austlii:nsw/NSWPIC/2025/386
General information, not legal advice.
NSWPIC
2025-08-07
Original judgment source is linked above.
AAI Limited t/as GIO v Russell [2025] NSWPIC 386
MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; settlement approval; claimant was injured on 22 September 2023; claimant was not working at the time of the accident; claimant is aware no entitlement to future statutory benefits once settlement is approved; - settlement complies with clause 7.37 of the Motor Accident Injuries Guidelines (version 9.3); settlement approved in the amount of $40,000.00; consisting of nil non-economic loss and past economic loss; future economic loss of $40,000.00 by way of a buffer.
(a) an un-displaced fracture of the lateral process of the left talus (the insurer's decision), which was assessed at 0% whole person impairment (WPI) after reviewing Dr Stephen Rimmer's report dated 31 October 2024 [A 14], and
(b) an adjustment disorder with anxiety, which was assessed at 1% WPI after reviewing Dr Juan D'Abrera's report dated 4 February 2025 [A 15].
The claimant has not sought to dispute the insurer's decision.
(a) a fracture of the lateral process of the left talus, and
(b) an adjustment disorder with anxiety (largely in remission).
"... she has had ongoing pain around the lateral aspect of her ankle ... the pain occurs mostly with walking but she has some pain at rest particularly in cold weather. She reports occasional night pain. She uses ibuprofren. The ankle does not feel right and her effort tolerance is reduced. She has a background history of asthma, osteoporosis, depression and cholesterol ..." [A10]
"... She still reports ongoing pain in her foot particularly with excessive walking. She prefers not to take analgesics. She is very active.
The CT scan of her foot today shows that there is one fracture line is still visible in the lateral
process of talus. This could also represent a very small osteochondral injury. There is no
obvious arthritis in the subtalar joint at this stage.
Brenda has sustained a fracture of the lateral process of talus and maybe developing some subtalar joint arthritis. At this stage there is nothing much that can be done for her. I'm hopeful that her pain will settle. If the arthritis progresses, she may need a cortisone injection or even surgery. I think that this is many years away. I return her to your care but would be happy to review her at anytime." [A 10]
Rehabilitation report (Benchmark Rehab)- closure report - 22 September 2023
"3.40 Effect of recovery of damages on statutory benefits
(1) If a person ('the claimant') recovers damages in respect of the death of or injury to a person caused by the fault of the owner or driver of a motor vehicle in the use or operation of the vehicle then (except to the extent that subsection (2) or (3) covers the case)
(b) the amount of any statutory benefits already paid under Division 3.3 in respect of the injury concerned is to be deducted from the damages (awarded or otherwise paid as a lump sum) and is to be paid to the person who paid the statutory benefits."
"6.23 Restrictions on settlement of claim for damages
(a) the claimant is represented in respect of the claim by an Australian legal practitioner, or
(b) the proposed settlement is approved by the Commission.
(3) The Commission is not to approve the settlement of a claim unless satisfied that the settlement complies with any applicable requirements of or made under this Act or the Motor Accident Guidelines."
(1) If a claimant, who is not represented by an Australian legal practitioner, and an insurer have agreed to a proposed damages settlement, the insurer must lodge an application for approval of a damages settlement under section 6.23 of the MAI Act, on behalf of both the claimant and the insurer, within 7 days of reaching the agreement.
"Under section 6.23(3) of the Act, before the Personal Injury Commission may approve the settlement of a claim for damages, it must be satisfied that:
(a) the proposed settlement satisfies the timing requirements in section 6.23(1) of the Act [since repealed];
(b) 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 the claimant, and taking into account any proposed reductions or deductions in the proposed settlement;
(c) the claimant understands that they are entitled to be represented in respect of the claim by an Australian legal practitioner, and
(d) the claimant understands the nature and effect of the proposed settlement and is willing to accept the proposed settlement."
(a) a deed of release;
(b) the amount of the proposed damages settlement, including a breakdown of the amount allowed for each head of damage and how each amount allowed has been calculated;
(c) the amount of any reductions in the proposed damages settlement including for contributory negligence or any other reduction, including brief reasons for that reduction and how any reductions have been calculated;
(d) the amount of any advance payments that the insurer has made in advance of the settlement and the dates of those advance payments, including brief reasons explaining why those advanced payments were made, and
(e) the evidence, documents and materials relevant to an assessment of the damages settlement including liability notices.
(a) of the amount of the proposed settlement and a breakdown of the amount allowed for each head of damage [pages 310 - 311, 317 and 318], and
(b) an executed settlement deed dated 4 July 2025, which identifies the total amount provided for the settlement and deductions sought to be made from the settlement [page 317].
4 July 2025 referred to in paragraph [62] above, the insurer filed an application to lodge additional documents at the Commission with a revised bundle on 21 July 2025. 2. On 28 July 2025 the claimant appeared at the further conference conducted by MS Teams. 3. As identified earlier in the introduction the claimant is not represented by an Australian legal practitioner. She is aware that she can instruct an Australian Legal Practitioner to act, however does not want to do this and has declined to do so. 4. During the conference the claimant was questioned about her understanding of the settlement and her rights under the relevant legislation, that it resolves her rights arising from the accident i.e. its finality and whether she was entering the settlement without coercion. I am satisfied by her responses, that she is entering into the settlement of her own free will, with the relevant understanding of its finality. 5. Further, the claimant is aware there will be no deductions from the settlement monies except those deductions permitted by law including the Social Security Act 1991. 6. The claimant is making her own enquiries with Centrelink in respect of the impact the settlement may have, if any, on her disability pension. 7. I indicated to the parties that I was satisfied that the amended settlement offer was appropriate and would approve the filing of the additional documents filed on 21 July 2025.
(a) the amount of the settlement is just, fair and reasonable (appropriateness), and
(b) the claimant understands the settlement and its terms and the effect of the settlement in ending her claim for damages (the claimant's understanding).
"It is a relationship of the award to the injury and its consequences ... which is to be proportionate ... It is not a matter to be resolved by reference to some norm or standard supposedly to be derived from a consideration of amounts awarded in a number of other specific cases ... The principle to be followed ... is that the amount of damages must be fair and reasonable compensation for the injuries received and disabilities caused. It is to be proportionate to the situation of the claimant ... and not to the situation of other parties in other actions, even if some similarity between their situations may be supposed to be seen. The judgment of a Court awarding damages is not to be overborne by what other minds have judged right and proper for other situations. It may be granted that a judge who is making such assessment will be aware of and give weight to current general ideas of fairness and moderation. But this general awareness is quite a different thing ...The awareness must be a product of general experience and not formed ad hoc by a process of considering particular cases and endeavouring ... to allow for differences between the circumstances of other cases and the circumstances of the case in hand." [Planet Fisheries Pty Ltd V La Rosa (1968) 119 CLR 118 per Barwick CJ, Kitto and Menzies JJ at paragraph 11].
AAI Limited t/as GIO
Russell [2025] NSWPIC 386;
(1968) 119 CLR 118