Legal Bulletin No. 259

Issued 8 May 2026

Welcome to the two hundred and fifty-ninth 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 Decision

Bond v Blacktown Area Community Centres Incorporated [2026] NSWPICPD 18

Workers compensation; section 66(1A) of the Workers Compensation Act 1987; section 322A of the Workplace Injury Management and Workers Compensation Act 1998 (the 1998 Act); only one claim for permanent impairment can be made; section 329 of the 1998 Act; referral of matter for further medical assessment or reconsideration; reconsideration must be limited to the medical dispute between the parties; New South Wales Department of Education v Connolly [2023] NSWPICPD 38; O’Callaghan v Energy World Corporation Ltd [2016] NSWWCCPD 1 discussed and applied; alleged failure to consider submissions; Wang v State of New South Wales [2019] NSWCA 263; Day v SAS Trustee Corporation [2021] NSWCA 71; Applicant WAEE v Minister for Immigration and Multicultural and Indigenous Affairs [2003] FCAFC 184 discussed and applied; Held – the Member’s Certificate of Determination dated 3 September 2025 is confirmed.

Decision date: 29 April 2026| Before: Acting Deputy President Elizabeth Wood

Motor Accidents non-Presidential Member Decisions

Gordian RunOff v Briggs (nee Black) [2025] NSWPIC 666

Motor Accidents Compensation Act 1999; insurer’s application for exemption under section 92(1)(b); motor accident occurred more than ten years ago; complex factual issues as a result of the lateness of the claim and the nature of the claim; complex factual and legal issues regarding causation of injury, contributory negligence and overlap with workers compensation, and other claims; Held – claim is not suitable for assessment by the Personal Injury Commission; recommendation made that the claim be exempted subsequently approved by Division Head as the President’s delegate.

Decision date: 10 December 2025 | Member: Maurice Castagnet

CFB v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 19

Motor Accident Injuries Act 2017; settlement approval under section 6.23(2)(b); accident as passenger; claimant sustained vertigo related injuries and psychological condition; period off work; subsequent return to pre-injury duties; chance of vertigo returning; insurer accepted claimant’s offer; proposed settlement fair, just and reasonable; Held – proposed settlement approved.

Decision date: 15 January 2026| Member: Terence O'Riain

Lam v AAI Limited t/as GIO [2026] NSWPIC 227

Motor Accident Injuries Act 2017; accident 2 February 2024; settlement approval under section 6.23(2)(b); accident as driver; insured driver died; workers compensation; claimant sustained sternum fracture and brief psychological condition; period off work; return to work full time over rehabilitation period of more than twelve months; returned to pre-injury duties; medical evidence supports continuing symptoms; sought legal advice but declined assistance; future economic loss offer includes two days off per week until retirement; claimant uneducated, required Cantonese interpreter and family support which satisfied he had agency to decide on accepting settlement; proposed settlement fair, just and reasonable; Held – proposed settlement approved.

Decision date: 22 April 2026| Member: Terence O'Riain

Buller v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 228

Motor Accident Injuries Act 2017; application for exceptional costs order; Calderbank letter; fixing of maximum costs for legal services; difference between costs payable for statutory benefits claims and damages claims; inherent uncertainty in making determinations and assessing damages; offer 2.5% below assessed damages; assessor functus officio; Held – application refused.

Decision date: 23 April 2026| Member: Hugh Macken

Insurance Australia Limited t/as NRMA Insurance v Fayle [2026] NSWPIC 229

Motor Accident Injuries Act 2017; assessment of damages; liability wholly admitted; claimant 45 years old female passenger exaggerated the severity of the collision and injuries; worked in IT in a highly paid position; no evidence to support claims she was made redundant caused by the accident; no evidence to support the claim she was required to attend the office; damages limited to past and future economic loss assessed as a buffer; Held – damages assessed; past economic loss in the sum of $20,000 and future economic loss in the sum of $75,000 plus costs agreed.

Decision date: 23 April 2026| Member: Elyse White

Sheehan v Allianz Australia Insurance Limited [2026] NSWPIC 232

Motor Accident Injuries Act 2017; motor vehicle accident; claims assessment; past and future economic loss; reliability of claimant’s evidence; most likely future circumstances; assessment of damages; 26-year-old claimant sustained injury in a motor bike accident on 7 June 2019; claim economic loss on basis of inability to pursue career with Air Force; unusual presentation; widespread complaints; descent into invalidity; discrepancies in histories provided to medical practitioners; evidence treated with caution; left tibial plateau fracture, soft tissue injuries to left foot and ankle, cervical and lumbar spine; alleged head injury; claimant did not sustain head injury with cognitive deficits; somatic symptom disorder found; claimant no capacity for employment since accident; not satisfied uninjured claimant would have joined ADF or RAAF; history of sporadic casual employment; Held - past loss of wages calculated at $450 net per week plus super in sum of $177,386; buffer for future economic loss on basis uninjured would have continued to engage in casual employment, interspersed with periods of unemployment; buffer assessed at $400,000, claim for interest made and not allowed; costs assessed.

Decision date: 24 April 2026 | Senior Member: Susan McTegg

Allianz Australia Insurance Limited v Jiron [2026] NSWPIC 233

Motor Accident Injuries Act 2017; claims assessment dispute about the amount of damages to be paid to the claimant under sections 7.36 (3) and 7.36 (4); claimant sustained injuries in a motor vehicle accident in August 2021; at the time of the accident, claimant in receipt of family tax benefits; claimant suffered soft tissue injury to the cervical spine and soft tissue contusion injury to the right radial wrist and thumb; claimant also alleged they suffered psychological injuries; claimant failed to comply with directions by the Medical Service in relation to assessment of her injuries; application to the Medical Service was dismissed; claimant is self-represented and failed to attend two teleconferences  in relation to her assessment of damages claim, matter set down for an assessment conference; claimant failed to provide submissions on damages and other documentation directed to be lodged by her; claimant failed to attend assessment conference; liability admitted; determined claimant not entitled to damages for either future or past loss of earnings; Held – claimant is not entitled to damages for past and future loss of earnings.

Decision date: 28 April 2026 | Member: David Ford

Workers Compensation non-Presidential Member Decisions

State of New South Wales (NSW Police Force) v Taylor [2026] NSWPIC 164

Workers Compensation Act 1987; Workplace Injury Management and Workers Compensation Act 1998 (1998 Act); Personal Injury Commission Act 2020 (PIC Act); accepted psychological injury assessed by Medical Assessor (MA) at 22% whole person impairment; exempt worker; application to rescind a Certificate of Determination (COD) to give way to a reconsideration of a Medical Assessment Certificate; additional evidence; Samuel v Sebel Furniture Ltd considered and applied; Held – MA made a conditional finding on the basis of an incorrect assumption and incomplete information; section 322A of the 1998 Act does not apply to exempt workers; COD is rescinded pursuant to section 57(1) of the PIC Act; matter referred back to the MA for reconsideration pursuant to section 329(1A) of the 1998 Act.

Decision date: 14 April 2026| Member: Kathryn Camp

Parker v Corrective Services NSW [2026] NSWPIC 231

Workers Compensation Act 1987; medical expenses; claim for medical expenses; applicant suffered accepted left knee injuries in the course of her employment; underwent surgery; claimed she suffered a consequential right knee condition; claim made for right total knee replacement; allegation of altered gait; Held – applicant suffered a consequential condition in her right knee; proposed surgery is reasonably necessary; respondent ordered to pay for right total knee replacement.

Decision date: 23 April 2026| Member: Parnel McAdam

Motor Accidents Medical Review Panel Decisions

Allianz Australia Insurance Limited v Vermeer [2026] NSWPICMP 288

Motor Accidents Injuries Act 2017; threshold injury dispute; claimant was the driver of a vehicle stationary in a line of traffic when she was hit from behind with a secondary collision in front; original medical assessment certificate (MAC) accepted claimant’s history of immediate left hip symptoms; MRI showed a partial tear of the gluteus minimus; Review Panel re-examined and accepted the claimant’s history of immediate left hip symptoms; mechanism of injury consistent with a frontal collision and force transmitted through the left foot from the clutch; nil past history of hip injury or symptoms; neck and shoulders main areas of complaint at the time of the accident; hip complaint present but of lesser severity and did not feature in the early medical documentation; left hip complaint documented about three months after the motor accident; Held – Review Panel  satisfied the partial tear to the gluteus minimus of the left hip was causally related to the motor accident; partial tear of a tendon is not a threshold injury; MAC confirmed.

Decision date: 23 April 2026| Panel Members: Member Jeremy Lum, Dr David Gorman, and Dr Alan Home| Injury module: Lower Limb

Dandan v Allianz Australia Insurance Limited [2026] NSWPICMP 289

Motor Accident Injuries Act 2017; section 3.24; claim for statutory benefits for payment of treatment and care expenses; request by the claimant for payment for a left knee arthroscopic surgery; whether the proposed treatment is reasonable and necessary in the circumstances; whether it is related to the injuries caused by the accident; aggravation of pre-existing meniscal tear; Medical Assessor (MA) found that the proposed treatment was reasonable and necessary in the circumstances, and was related to the injuries caused by the accident; insurer approved the surgery after the Medical Assessment Certificate (MAC) of the MA was issued; surgery has since been performed; utility of review application lodged by insurer; Held – MAC confirmed.

Decision date: 23 April 2026| Panel Members: Member Maurice Castagnet, Dr Drew Dixon, and Dr David Gorman| Injury module: Spine, Lower Limb, Mental and Behavioural

Insurance Australia Limited t/as NRMA Insurance v Lasek [2026] NSWPICMP 290

Motor Accident Injuries Act 2017; degree of whole person impairment (WPI) dispute; claimant was a rear seat passenger in a vehicle; claimant did not see the collision; claimant sustained physical injuries to her lumbar spine and neck; both jaw joints were dislocated which resulted in chronic pain; claimant developed psychological symptoms, including nightmares of the subject accident; Medical Assessor (MA) certified accident caused the claimant to suffer post-traumatic stress disorder (PTSD) and persistent depressive disorder; MA utilised the psychiatric impairment rating scale (PIRS) to assess WPI at 22%; insurer’s independent medical examiner diagnosed somatoform disorder for which PIRS cannot be used to assess WPI; insurer’s review application allowed on basis that the MA wrongly considered contribution of claimant’s pain in assessing impairment in PIRS category of concentration, persistence and pace; MA was precluded from considering the effects of pain when assessing claimant’s impairment in any of the PIRS categories; claimant re-assessed remotely by Review Panel Medical Assessors who agreed that accident caused the claimant to suffer PTSD and persistent depressive disorder; both agreed a diagnosis of somatic symptom disorder with persistent pain not appropriate; utilised PIRS to assess a WPI at 19%, based upon the claimant’s presentation, at the time of the assessment; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 24 April 2026| Panel Members: Member Gary Victor Patterson, Dr Christopher Rikard-Bell, and Dr Gerald Chew| Injury module: Mental and Behavioural

Pok v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 291

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); dispute about whether psychological injury caused by accident is a threshold injury; Medical Assessor certified post-traumatic stress disorder caused by the accident not a threshold injury; Held – MAC revoked; new MAC issued; panic disorder caused by the accident is not a threshold injury.

Decision date: 24 April 2026| Panel Members: Senior Member Brett Williams, Dr John Baker, and Dr Christopher Canaris| Injury module: Mental and Behavioural

Stuart-Webster v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPICMP 294

Motor Accident Injuries Act 2017; review of Medical Assessment Certificate (MAC); treatment and care dispute; total right hip replacement; original Medical Assessor (MA) found treatment causally related and reasonable and necessary; claimant was on horseback when she fell and struck the bonnet of a car before falling onto the road; hip injury not causally related to motor accident; delay of any hip symptoms for two years and four months following pelvic fracture repair and subsequent healing; claimant return to normal functioning; no acute hip pathology in bone scan and MRI radiology; pre-existing hip complaints; Held – Review Panel found motor accident could have caused a right hip injury but after review of documentation found that the motor accident did not cause a right hip injury; Review Panel not satisfied total right hip replacement surgery to be causally related to motor accident; MAC revoked; new MAC issued.

Decision date: 28 April 2026| Panel Members: Member Jeremy Lum, Dr Drew Dixon, and Dr Margaret Gibson| Treatment Type: Surgery

Singh v AAI Limited t/as Suncorp Insurance & Anor [2026] NSWPICMP 295

Motor Accident Injuries Act 2017; motor accident on 6 September 2023; insured truck collided with claimant’s vehicle; assessment of whole person impairment (WPI) for psychological injuries; claimant presented with loss of functioning which had deteriorated substantially over time to a severe level; deterioration medically plausible but unlikely; Review Panel relied on clinical expertise of Medical Assessors and absence of real contradiction of claimant’s presentation; Held – claimant WPI assessed at 44%; original medical assessment certificate (MAC) revoked; new MAC issued for psychological injury greater than 10%.

Decision date: 29 April 2026| Panel Members: Principal Member John Harris, Dr Wayne Mason, and Dr Christopher Canaris| Injury module: Mental and Behavioural

Workers Compensation Medical Appeal Panel Decisions

Corkhill v National Roofing Pty Ltd [2026] NSWPICMP 292

Workplace Injury Management and Workers Compensation Act 1998; lump sum claim for injury to the left upper extremity and scarring; appellant complained on appeal that the Medical Assessor made a demonstrable error and or made an assessment on the basis of incorrect criteria in respect of both the assessments for the left upper extremity and scarring; no error found on appeal in respect of the assessment of the left upper extremity; error in respect of scarring assessment found and a re-examination was required; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 24 April 2026| Panel Members: Member Jane Peacock, Dr Drew Dixon, and Dr Tommasino Mastroianni| Injury module: Left Upper Extremity, and Scarring (TEMSKI)

Sonder Australia Pty Ltd v Arumugaiyer [2026] NSWPICMP 293

Workplace Injury Management and Workers Compensation Act 1998; whether Medical Assessor (MA) took into account irrelevant matters when assessing the appellant’s impairment in social and recreational activities and in concentration, persistence and pace; whether MA adequately explained whether a physical illness the appellant suffered had any effect on her function in the several psychiatric impairment rating scale (PIRS) categories; whether the MA considered whether the symptoms the appellant suffered from her physical illness affected her capacity in the several PIRS categories; Appeal Panel found the MA did not have regard to whether the  appellant’s symptoms from her physical illness affected her function in all PIRS categories, and that was an error; appellant re-examined; Held – Medical Assessment Certificate (MAC) revoked; new MAC issued.

Decision date: 24 April 2026| Panel Members: Member Marshal Douglas, Dr Michael Hong, and Professor Nicholas Glozier| Injury module: Psychological/Psychiatric

Motor Accidents Merit Review Decisions

Kim v Allianz Australia Insurance Limited [2026] NSWPICMR 14

Motor Accident Injuries Act 2017; merit review; dispute under Schedule 1 Clause 2; whether the claimant is an earner; inconsistencies in evidence; unreliable evidence; whether documents contemporaneous; credit in issue; onus of proof; actual persuasion required; whether there is reasonable satisfaction on the evidence that the facts are made out; whether alternative case not put by claimant can be considered; procedural fairness; Bellpac Pty Limited (Receivers and Managers Appointed) (In Liquidation) (No 2); Pollock v NSW Trustee & Guardian; Nguyen v Cosmopolitan Homes; Ballard v Multiplex; Held – the reviewable decision is affirmed.

Decision date: 28 April 2026| Merit Reviewer: Katherine Ruschen

Cameron v Allianz Australia Insurance Limited [2026] NSWPICMR 15

Motor Accident Injuries Act 2017 (MAI Act); Personal Injury Commission Act 2020 (NSW) (PIC Act);merit review; dispute under Division 3.3, sections 3.6 and 3.7; whether the claimant suffered a loss of earnings giving rise to an entitlement to weekly payment of statutory benefits; meaning of loss of earnings; Schedule 1 Clause 3 of the MAI Act; where post-accident earnings exceed pre-accident weekly earnings but incapacity impacted ability to earn more; whether additional business expenses incurred post-accident and/or gratuitous assistance by family in the business is compensable; section 42 of the PIC Act; just, quick and cheap resolution of the real issues in the proceedings; Held – the reviewable decision is affirmed.

Decision date: 29 April 2026| Merit Reviewer: Katherine Ruschen

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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