austlii:nsw/NSWPIC/2025/103
General information, not legal advice.
NSWPIC
2025-03-21
Original judgment source is linked above.
Brown v AAI Limited t/as AAMI [2025] NSWPIC 103
MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; the claimant was injured in a motor vehicle accident on 11 December 2020; the insurer wholly admitted liability for the claim; assessment of damages; claim for damages pursuant to ; non-economic and economic loss damages for physical and psychological injury; Division 4.2 applied; past economic loss; applied; applied; applied; applied; future economic loss; applied; applied; non-economic loss; ; applied; applied; applied; - damages for past, future and non-economic loss assessed at $1,060,300.36; claimant's costs assessed at $74,377.20 inclusive of GST.
(the MAI Act). 5. AAMI accepted liability for the claim on 5 February 2024. By admitting liability, AAMI accepted that:
(a) the insured driver owed the claimant a duty of care;
(b) the insured driver breached that duty of care, and
(c) the claimant suffered some injury, loss or damage as a consequence of the insured's driver's breach of the duty owed.
(a) the amount to be awarded for non-economic loss (NEL);
(b) the amount for past-economic loss (PEL). In this respect, AAMI submits that a reasonable allowance for PEL is about $100,000 representing a total loss of income for six months after the accident and a partial loss from then until January 2023, when Ms Brown underwent what it contends an unrelated lumbar surgery and when, at about the same time, Ms Brown's employer at the time of the accident ceased operations in Sydney, and
(c) AAMI disputes the amount to be awarded for future-economic loss (FEL), submitting that a reasonable allowance is by way of buffer in the amount of $50,000.
15 January 2025. 2. AAMI made further submissions on 5 December 2024 and Ms Brown made further submissions on 30 January 2025. Further, AAMI made further submissions on
13 February 2025 and Ms Brown made submissions in reply on 20 February 2025.
"I was stationary at traffic lights with three or four cars stopped in front of me. Vehicle hit me from behind at some speed. Impact threw me forward then back. Where my bag and contents were all over floor, and phone damaged."
[1] Employed by Civ Force Traffic as a traffic control officer.
[2] Commenced employment with Civ Force Traffic in October 2020.
[17] On way home from work, was involved in an Accident.
Further Statement of Kim Brown - 21 September 2022
[15]-[21] Refers to the examination by Dr Miniter. The consequences of the examination by
Dr Miniter; Admission to Westmead Hospital 21 July 2022.
Supplementary Statement of Kim Brown - 7 December 2023
[41]-[44] Lists previous injuries and medical conditions.
Dr Mark Lim. He provided Certificates of Capacity. * [33] Shortly after the accident, attended an optometrist as she continued to have pain in her left eye. The optometrist advised that she had lost 50% vision of the left eye. * [34] Attended an ophthalmologist, Dr Cass. She recommended an MRI scan. The MRI did not show any fractures or haematoma. * [35] Also attended orthopaedic surgeon Dr Kanawati. * [36] On 23 January 2023, had a lumbar fusion at Westmead Hospital. She was in hospital for 10-11 days. * [37] Attended physiotherapy at My Health Merrylands. To the date of this Statement, had had 24 sessions. * [38] Workers Compensation Insurer covered the cost of the physiotherapy. * [39] Attended a psychologist for counselling. Did not feel that the counselling helped. * [40] Attended Hassan Qureshi from Exercise Physiology, Wentworthville. * [41] Has "been required to take":
(a) Amitriptyline 10mg twice a day; > > (b) Lyrica 50mg - three times per day; > > (c) Palexia 50 mg six time per day (Stopped taking it in three weeks ago); > > (d) Panadol - as required; > > (e) Panadeine - as required; > > (f) Tapendatol 50mg four times per day; > > (g) Tramadol 50mg three times a day, and > > (h) Gabapentin 300ml two times per day.
(i) Orthopaedic surgeon - Dr Andrew Kanawati; > > (ii) Neurologist Dr Grant L Walker; > > (iii) Pain Specialist Dr Tze Chow Chow; > > (iv) Physiology - Hassan Qureshi, and > > (v) Psychologist Dr Alfred De Robillard.
Collision and biomechanics report of Andrew McIntosh (PHD) dated 9 September 2024
"[48] In my opinion, based on the Incident descriptions, absence of airbag deployment in vehicle 1 and observed and described vehicle damage, the closing speed was most likely in the range of approximately 10 to 20 km/h with a change in velocity of the Claimant's vehicle in the range of approximately 6 to 12 km/h. Closing speeds greater than approximately 20 km/h, would have been associated with airbag deployment in vehicle 1."
"[49] My opinion is based on my training and experience, including experience in studying and examining collisions, reviewing crash cases and vehicle damage, comparing vehicle damage to vehicle recorded crash data, participating in vehicle crash testing (components and full tests), and reviewing crash test data."
"[106] ...there is a very low likelihood of the speed and forces involved in the subject accident being capable of causing the physical injuries alleged by the Claimant in total, in particular the lumbar spine injury requiring surgery."
"[109] ...it is plausible that the biomechanical forces acting on the Claimant in the subject accident were capable of causing:
"[110] ...it is unlikely that the biomechanical forces acting on the Claimant in the subject accident were capable of causing:
"[115] The thoracolumbar spine would have been very well-supported by the seat in the collision. Loads applied to the thoraco-lumbar spine in the collision would have been very low magnitude and unlikely to cause injury. The likely change in velocity of the Claimant's vehicle is less than recognised and well documented thresholds for the onset of thoracolumbar spine injury in rear end motor vehicle collisions. Thoracolumbar spine intervertebral disc or structural injury is very unlikely. Figure 17 shows that less than 10% of occupants in a rear end collision of similar severity as the Incident will experience an acute thoracic or lumbar strain."
"[116] ...Biomechanical forces acting on the lumbar spine during the Incident would have been similar to those that the Claimant would have experienced at work and home"
"(5) There is a very low likelihood of the speed and forces involved in the subject accident being capable of causing the physical injuries alleged by the Claimant, in particular the lumbar spine injury requiring surgery."
"(7) It is unlikely that the biomechanical forces acting on the Claimant in the subject accident were capable of causing:
(a) head and facial injury - brain injury (concussion/mTBI/other), superficial facial injuries (lacerations and swelling);
(b) cervical spine (neck) - structural injury, e.g intervertebral disc injury or bony injury (crushed C1 and C3);
(c) lumbar spine (low back) - soft tissue injury / sprain strain injury;
(d) lumbar spine (low back) - structural injury, e.g intervertebral disc injury;
(e) chest bruising, and
(f) shoulder - soft tissue injury / sprain-strain / rotator cuff disorder."
Consulting notes of Dr Mark Lim general Practitioner - 6 August 2022
The latest symptom is worsening of R sided symptoms occurring after what Kim felt was a very aggressive manipulation by the independent specialist. Kim again recounting her story .... 'He just yanked me off the bench. I thought he was giving me his hand to help me sit up so I could get off the bench. I was crying at that stage, I was in agony, then he carried on abusing me look at the state of you, you are unfit and your teeth are terrible. I am done, I do not know what to do. The pain he left me in ......'
Kim and I cannot understand why the insurer has so many issues with approving surgery. Hopefully this will be approved shortly so that Kim can have a chance of having her symptoms and life significantly improved."
Report of Dr Helene Cass, Ophthalmologist - 6 January 2021
Report of Dr John O'Rourke, Radiologist - 6 March 2021
MRI Lumbar by Dr Samer Ghattas - 24 August 2021
MRI Lumbosacral by Dr John O'Rourke - 3 August 2022
Reports of Dr Kanawati to the claimant's solicitor - multiple dates
"Kim describes being a restrained driver and was struck from the left rear side by another car. I would describe the mechanism as high energy as the car that struck her caused her car to elevate in the air above the bonnet that struck her. I note that the opinion of Paul Miniter is that he believes that the energy involved was low and Kim's symptoms are not consistent with the mechanism of injury. I think this is incorrect and the high-energy nature of this accident I certainly consistent with the severity of Kim's symptoms."
"To my knowledge, Kim has not complained of prior episodes of lower back pain or radicular pain. Despite the medical imaging showing some spondylitic changes, this injury is certainly a severe new condition which is an exacerbation of what seems like preexisting spondylitic changes. The symptoms that Kim has been complaining of since the accident are definitely related to the accident directly and were not present prior to the injury and I suspect that if Kim had not had this injury, she would have remained asymptomatic."
"I think I think Dr Miniter's report is very disappointing, highly biased and quite frankly inaccurate. It seems that Dr Miniter made an early opinion of Kim based on her appearance and smoking status, and his judgemental report is reflective of this... Overall, I believe that his assessment is inaccurate, in some places incorrect, judgemental and inconsistent with my experiences with this patient."
MRI Cervical by Dr Ankar Srivastava- 13 October 2022
Report of Dr Chow Chow, pain specialist - 22 February 2024
who reported back on 22 February 2024. He diagnosed:
(a) chronic post traumatic cervical and back pain;
(b) cervical and lumbar spondylosis;
(c) whiplash associated syndrome;
(d) previous L5/S1 posterior fusion;
(e) chronic neuropathic pain;
(f) chronic secondary musculoskeletal pain; and
(g) post-traumatic stress disorder.
(a) high pain interference;
(b) maladaptive pain cognition with Pain catastrophising and low self-efficacy, and
(c) Previously worked as supervisor in a traffic control.
"Kim Brown has been experiencing significant and problematic pain following a vehicle accident. She has undergone L5/S1 decompression and fusion surgery performed by Dr. Kanawati, who noted C2/3 anterolisthesis and foraminal narrowing of the exiting C3 nerve root. Despite a nerve block injection, Kim unfortunately developed shingles post-procedure.
The accident has had a profound impact on Kim's life, leading to severe psychological distress, including symptoms of PTSD, adjustment disorder, and high pain interference with her daily activities. She has a history of working in traffic control, which she cannot return to due to her injuries and resulting pain. Kim's family, including her stepson David and her daughters, have been supportive throughout her treatment and recovery process.
Kim continues to experience pain, rated at 8 out of 10, with significant impact on her sleep and quality of life. She suffers from fatigue, memory loss, headaches, and vision changes since the accident. Her treatment regimen includes ongoing physiotherapy, psychological support, and medication management, with an emphasis on exploring non-addictive pain relief options."
Dr Grant Walker, treating neurologist - 11 April 2023 and 9 August 2023
Dr Andrew Porteous, occupational physician - 7 May 2024
Report of Dr Bodel to Gerard Malouf & Partners - 27 September 2023
"... this claimant clearly does have significant pathology in the lower part of the back and significant sciatic nerve root irritation in the left leg which warrants the surgery as proposed."
"I am satisfied that the proposed surgery from two reputable surgeons ... is reasonably necessary treatment to manage the mechanical disc pathology and the left-sided sciatica that occurred as a result of the motor vehicle accident ...."
Report of Dr Murray Hyde Page for Moray and Agnew for the CTP Insurer - 3 April 2024
"there was a very low likelihood of the speed and forces involved in the accident being capable of causing physical injuries alleged by Ms Brown, and in particular, the lumbar spine requiring surgery"
"it is plausible that the biomechanical forces acting on the claimant...were capable of causing:
(a) cervical spine (neck) - whiplash associated disorder / soft tissue injury / symptomatic aggravation of a preexisting musculoskeletal disorder (MSD), and
(b) lumbar spine (low back) - symptomatic aggravation of a pre-existing musculoskeletal disorder (MSD)."
Report of Medical Assessor Cameron of 19 August 2022
Report of Medical Assessor Friend of 18 February 2023
"Ms Brown was examined by video teleconference. She was generally distressed, struggled to provide an account of her symptoms, especially psychiatric/psychological symptoms, and did not appear to understand the importance of providing an accurate and complete account of her symptoms.
She was overly focussed on her pain even though she was repeatedly asked about psychiatric/ psychological symptoms. She had to be repeatedly asked clarifying questions to obtain the account outlined above.
Ms Brown described ongoing pain in the lower back which radiated into both legs, on the right to the knee and on the left to the back of the calf. She had pain in the left shoulder which came up to the neck, behind her left ear and across the eyebrows. She had a pulsating sensation in her head.
She described feeling overwhelmed, depressed, having thoughts of dying and suicide and seeing the future as hopeless. She had no energy or motivation and was very distressed by the change in her life and circumstances. She felt that her life had stopped and she was not able to move on in her life. She was aghast at the loss of her physical abilities both at work and at home. She felt that she was no good to anybody and no one would want her in the future."
"Ms Brown described her sleep as poor. She has difficulty getting to sleep and wakes up during the night. It is difficult to get out of bed because of the pain from her back, such that she needs to slide out of the bed sideways. She can be incontinent of urine, if she gets up during the night, not being able to get to the toilet in time. She is very upset that she has three large scars on her back and 30 staples from the surgery. She was expecting to have one small scar. She cries herself to sleep and wakes up crying and feeling fatigued. She nonetheless showers every day and wears clean clothes and underwear every day. One of her daughters has purchased a shower chair for her and her daughters, who visit her, have changed the dressings on her back.
She is able to put bread in the toaster and to make tea for breakfast. Friends are cooking for her. Her granddaughter and a friend buy her groceries and also do her laundry and cleaning of her apartment.
These activities are limited by pain and her psychiatric/psychological symptoms.
Prior to the motor accident Ms Brown had an active social life going out with friends, seeing her children and attending Christmas parties and family functions.
Since the motor accident she has been out socially to a local park with a friend to have lunch on two occasions. She feels incapable of doing any more.
She avoided driving for 3-4 months following the motor accident because of the pain and feeling too scared. She can now drive to consult her doctor, which is five minutes' drive and the Dr Kanawati who is a similar distance away. She cannot drive to visit her daughters because they live much further away. She is always fearful and scared and looks around her when driving. She describes herself as very anxious, has lost her confidence and generally fearful of a further motor accident. She brakes very readily if she sees something potentially dangerous. She feels particularly fearful if she is stationary at traffic lights or a stop sign and looks repeatedly behind her.
She repeatedly tells the driver to slow down and not to be too close to the vehicles in front or beside them, when travelling as a passenger.
Ms Brown has lost contact with many of her friends. Her daughters telephone her every day and her son telephones her, less frequently. She has contact with two friends. She sees her granddaughter infrequently.
Ms Brown has a poor memory and is forgetful. She repeatedly tells her children that she is not confident that she remembers things correctly.
Ms Brown finds it difficult to read and write because of difficulty with concentration. As note above Her vision had returned to normal by 3 February 2021.
She avoids watching news reports of motor accidents feeling that they remind her of her accident.
She struggles to remember what she watches on television and is not confident she remembers everything correctly.
Ms Brown made two unsuccessful attempts to return to work and has not made further attempts to return to work. She is physically and mentally inactive. She spends most of the day at home sitting. Her weight has increased. She has increased a dress size 8 to a dress size 14."
"She feels depressed every day and feels sad, tearful, hopeless and that her life is completely changed.
She has loss of interest and pleasure in all activities.
She has sleep disturbance. She has a loss of energy and motivation. She feels worthless and useless to anybody and that no one would want to have anything to do with her.
She has recurrent thoughts of suicide and dying but has not actually formulated a plan although at times she has thought about overdosing.
These symptoms cause distress and impairment in her day-to-day functioning and have contributed to her not returning to work, in addition to adversely impacting on her social functioning.
These symptoms are not attributable to the physiological effects of a substance or another medical condition and not better explained by another psychiatric condition.
"Ms Brown was fit and active, working full time and in a relationship at the time of the motor accident.
She has been unable to sustain a return to work principally because of pain but also because of the psychiatric/psychological symptoms.
She has not been involved in any subsequent motor accident and has not suffered any other injuries or significant illnesses unrelated to the motor accident.
There is no other cause for her current symptoms and diagnosis of Major Depressive Disorder."
Report of Associate Professor Paul Miniter, orthopaedic surgeon - 28 July 2022
Vocational assessment of Erin Simpson, rehabilitation consultant - 7 December 2023
(a) customer service, and
(b) sales assistant.
Claimant's further submissions of 14 November 2024
11 December 2020. * [4] AAMI sets out the injuries alleged by Ms Brown. * [5] She underwent an L5/S1 decompression and lumbar fusion in January 2023, but AAMI declined coverage for the surgery in September 2022. * [6] Ms Brown has received workers compensation statutory weekly payments. * [7] Liability was admitted by AAMI. * [8] Medical Assessor Friend determined Ms Brown's psychiatric injury to be a non-threshold injury, and as such she is entitled to damages pursuant to s 4.4 of the MAI Act. * [9] AAMI conceded that Ms Brown's WPI is greater than 10% and is therefore entitled to damages for non-economic loss pursuant to s 4.11 of the MAI Act.
[10]-[12] AAMI disputes that Ms Brown's back injury and need for the L5/S1 decompression and lumbar fusion were caused by the accident as well as Ms Brown's description of the accident to medical professionals.
[13]-[14] The police report noted the incident to be a minor traffic crash, and no police nor ambulance attended the scene. NSW Fire & Rescue attended the accident.
[15] The insured driver described the accident it as a low-speed collision in gridlocked traffic, with minimal damage to the claimant's vehicle. No air bags deployed.
[16] AAMI relies on the collision and biomechanics report of Dr Andrew McIntosh dated
9 September 2024, where the closing speed of the collision was determined to likely be between 10-20 km/hour.
[17] The photographs of the vehicles after the accident suggest that the accident was a relatively minor impact.
[18] AAMI challenges Ms Brown's descriptions of the accident, such as claiming she had been struck by a 'fast moving vehicle' [Dr Suttor 3 November 2021] which allegedly exaggerated the force of impact.
[19] AAMI discussed Ms Brown's pre-accident history referring to the Records of Wentworthville Medical & Dental Centre and My Health Merrylands.
[20]-[22] Initial medical visits in December 2020 reported neck and chest pain, with no mention of lumbar spine issues.
[23]-[24] The first back pain complaint appeared in July 2022, leading to spinal surgery in January 2023, which AAMI declined was related to the accident.
[25]-[29] Ms Brown was found to have soft tissue injuries (threshold injuries) to the neck, lumbar spine, shoulders, and chest but no head, hip, or eye injuries. The lumbar spine injury was deemed unrelated to the accident.
[30]-[31] Radiculopathy and degenerative spine disease were attributed to pre-existing conditions, not the accident.
[32]-[37] Facial symptoms, eye injuries, and trigeminal neuralgia were determined not to be related to the accident.
[38] Ms Brown was diagnosed with Major Depressive Disorder, but the insurer argues this diagnosis wrongly relied on the lumbar injury being related to the accident.
[39]-[44] AAMI's orthopaedic surgeon and other experts concluded Ms Brown's injuries were soft tissue only and that the lumbar surgery was unrelated to the accident.
[45]-[48] Ms Brown's doctors (Dr. Bodel & Dr. Porteous) linked the back injury to the accident, but the insurer argues they relied on incorrect accident descriptions.
[49]-[52] Since AAMI conceded a WPI of greater than 10%, Ms Brown is entitled to non-economic loss, but the insurer argues it should be limited to $200,000 based on soft tissue injuries only.
[53]-[64] Ms Brown was earning around $1,400 gross per week pre-accident. AAMI disputes full economic loss, arguing that post-accident work capacity was affected more by the unrelated back condition than the accident.
[69]-[71] Ms Brown received $311,622.95 in statutory weekly payments, but AAMI argues there was an overpayment of $41,837.90 due to overlapping CTP and workers' comp payments.
[1]-[4] Ms Brown sets out the issues addressed in her submissions.
15 December 2020.
19 December 2020. There is no note of complaint of lumbar spine pain on this date.
"I reviewed Kim on two occasions, the first being 17 June 21, the second being 27 August 21...Kim was suffering from several symptoms. The main ones were back pain, left leg radiculopathy, neck pain and occipital headache. Her back pain and leg pain are related to an L5-S1 disc injury which was impinging upon the L5 nerve root. I believe that this is the main reason why Kim is having discomfort and functional limitation...I believe that Kim's symptoms and her complaints are directly related to the motor vehicle accident."
"On examination, she was teary during the consultation today and in obvious discomfort. She walked with a significant left antalgic gait. Neurological exam of the lower limbs demonstrated intact power although this was pain affected. Straight leg raise test was positive on the left and she had an absent left ankle jerk. Hips are non-irritable...MRI scan of her lumbar spine demonstrates a far lateral disc protrusion at L5/S1 which is displacing and tenting the existing L5 nerve root which would correlate with her clinical symptoms. This does result in a significant foraminal stenosis there. She does have some fluid in the facet joints at this level as well. There is no significant neutral stenosis anywhere else in the spine(sic) lumbar spine."
(a) chronic post-traumatic cervical and back pain;
(b) cervical and lumbar spondylosis;
(c) whiplash associated syndrome;
(d) previous L5/S1 posterior fusion;
(e) chronic neuropathic pain;
(f) chronic secondary musculoskeletal pain, and
(g) post-traumatic stress disorder.
(a) lumbar spine - soft tissue injury;
(b) cervical spine - soft tissue injury;
(c) chest - soft tissue injury;
(d) shoulder - left and right soft tissue injury, and
(e) arm - left and right soft tissue injury.
"Ms Brown, in my opinion, aggravated or exacerbated pre-existing ageing-related degenerative change in the cervical and lumbar spine with also a degree of radicular pain...She has got a chronic pain disorder...There is no evidence of pre-existing injuries although Ms Brown more likely than not had underlying degenerative change although it was asymptomatic"
"This claimant has mechanical back ache associated with disc pathology at the lumbosacral junction and I am satisfied that the effect of the motor vehicle accident has caused, at the very least, the aggravation, acceleration, exacerbation and deterioration of a disease process being the degenerative disc disease at lumbosacral junction involving L5/S1 in particular..."
25 March 2024 who noted her eye injuries caused by the motor accident have resolved and give rise to no assessable permanent impairment.
[66]-[72] Claims include past and future economic loss, superannuation, Fox v Wood, non-economic loss, and repayment of workers' compensation and CTP payments totalling $304,617.05.
[84]-[86] Based on Ms Brown's CivForce payslips, her average net weekly income was $1,433.55.
[88]-[90] Past economic loss estimated at $364,800, including long service leave.
[96]-[97] Cl 4.7(2) and (3) of the Act, requires the Commission to adjust by percentage the possibility that the events concerned might have occurred, even without the Accident injury (a Malec v JC Hutton Pty Ltd (1990) 169 CLR 638 common law approach). A 3% adjustment under the Act results in $511,200 ($527,010 - $15,801).
[98]-[99] Ms Brown submitted that she is unfit for work due to her back injury, lacks office experience, and faces employment barriers due to her injury history.
[1]-[2] Ms Brown, 65, was injured in the accident on 11 December 2020. Liability is admitted by AAMI and the only controversy to be resolved is the damage quantification.
[10]-[17] AAMI argues the ongoing lumbar spine issues stem from pre-existing degenerative changes rather than the Accident. AAMI refers to expert opinions from Dr. Hyde Page and Dr. McIntosh which suggest any lumbar injury was at most an aggravation of prior pathology. AAMI relies on decisions in Seltsam Pty Ltd v Ghaleb [2005] NSWCA 208, Wilson v Peisley (1975) 7 ALR 571, and State of New South Wales v Burton [2006] NSWCA 12 which indicate pre-existing conditions must be considered in damage assessments.
[34] AAMI submits that no increase should be made for inflation per Todorovic v Waller [1981] HCA 72; (1981) 150 CLR 402. No proper basis exists for an increased sum based on historical earnings due to fluctuating hours and lack of evidence for continued wage increases.
[35] AAMI submits that Ms Brown's lumbar spine injury is unrelated to the accident, and as this is the primary impediment preventing her from returning to work, she should not recover total loss through to the date of the certificate.
[36] AAMI refers to [63]-[65] of its Submissions of 21 November 2024 and maintains that its previous assessment of $100,000 for past net loss is correct and reasonable.
[37] AAMI submits that if all past loss is attributed to accident-related injuries, Ms Brown's weekly net loss should be $1,120, with 11% lost superannuation.
[38] In respect to Future Economic Loss, Ms Brown's claimed weekly loss of $1,650 with reference to inflation and her past work is inconsistent with financial records and should not be accepted.
[39] AAMI submits Ms Brown's proposed 3% reduction under s4.7(2) - (3) for future loss claimed for a period of seven years is unrealistic, as it assumes work until age 72 - beyond the typical retirement age.
[40] FAI Allianz v Lang (2004) confirms the usual range of 15% reduction for contingencies, covering wide-ranging uncertainties.
[41] AAMI submits a 3% reduction disregards life's uncertainties, including Ms Brown's history of smoking and related health issues. A higher reduction is appropriate.
[42] Ms Brown's health history and degenerative lumbar spine changes guided by the authorities favour a greater reduction, though a specific percentage is unnecessary due to the buffer outlined below.
[43] AAMI submits Ms Brown's intention to work until 72 is not reliable evidence without medical expert support and contradicts the physical demands of her role.
[44] The statement from Mr. Black suggesting extended work life lacks weight, as Ms Brown previously left a job she "loved" for another role. AAMI submits that this indicates that it is equally as probably that Ms Brown's priorities in the future might have shifted and she might have spent more time with her grandchildren.
[45] Working until 72 is inherently improbable; and the more likely scenario would have been retirement at or around 67.
[46] AAMI submits the claim for lost long service leave is too speculative, as it is improbable to determine whether Ms Brown would have worked for enough time to accrue the necessary level of leave.
[47] Ms Brown bears the burden of proving total loss of earning capacity before the insurer must demonstrate viable job options.
[48] AAMI submits that Dr. Porteous' report inconsistently states total incapacity while implying potential job options, and it lacks substantive reasoning.
[49] AAMI further submits that Ms Brown's medication is taken at night and is not prohibitive of her working.
[50] Ms Brown previously worked as a boom gate operator post-accident, but did not reconsider it as a viable job despite feeling that she could manage it.
[51] Apart from a failed work trial, Ms Brown had only recently started job-seeking, proving she is capable of working.
[52] Ms Brown applied for multiple jobs, including library and car park attendant roles, and was even offered a job but declined due to not being able to drive a manual car - not due to physical limitations - and also stated that she could not reverse, despite the fact that she continues to drive.
[53] AAMI submits that based on the evidence, Ms Brown does not have a total loss of earning capacity.
[54] In respect to an assessment of future loss, AAMI maintains that a $50,000 buffer is generous, submitting:
[55] Fox v Wood payments will be determined once the Member sets a date for publishing reasons.
[56] AAMI provides a proposed total loss assessment:
Claimant's Submissions in reply of 20 February 2025
(a) Ms Brown submits that a minor $33 discrepancy in estimated weekly earnings is normal, as it is not reasonable to expect precision from her memory in respect of net weekly earnings; > > (b) Ms Brown disclosed the discrepancy and repaid any COVID-19 overpayments, and no legal action was taken; > > (c) Ms Brown submits that AAMI's own medical evidence supports Ms Brown sustaining at least a soft tissue lower back injury and an aggravation of her degenerative changes in the lumbar spine, and there is evidence of back complaints in Dr Lim's medical records, and > > (d) no evidence supports the claim that Ms Brown would have reduced work hours to spend time with grandchildren.
[17]-[20] Ms Brown notes legal precedents cited by AAMI do not undermine her position. There is no evidence to determine when, if ever, her degenerative conditions would have become symptomatic without the accident.
[27]-[28] Ms Brown submits AAMI's reliance on FAI Allianz Insurance Ltd v Lang [2004] NSWCA 413 is misplaced, as that case involved a much younger plaintiff.
Ms Brown sustained the following injuries and or conditions in, or as a result of, the accident:
(a) musculoligamentous injury to the cervical spine;
(b) musculoligamentous injury to the lumbar spine;
(c) musculoligamentous injury to the chest;
(d) musculoligamentous injury to both shoulders;
(e) musculoligamentous injury to both arms;
(f) aggravation of degenerative changes in cervical spine;
(g) aggravation of degenerative changes in lumbar spine;
(h) superior hemifield visual defect in the left eye;
(i) Quadrantanopia of the right eye, and
(j) major depressive disorder.
"Kim describes being a restrained driver and was struck from the left rear side by another car. I would describe the mechanism as high energy as the car that struck her caused her car to elevate in the air above the bonnet that struck her. I note that the opinion of Paul Miniter is that he believes that the energy involved was low and Kim's symptoms are not consistent with the mechanism of injury. I think this is incorrect and the high-energy nature of this accident I certainly consistent with the severity of Kim's symptoms."
"To my knowledge, Kim has not complained of prior episodes of lower back pain or radicular pain. Despite the medical imaging showing some spondylitic changes, this injury is certainly a severe new condition which is an exacerbation of what seems like preexisting spondylitic changes. The symptoms that Kim has been complaining of since the accident are definitely related to the accident directly and were not present prior to the injury and I suspect that if Kim had not had this injury, she would have remained asymptomatic."
11 April 2023. 11. I note the opinion of Dr Porteous, occupational physician, that Ms Brown was unfit for her pre-accident employment.
(a) "pain and suffering;
(b) loss of amenities of life;
(c) loss of expectation of life, and
(d) disfigurement"
1 October 2024 been $654,000 [s 4.13(1)]. 2. The s 4.13(1) figure is merely a cap and the claimant being entitled to non-economic loss damages they are assessed in accordance with common law principles within the confine of the cap in the matter of Hodgson v Crane [2002] NSW CA 276 (Crane), and RACQ Insurance Ltd v Motor Accidents Authority of NSW (No.2) 2014 NSW SC 1126. See also Hoffer v Brown [2009] NSW DC 32. 3. The amount of non-economic loss damages to be awarded should be proportionate to the claimant's injuries and disabilities:
"11. 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 .... It 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 an 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 [11]
"which on its own would incapacitate someone from all work."
Ms Brown also relies on the opinion of Dr Bodel and of the treating surgeon. 6. In summary, Ms Brown, as a result of the totality of her injuries and disabilities as noted above, suffered a significant change in her life circumstances and one which has removed her from the workforce and from employment, which she enjoyed, and left her isolated and suffering from a variety of painful symptoms and major depressive disorder. 7. I assess Ms Brown's damages for non-economic loss at $375,000.
Past Impairment of earning capacity and its economic consequences
11 December 2020. 13. I cannot see the logic in the base amount for net weekly earnings on the restricted period set out in [85]. Rather, it is more appropriate to calculate the loss based on the Notices of Assessment for financial year 2020, that is $1,339.80 per week. 14. I calculate past loss of earnings at $1,339.80 per week from the date of the accident to date, giving 221 weeks being $296,095.80. 15. Ms Brown has not established by evidence the basis for an entitlement to past loss of long service leave. 16. Ms Brown has not established by evidence the alleged loss referred to in paragraph [88]. 17. Past loss of Superannuation was agreed at a figure of 11% of $296,095.80, giving $34,051.01. 18. Fox v Wood accounts for $61,196 plus any statutory payments not included in that amount.
"Future economic loss - claimant's prospects and adjustments
(1) Damages may not be awarded for future economic loss unless the claimant first satisfies the court or Commission that the assumptions about future earning capacity or other events on which the award is to be based accord with the claimant's most likely future circumstances but for the injury.
(2) The amount of damages for future economic loss that would have been sustained on those assumptions is to be adjusted by reference to the percentage possibility that the events concerned might have occurred but for the injury.
(3) If an award for future economic loss is made, the court or Commission is required to state the assumptions on which the award was based and the relevant percentage by which damages were adjusted."
How the Court deals with the assumptions of fact
"The assumptions or events upon which a baseline may commonly be calculated include:
(a) identification of the skills, training and experience of the plaintiff, as at the date of the accident;
(b) the work he or she was undertaking immediately prior to the accident;
(c) the likelihood that he or she would have continued in such employment, but for the accident;
(d) the possibility that he or she might have obtained promotion or other benefits, but for the accident;
(e) the age to which he or she was likely to have worked in that employment, and
(f) the possibility that the employment would not have been continuous."
Mr Quickenden's submissions of 30 January 2025 for the following reasons:
(a) even though there was a historical trend in the increase of her taxable income between 2017 and 2020, there is no evidence as to any arrangements which
Ms Brown had or did not have with her employer to adjust her pay for inflation as argued in [88]. There is no evidence as to her employer's capacity to pay, or as to the market conditions immediately prior to the accident;
(b) there is no evidence as to the relevant terms and conditions of her employment with respect to adjustments for inflation, and
(c) there is no evidence as to comparable earnings of traffic controllers relevant as at the time of the accident.
Maximum fees for Medico-legal services (Clause 28(1))
Unregulated costs assessed as fair and reasonable
(a) the claimant is a person under legal incapacity; or
(b) exceptional circumstances exist that justify payment of legal costs incurred by the claimant.
As submitted, that case referred to; "particular unusual situations where the maximum costs fixed by the regulations may not be adequate" as some cases may be exceptional "because they involved an unusual degree of factual or legal complexity or for some other reason, and this required the incurring of more substantial legal costs by a claimant." This application fails. There was no particular factual or legal complexity to justify the making of an exceptional costs order.
Brown
AAI Limited t/as AAMI [2025] NSWPIC 103
(1960) 108 CLR 158
(1995) 182 CLR 1
(1990) 169 CLR 638
(1975) 7 ALR 571