Background
The Plaintiff, Mr Briggs was injured in a motor vehicle accident on 22 May 2018. The Motor Accident Injuries Act 2017 therefore applied to his claim.
NRMA insurance alleged the Plaintiff suffered a minor injury. In disputing this decision, the Plaintiff asserted that he suffered an annular tear at L4/5, taking his claim outside the minor injury classification.
The dispute proceeded to the Dispute Resolution Service and ultimately to the Review Panel. The Review Panel determined that, while the Plaintiff did have an annular tear at L4/5, this was not causally related to the accident.
In arriving at this conclusion, the Review Panel placed reliance on a Spine Journal Article. The article contained medical jargon external to the Motor Accident Injury Guidelines.
The Plaintiff sought a judicial review of this decision. The grounds of review included a denial of procedural fairness in relying on the Spine Journal Article without notice to the Plaintiff. This ground succeeded.
The Review Panel’s decision was quashed, with the matter remitted to the State Insurance Regulatory Authority to be determined according to law.
Implications
Solicitors should pay close attention to material relied on by medical assessors.
If it is extraneous to the Act and Guidelines, this may provide a foundation for judicial review.
This case also highlights the primacy of medical imaging in “minor injury” disputes.
Depending on the interpretation of the Medical Assessor, injured Plaintiffs can face an “uphill battle” in establishing that abnormalities like a disc protrusion in the spine or a tear in the shoulder relate to an accident.
