austlii:nsw/NSWPIC/2025/548
General information, not legal advice.
NSWPIC
2025-10-17
Original judgment source is linked above.
Alibabic v AAI Limited t/as GIO [2025] NSWPIC 548
MOTOR ACCIDENTS - Motor Accidents Compensation Act 1999 (MAC Act); (PIC Act); the Medical Assessor assessed claimant at 2% and found none of the treatment was caused by the accident; claimant review of medical assessment; matter referred to Review Panel; Review Panel required to re-examine to determine issue; claimant failed to attend medical examination, failed to explain her non-attendance, and did not respond to directions from Review Panel; claimant provided with further opportunity to respond and did not reply to direction; - dismissal application exercised sparingly and with exceptional caution; applied; application for review of the medical assessment dismissed pursuant to section 54 of the PIC Act due to a failure to prosecute proceedings with due dispatch and failure to respond to directions.
s 58(1)(a) of the MAC Act, and whether any such treatment relates to the injury caused by the motor accident under s 58 (1)(b) of the MAC Act. 2. Section 57 of the MAC Act defines a "medical dispute" as a disagreement or issue to which Part 3.4 of the MAC Act applies. 3. Section 58 of the MAC Act provides that a disagreement between a claimant and an insurer on three distinct matters is referred to as "medical assessment matters". Medical assessment matters include "whether the treatment provided or to be provided to the injured person was or is reasonable and necessary in the circumstances" and "whether any such treatment relates to the injury caused by the motor accident". 4. Section 60 of the MAC Act provides that either party may refer a medical dispute to the President who is to arrange for the dispute to be referred to one or more Medical Assessors. The medical assessment may then be referred to a Review Panel (s 63). The review is by way of a new assessment of all the matters with which the medical assessment is concerned.
"The issue of dismissal for want of prosecution of the claimant's review of the medical assessment of Medical Assessor Cameron dated 23 February 2024 has been referred to me.
I have considered the submissions sent by the insurer dated 26 June 2025 (Barry Nilsson) and 3 October 2025 (Sparke Helmore).
The claimant is to file any submissions in response including any supporting statement by the claimant by close of business, 16 October 2025.
The parties will be advised if there is a need for further submissions. In the absence of a response by the claimant, the parties are advised that the dismissal application will be immediately determined on the papers."
"(a) if it is satisfied that the proceedings have been abandoned, or
(b) if it is satisfied that the proceedings are frivolous or vexatious or otherwise misconceived or lacking in substance, or
(c) for any other ground of dismissal specified in the Commission rules."
"(ii) the applicant has failed, without reasonable excuse, to comply with a direction given by the Commission or the President, or
(iii) the applicant has failed to prosecute the proceedings with due dispatch".
"But for present purposes, two matters are clear. One is that common to all the various formulations is the need for 'exceptional caution', as was explained in Agar v Hyde (2000) 201 CLR 552; [2000] HCA 41 at [57] and Spencer at [53]-[55]. The other is that the inquiry is as to the demonstrated certainty of the outcome of the litigation, as opposed to its prospects of success."
[1] Section 7.26(5) of the MAI Act; determination dated 16 February 2023.
[2] See Rule 127 (1)(d) of the PIC Rules.
[3] [1964] HCA 69; (1964) 112 CLR 125 (General Steel) at [129].
[5] (at [30], Macfarlan and Simpson JJA agreeing).
Alibabic
AAI Limited t/as GIO [2025] NSWPIC 548;
(2000) 201 CLR 552
(1964) 112 CLR 125