I approve the settlement of $375,000 in respect of the claim for damages.

Issued under s 6.23 of the Motor Accident Injuries Act 2017

1. On 2 June 2022 Ms Amanda Meredith (the claimant) sustained injury as a passenger in a vehicle driven by her husband which collided with the rear of a stationary vehicle (the accident).
2. The insurer accepted liability for the common law claim for damages on 10 June 2025.
3. Ms Meredith was 57 years of age at the time of the accident, and she is now 60 years of age.
4. In the Application for personal injury benefits dated 6 June 2022 Ms Meredith described her injuries as multiple rib fractures secondary to motor vehicle accident. The claimant sustained the following injuries:
   • Chest trauma involving a sternal fracture, multiple right sided rib fractures and a pneumothorax. Mrs Meredith was treating surgically with open reduction and internal fixation of the lower right ribs and insertion of a chest tube.
   • Right clavicle and proximal humeral fracture that was managed conservatively.
   • Fracture of the right distal radius and ulna managed surgically with open reduction and internal fixation under the care of Dr Chow.
   • Fracture of the right proximal femur treated surgically with internal fixation and an intramedullary femoral nail under the care of Dr Chow.
   • Soft tissue injury of the left shoulder managed conservatively.
5. The insurer accepted that Ms Meredith had non-threshold injuries and pursuant to Division 3.4 of the Motor Accident Injuries Act 2017 (the MAI Act) she is entitled to payment of reasonable treatment and care for the rest of her life for her accident caused injuries.
6. The insurer conceded Ms Meredith sustained a whole person impairment (WPI) greater than 10% and agreed Ms Meredith is entitled to recover damages for non-economic loss. There is no claim for economic loss.
7. The claimant and the insurer have agreed to settle the common law claim for damages in the sum of $375,000, in respect of non-economic loss.
8. Because Ms Meredith is not represented by a lawyer, her settlement must be approved in accordance with the MAI Act.
9. The insurer lodged the application for approval of the settlement with the Personal Injury Commission (Commission) and it was referred to me for consideration.

1. Section 6.23(2) and (3) of the MAI Act requires approval of the settlement and I am not to approve the settlement unless I am satisfied it complies with the requirements of the MAI Act and the Guidelines.
2. Clause 7.37 of the Guidelines states I must be satisfied as to the following:

(a) the proposed settlement is just, fair and reasonable and within the range of likely potential damages assessments for the claim were the matter to be assessed by the Commission taking into account the nature and extent of the claim and the injuries, disabilities, impairments and losses sustained by Ms Meredith, and taking into account any proposed reductions or deductions in the proposed settlement;

(b) Ms Meredith understands she is entitled to be represented in respect of the claim by an Australian legal practitioner, and

(c) Ms Meredith understands the nature and effect of the proposed settlement and is willing to accept the proposed settlement.

1. I have considered the documents uploaded by the insurer in one indexed and paginated bundle on 3 July 2025 paginated from pages 1 to 125.

1. Ms Meredith has the following medical history:
   • chronic renal failure for which she underwent a renal transplant in 2019;
   • osteoporosis with resultant marked thoracic kyphosis;
   • thoracic fracture due to osteoporosis;
   • severe scoliosis;
   • epilepsy, with last seizure in 2007;
   • chronic lower back pain;
   • depression and anxiety, and
   • hypertension, raised cholesterol and asthma.
2. Ms Meredith was not working at the time of the accident and there is no claim for wage loss.
3. Following the accident on 2 June 2022 Ms Meredith was transported to Nepean Hospital by ambulance. She was noted to have sternal fractures, multiple rib fractures and a right calcaneal fracture. Ms Meredith underwent open reduction with internal fixation (ORIF) of the fracture of the shaft of the radius and ulna, ORIF of the right hip due to intra-trochanter fracture, ORIF right ribs 2, 3 and 4 and right thoracotomy.
4. On 8 June 2022 Ms Meredith and her husband were transferred to Norwest Private Hospital and on 7 July 2022 they were both transferred to The Hills Private Hospital for rehabilitation until discharge on 3 November 2022.
5. Rehab Management undertook an activities of daily living assessment on 28 November 2022. At that time Ms Meredith was using a 4-wheel walker to mobilise. Rehab Management recommended the provision of short-term domestic assistance of 4 x 2-hour services on a fortnightly basis.
6. Ms Meredith commenced treatment with Dr Mominul Hassan at Sydney Pain Management Centre on 2 November 2023. He reported her primary pain was chronic right side chest wall pain, radiating to the right back which increases with movement. Her secondary pain was chronic right hip pain which increases with walking and sleeping on her right side.
7. Dr Hasson reported Ms Meredith had seen a psychologist since 2005 for significant anxiety. He reported a pain related sleep disturbance and mixed insomnia. Her mood was irritable and whilst independent in personal care she depended heavily on her husband for domestic tasks. She as able to walk for five minutes with a 4-wheeled walker, stand for five minutes and sit for 10 minutes. Dr Hassan noted a component of fear avoidance.
8. On examination Dr Hassan noted an antalgic gait on the right, severe thoracic scoliosis, diffuse right side chest wall tenderness and hyperalgesia. There was right hip tenderness.
9. On 1 March 2024 Dr Hassan reported Ms Meredith had pain in multiple sites including an active fracture and arthritis worse in the right chest wall and hip. Unfortunately, on

15 January 2024 Ms Meredith had fallen hitting a table injuring her right hip and shoulder. She sustained new fractures of her pelvis, superior and inferior rami and right sacral ala. She also fractured her right clavicle. She was hospitalised for five weeks. 10. On 10 May 2024 Dr Hassan reported chronic right rib and hip pain noting the presence of multiple old healing fractures in both sides of her ribs, right clavicle, sternum and right distal radius. He noted wedge compression fractures of T6, T8 and T9 with height loss from 50 to 75%. He noted active arthritis in various sites including the shoulder, knee, hand and both sacroiliac joints. 11. On 24 September 2024 Dr Hasson recommend Ms Meredith see an orthopaedic specialist for possible corrective surgery where an X-ray revealed the pin from the proximal femur fracture protruded past the cortex abutting the iliotibial band causing soft tissue thickening and fluid collection, consistent with focal impingement, contributing to her ongoing right hip and thigh pain. On 3 December 2024 Dr Hasson reported Ms Meredith had seen Dr Chow and Dr Khatib for her right hip pain. Dr Khatib confirmed there were no surgical options available having regard to the development of heterotopic ossification around the nail with a Brooker class 3 bone formation. He thought discomfort in the right hip was likely due to the heterotopic ossification. He also noted the insurer had approved radiofrequency treatment for the left shoulder. 12. On 21 January 2025 Dr Hasson reported following radiofrequency treatment the claimant's left shoulder pain had improved. He reported the claimant's right hip pain had worsened and was exacerbated by walking and physical activity. 13. On 18 February 2025 Dr Hasson reported Ms Meredith could not stand for more than a few minutes due to right hip pain and weakness in the right thigh. She continued to report severe right hip pain and chronic left shoulder pain with a good response from radiofrequency.

1. Ms Meredith was reviewed by Dr Richard Powell, orthopaedic surgeon on 19 March 2025 at the request of the insurer.

1. Dr Powell recorded Ms Meredith reported the following symptoms:
   • an aching pain in the region of the anterior and right side of the chest wall extending to the thoracic region;
   • intermittent right shoulder pain aggravated by activity and constant aching pain accompanied by stiffness and restricted range of motion of the left shoulder, aggravated by the need to lie on the left side due to the ongoing right chest wall issues;
   • pain in the right buttock extending to the right hip accompanied by stiffness and restricted range of motion, noting symptoms from the accident overlap with symptoms from the January 2024 fall, and
   • he reported range of motion of the right wrist was mildly restricted.
2. Dr Powell reported the claimant could perform all elements of personal hygiene and grooming though with difficulty. She was restricted in her ability to perform domestic tasks which were done by her husband. She moved with difficulty between sitting, standing and supine positions. Dr Powell noted marked thoracic kyphosis. He reported Ms Meredith had a complex gait pattern and was unstable and required the use of a frame to walk. He noted surgical scars.
3. Dr Powell diagnosed the following injuries:
   • chest wall trauma with fractures involving the sternum and multiple ribs requiring surgical treatment, namely open reduction and internal fixation of the right lower rib fractures with the insertion of a chest tube to address a pneumothorax. He noted she remains symptomatic;
   • right shoulder girdle injury incorporating fractures of the clavicle and proximal humerus resulting in ongoing pain and restricted range of motion;
   • soft tissue injury of the left shoulder resulting in pain and stiffness in the left shoulder;
   • right wrist fracture which required open reduction and internal fixation of the distal radius. Ms Meredith has some minor residual stiffness and restricted range of motion;
   • fracture of the right proximal femur managed surgically by Dr Chow with open reduction and internal fixation, and
   • he also noted she had sustained a significant further injury in a fall resulting in fractures of the pelvis and further hospitalisation.
4. Dr Powell assessed a total 22% whole person impairment caused by the accident.

1. Ms Meredith discussed with her husband legal representation and decided it was not required. She has been very happy with the support she has received from the insurer and was not aware of her entitlement to common law damages until she was informed of same by the insurer. Ms Meredith indicated she thought she might receive $1,000. Ms Meredith confirmed she wished to settle her claim for damages for the sum of $375,000, the offer made by the insurer.
2. Ms Meredith confirmed that she had not worked for wages for many years at the time of the accident and she understood the settlement was in respect of non-economic loss or pain and suffering.
3. I reminded Ms Meredith of the insurer's obligation to pay her reasonable and necessary treatment expenses for the remainder of her lifetime. She said she does not like to ask for anything and generally her pain specialist submits the treatment requests. Ms Meredith confirmed she was aware of her right to have her reasonable treatment expenses paid for the remainder of her life.
4. Since the accident Ms Meredith has required the use of a 4-wheeled walker. She said she does not go out at night and when she does go out, she cannot go anywhere where there are steps. I reminded Ms Meredith that the insurer may also consider payment of psychological treatment. However, because she has kidney disease and underwent a kidney transplant, Ms Meredith has been under the care of a psychologist through Liverpool Hospital since 2005. She has not attended for some time, but she proposes to resume that treatment shortly.
5. Ms Meredith said her husband tries to clean. She can do very little. I suggested she approach the insurer for some assistance and explained that the insurer's obligation in relation to payment of ongoing treatment expenses includes domestic assistance.
6. Ms Meredith confirmed she was aware approval of the settlement will mean she is unable to make any further common law claim for damages for non-economic loss.
7. I informed the parties I was prepared to approve the settlement.

1. Section 1.4 of the MAI Act defines non-economic loss as:

(a) pain and suffering;

(b) loss of amenities of life;

(c) loss of expectation of life, and

(d) disfigurement.

1. The current maximum payable for non-economic loss is $654,000.
2. I note the comment of Dr Powell as follows:

"Ms Meredith's current presentation is multifactorial taking into account contribution from the significant pre-existing pathology, the ongoing effects of injuries sustained in the subject motor vehicle accident, as well as contribution from post-accident incidents".

1. Ms Meredith is currently 60 years of age with a life expectancy of 28 years. There is little prospect of further recovery. I consider the allowance of $375,000 for non-economic loss to be within the range of the award of damages the claimant would receive for non-economic loss if the matter was to proceed to assessment.
2. I am satisfied that Ms Meredith is aware of her right to have her reasonable treatment expenses paid for the remainder of her life.
3. The insurer will not deduct and pay monies to Medicare under the Health and Other Services (Compensation) Act, 1995 (Cth) from the settlement sum. In the event a Notice of Charge is raised by Medicare for reasonable and necessary treatment expenses the insurer will pay the charge in addition to the settlement sum as part of their obligation to pay statutory benefits.

1. I am satisfied the proposed settlement is just, fair and reasonable and within the range of likely potential damages assessments if the claim was to proceed to assessment taking into account the nature and extent of the claim, the injuries, disabilities, impairments and losses sustained by Ms Meredith.
2. I am satisfied Ms Meredith is aware she can seek legal advice but does not wish to do so.
3. I am satisfied Ms Meredith understands the binding nature of the settlement and that she will be precluded from making a further claim for damages arising out of the accident. I am satisfied Ms Meredith is willing to accept the proposed settlement.
4. Accordingly, pursuant to s 6.23(2)(b) of the MAI Act I approve the settlement of $375,000 in respect of the claim for damages.