026| Panel Members: Principal Member John Harris, Dr Sophia Lahz, and Dr Leslie Barnsley| Injury module: Spine, Upper Limb, and Nervous System
Rababi v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 175
Motor Accidents Injuries Act 2017; threshold injury dispute; claimant was the driver in the middle lane of a road when a car exited a service station and collided with the left passenger side of the claimant’s vehicle; all airbags deployed with significant damage to the claimant’s vehicle; ambulance and hospital notes indicate pain to the left lower ribs; x-ray revealed possible left 10th rib fracture while CT scan of the thorax showed no fractures; original medical assessment certificate (MAC) accepted a fracture to the 10th left rib shown on the x-ray; MAC made no reference to the CT scan; claimant uncontactable; Review Panel determination made on the papers; Review Panel attributed greater weight to the clinical picture from the ambulance and hospital notes than the radiology, the latter of which in the Review Panel’s view, are tools to confirm a clinical diagnosis; Held – Review Panel accepted that the claimant suffered a fracture of the 10th left rib caused by the motor accident and is not a threshold injury; MAC confirmed.
Decision date: 6 March 2026| Panel Members: Member Jeremy Lum, Dr Margaret Gibson, and Dr Christopher Oates| Injury module: Facial Injury and Impairment
AAI Limited t/as GIO v Ademovic [2026] NSWPICMP 178
Motor Accidents Injuries Act 2017; threshold injury and permanent impairment disputes; claimant 13 years of age in a car driven by his older sister; whether claimant has post-traumatic stress disorder as a result of motor accident; Medical Assessment Certificate (MAC) found non-threshold injury and whole person impairment (WPI) of 8%; biomechanical report suggests minor forces involved; whether criterion A satisfied for post-traumatic stress disorder; Review Panel re-examined and obtained greater details regarding motor accident details; subjective element may be considered when evaluating criterion A stressor; claimant’s young age at time of motor accident amplified fear response; David v Allianz Australia Insurance Ltd, and Lynch v AAI Limited t/as AAMI applied; Held – post-traumatic stress disorder found caused by the motor accident; permanent impairment assessed at 7% WPI; MAC part confirmed, part revoked.
Decision date: 10 March 2026| Panel Members: Member Jeremy Lum, Dr Thomas Newlyn, and Dr Surabhi Verma| Injury module: Mental and Behavioural
Lew v Allianz Australia Insurance Limited [2026] NSWPICMP 179
Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC) under section 7.26; dispute regarding degree of permanent impairment resulting from physical injuries; lumbar spine and pelvic fractures referred for assessment; Medical Assessor certified that injuries caused by accident resulted in permanent impairment of 4%, being not greater than 10%; claimant examined; no issues of principle; Held – Review Panel satisfied claimant’s injuries of lumbar spine and pelvic fractures were caused by the accident; Review Panel assessed a degree of permanent impairment resulting from those injuries to be 6% for the purposes of the Act, which is not greater than 10%; MAC revoked.
Decision date: 11 March 2026 | Panel Members: Member Bianca Montgomery-Hribar, Dr Drew Dixon, and Dr David Gorman| Injury module: Spine, and Lower Limb
Workers Compensation Medical Appeal Panel Decisions
Quiggin v RSL LifeCare Ltd [2026] NSWPICMP 176
Workplace Injury Management and Workers Compensation Act 1998; psychological Injury; lump sum claim; appellant worker challenged assessment in four of the six psychiatric impairment rating scale categories; self-care and personal hygiene, travel, social functioning, and concentration, persistence and pace; error found in inadequate path of reasoning and inadequate record of findings on mental state examination; re-examination considered necessary in the circumstances of a finding of error; Held – Medical Assessment Certificate revoked.
Decision date: 6 March 2026 | Panel Members: Member Jane Peacock, Dr Douglas Andrews, and Dr Michale Hong| Injury module: Psychological/Psychiatric
Platypus Shoes (Australia) Pty Ltd v Rapley [2026] NSWPICMP 177
Workplace Injury Management and Workers Compensation Act 1998; assessment of whole person impairment (WPI) of right lower extremity (knee); Medical Assessor (MA) satisfied that worker had complex regional pain syndrome 1 in accordance with Table 17-1 of the SIRA NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment, 4th ed (Guidelines); assessed 26% WPI after classifying her at the maximum percentage in Grade 3 under Table 16-10 of American Medical Association Guides to the Evaluation of Permanent Impairment, 5th ed (AMA5); appeal on basis of demonstrable error and application of incorrect criteria; Appeal Panel satisfied that the MA used his clinical judgment in assessing the maximum percentage in Grade 3 of the AMA5 and provided sufficient reasons in the Medical Assessment Certificate (MAC) for the assessment; Appeal Panel found that the MA did not err in the interpretation of AMA5 Table 16.10a, nor did he assess impairment in a manner contrary to Table 17.1 of the Guidelines; Held – MAC confirmed.
Decision date: 9 March 2026 | Panel Members: Member Carolyn Rimmer, Dr Drew Dixon, and Dr Christopher Oates| Injury module: Right Lower Extremity
Secretary, Department of Education v Butfield [2026] NSWPICMP 180
Workplace Injury Management and Workers Compensation Act 1998; whether Medical Assessor (MA) erred by incorrectly rating the respondent’s impairment due to a resection arthroplasty; whether MA erred by failing to rate respondent’s impairment due from a brachial plexus injury; Held – MA erred on both issues; respondent re-examined; Medical Assessment Certificate revoked .
Decision date: 12 March 2026 | Panel Members: Member Marshal Douglas, Dr Drew Dixon, and Dr Tommasino Mastroianni| Injury module: Left Upper Extremity
Motor Accidents Merit Review Decision
AAI Limited t/as GIO v Rauf [2026] NSWPICMR 7
Motor Accident Injuries Act 2017; statutory benefits disputes involving calculation of pre-accident average weekly earnings where claimant self-employed, which was determined by consent following a Merit Review Panel preliminary conference; costs order sought by claimant under section 8.10(4)(b) in respect of the first instance merit review; San v Rumble (No 2), Ho v Professional Services Review Committee No 295, and AAI Ltd trading as GIO v Moon considered and applied; Held – exceptional circumstances exist that justify payment of the claimant’s reasonable and necessary legal costs incurred in respect of the pre-accident average weekly earnings merit review proceedings pursuant to s 8.10(4)(b); claimant’s reasonable and necessary legal costs were assessed; insurer is to pay the claimant’s legal costs as assessed.
Decision date: 9 March 2026| Merit Reviewer: Anthony Scarcella
This publication is for information only. The publication is not legal advice. The information provided is not a substitute for reading the decisions. The Commission does not accept liability for the information in this publication or for way the information is used.
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