Khalil v Taoube

Nature of case 1The plaintiff, Mrs Miriana Khalil, a motor vehicle passenger, claims damages against the defendant, Mr Hamed Taoube, the driver of the vehicle, in respect of injuries she received in a motor vehicle accident on 1 November 2006. The proceedings are governed by the provisions of the Motor Accidents Compensation Act 1999 ["MAC Act"]. 2The accident involved two collisions, the first occurred when the driver's side of Mr Taoube's vehicle was struck by another vehicle as those vehicles negotiated an intersection roundabout. The second collision occurred when Mr Taoube's vehicle then spun out of control and into a further collision involving contact with a power pole. 3The CTP insurer of Mr Taoube's vehicle admitted breach of duty of care in respect of the collisions. Notwithstanding that admission, the insurer devoted significant resources to strenuously contesting the plaintiff's claim for damages, citing credit issues. 4The plaintiff's case developed a bizarre facet when, on Friday 20 May 2011, which was the 6th day of the trial, and the second day of her cross-examination, the plaintiff was temporarily excused from attending for continuing cross-examination because she needed to seek medical attention. This was said to have been because she was stressed, depressed, physically ill, and therefore unable to continue to give evidence. 5Subsequently, it transpired that on that day, the plaintiff had gone to hospital where she was delivered of a child by caesarean section in circumstances where, immediately beforehand, the legal representatives of the parties had not known she was pregnant. It was not until the proceedings resumed on the following Monday, 23 May 2011, and after the proceedings had then continued for a further 2 days of cross-examination of the plaintiff, that the fact of the birth of the plaintiff's most recent child was revealed by the answer to a chance question.

Complexity and attempts to narrow issues 6The inherent complexity of the proceedings was well understood by the legal representatives of both parties long before the trial was due to commence. 7It was plain that in the lead-up to the trial, the parties had not adequately come to grips with their obligations to seek to simplify the complexity of the proceedings in an attempt to achieve a just, quick and cheap resolution of the litigation: s 56 of the Civil Procedure Act 2005. Prior to the trial, the parties had not made any significant efforts to seek to narrow the issues, or to confine the extent of the medical evidence that was to be adduced in oral form. 8This was apparent from the several pre-trial directions hearings, and the need for the parties to obtain variations to timetabling orders for compliance with case management directions in what was foreshadowed to be an unusually lengthy 4 week trial, in a motor vehicle personal injury case, where the issues to be tried were limited to damages. 9The plaintiff had retained successive solicitors and each of those firms had retained consultant psychiatrists to provide opinions in addition to the opinion of the plaintiff's treating psychiatrist as to the nature of the plaintiff's ongoing disability. There had been no pre-trial attempt to arrange for a joint expert report concerning the opinions of the 5 consultant psychiatrists who were ultimately called to give evidence. The parties had not considered nor sought to arrange for the evidence of those experts to be given concurrently, despite clear indications that such a course was justified in the interests of streamlining the case and the parameters of the areas of disputed medical issues. 10On the eve of the trial, the parties had been directed to attempt to reach areas of agreement by seeking to identify the facts not in dispute, and to identify the issues calling for determination. 11In purported compliance with those directions, at the commencement of the trial, only a very limited statement of agreed facts was produced by counsel for the parties. This was in the form of a written document that comprised MFI "2", and which was in the following brief and unrevealing terms: "(1) The plaintiff was born on 15 September 1973. (2) The plaintiff was a front seat passenger in a motor vehicle driven by the defendant which was involved in an accident on 1 November 2006. (3) The plaintiff sustained injury in the aforesaid accident." 12Since the parties had taken some time and trouble to pre-prepare a large bulk of documentary evidence in the form of indexed exhibit bundles, it was unfortunate that only the very few facts cited in the preceding paragraph were the subject of agreement, and that so many other facts were said to remain in bona fide dispute. 13The plaintiff's exhibits bundle, Exhibit "C" comprised 22 medical reports (152 pages). The defendant's medical exhibits bundle, Exhibit "3" comprised 19 medical reports (279 pages). The defendant tendered a bundle of miscellaneous documents, Exhibit "6", (234 pages). The defendant also tendered as Exhibit "7', a folder of 12 surveillance reports relating to many days of surveillance film taken of the plaintiff, and also static or unmanned surveillance at her several known addresses (136 pages). 14The transcript of the proceedings was voluminous, and it reflected the detail of the many areas of disputed fact, credit and interpretation of events that the defendant's insurer sought to place in contention in the litigation. 15The plaintiff's evidence in chief economically comprised some 37 pages of transcript. The transcript of the cross-examination of the plaintiff occupied several hundred pages. This was the subject of a number of complaints by counsel for the plaintiff concerning repetition and prolixity of questioning: T71.19 - 71.22; T74.16; T165.5. The plaintiff also voiced her own complaints concerning repetitive cross-examination on a number of occasions: T173.35; T199.32; T328.36; T333.16. On one such occasion she stated "... I can't keep coming and sitting there and answering the same questions over and over again": T333.16. Although some latitude was given for cross-examination on matters of credit, at various stages, attempts were made to restrict or disallow repetitive cross-examination: T70.12; T71.29; T74.19; T233.16; T353.49; T354.6; T354.15. 16Of the 7 consultant psychiatrists who had examined and reported upon the plaintiff's condition, only 5 were compellable as witnesses, as the other 2 psychiatrists were Medical Assessment Service (MAS) assessors. An order for concurrent expert evidence was made during the trial. Ultimately, those 5 expert psychiatrists gave their evidence concurrently. The direction for concurrent evidence was persistently resisted by the legal representatives of the defendant. I was informed that such resistance was maintained both before and after the direction had been made for concurrent evidence. 17Notwithstanding repeated complaints by counsel for the defendant of unfairness in relation to the order for concurrent expert evidence, including claimed procedural unfairness, a matter to which I shall in due course return, I found that the format and content of the concurrent evidence of the psychiatric experts to be a very helpful aide in the task of sifting the content of, and the basis for, the respective psychiatric opinions concerning the plaintiff's condition. 18The medical evidence tendered by the parties was voluminous. The defendant considered the statements recorded within the histories in those reports to be crucial to the outcome of the proceedings. It is therefore necessary that I undertake the task of examining that body of evidence in some detail in order to understand the basis of the respective medical opinions before arriving at my findings on the credit challenges that the defendant's representatives made to the evidence of the plaintiff. 19My summary of that process of analysis, which is perhaps longer than might have been usual for a less complicated case, appears between paragraphs [97] to [359] of these reasons.

Issues - as initially defined by the parties 20At the commencement of the trial, and in purported compliance with directions given before the trial, counsel for the respective parties also produced a document in the very briefest of terms, in which they had jointly, and somewhat simplistically, defined the agreed issues for determination in the proceedings as comprising an abstracted single catch-all umbrella issue, which was stated in MFI "3", as follows: "The nature and extent of injuries and disabilities caused by the motor vehicle accident on 1 November 2006" 21That statement of the issues proved to be an oversimplification. It belied the true parameters of the contest between the parties, which involved a much greater degree of undefined complexity, including a significant number of sub-issues concerning the credit of the plaintiff. The document provided almost no assistance to the court in defining the true issues to be determined in the proceedings. 22At the outset of the trial, senior counsel for the plaintiff drew attention to an apparent concern in the plaintiff's camp that the defendant's CTP insurer was seeking to run an unpleaded defence of fraud against the plaintiff's case: (T1.39). What then followed was an attempt, in vain, to seek a more precise definition of the issues at an early stage of the hearing: (T2.5 - T2.44): "HIS HONOUR: Well, I'm a bit puzzled as to why these three cases which are for assessment should take three to four weeks. CRANITCH: Well, precisely. I am somewhat puzzled because I can understand it if it was alleged to have been a fraud case of some sort where - well, you might have spend a bit of time on it. But since it's not alleged - I'm told by my learned junior - I don't know how accurate it is - he's got the statement of issues - that the only issue is, as I understand it, disability. HIS HONOUR: Well, I better hear from Mr Fitzsimmons as to what he thinks the issues are. FITZSIMMONS: Your Honour, as your Honour will see there are three cases listed. There's the mother's case and two children's cases. Your Honour, the issue is essentially one of injury and the extent of disability in each of the cases. HIS HONOUR: So to be specific, are you alleging, as Mr Cranitch apprehended, that if there was any aspect of the claims made to be fraudulent? FITZSIMMONS: Your Honour, we will seek to put before your Honour some evidence and cross-examination particularly of the plaintiff of what we would say, your Honour, is an embellishment or exaggeration in terms of the extent of injury or disability. So, your Honour, that's essentially the case that we will be running that, your Honour, at the end of the day having the heard the plaintiff's evidence and any other evidence and having seen material which we will seek to tender that your Honour in due course, your Honour could not be satisfied of the plaintiff's statements as to the extent of disability which she alleges which gives rise to the claim. HIS HONOUR: So, I take it from what you've just said that you concede the plaintiff was injured as claimed? FITZSIMMONS: We concede, your Honour, that the plaintiffs sustained some injury in the accident, yes. HIS HONOUR: So am I getting from this that there are credit issues. FITZSIMMONS: Yes, your Honour. Very much so." 23The reference to there being 3 cases to be determined, was a reference to the 2 claims that were brought on behalf of the plaintiff's children, in addition to the present proceedings. Those additional claims did not occupy any actual hearing time, and they were settled on terms approved by the List Judge during the course of this hearing without any evidence being taken in relation to those 2 cases. Properly, the terms of those settlements were not disclosed to me.

Issues - as ultimately identified 24Since the legal representatives of the parties had not, before the conclusion of the evidence, identified with any useful degree of specificity, the issues to be determined in the proceedings, I have gleaned the ultimate issues requiring determination to be as follows: Issue 1 - The credibility of the plaintiff's testimony, having regard to the matters of relevance within multiple areas of attack upon the credibility of her evidence. This is a matter to which I shall shortly return at paragraph [34] of these reasons, where I have sought to identify and isolate the principal topics that were entailed in the insurer's credit attack upon the plaintiff; Issue 2 - The circumstances, nature and force of the collisions in which the plaintiff came to be injured; Issue 3 - The particular areas of the plaintiff's body that were injured in the collisions; Issue 4 - The nature and extent of the plaintiff's remaining disabilities that are due to the effects of the accident. These matters required the resolution of conflict within the body of opinions of medical experts in order to determine which opinions should be preferred; Issue 5 - The assessment of the plaintiff's entitlement to damages in respect of the following 4 claimed heads of damage: (i)Future loss of earning capacity (ii)Past domestic assistance (iii)Future domestic assistance (iv)Past out-of-pocket expenses. 25A number of sub-issues also arose within the above issues. Some of the matters arising within Issues 2 to 5 overlapped with the credit issues that I shall shortly identify at paragraph [34] of these reasons. Where it was considered appropriate to do so, I have analysed these matters in the context in which they arose. Before outlining the credit issues I shall identify the parameters of the evidence adduced in the proceedings.

Evidence overview 26In the case for the plaintiff, in addition to the plaintiff's own oral evidence, which was taken over a number of days, oral evidence was also given by Mr Mohamed Taoube (the son of the defendant driver), Mrs Salwa Ishak and Mrs Ezze Yasier, the latter two persons being friends of the plaintiff. The evidence from those witnesses was directed to the damages issues concerning the claim for domestic assistance. Oral evidence was also given by Mr Youseff Hage Youseff, a pre-accident prospective employer of the plaintiff. The defendant had required Dr Donald Faithfull, a consultant orthopaedic surgeon who had assessed the plaintiff on behalf of her solicitors, to be cross-examined. Dr Elias Matalani, a consultant occupational physician who had also examined the plaintiff at the request of her solicitors, was similarly required for cross-examination by the defence. 27There were no lay or factual witnesses called in the case for the defendant. The legal representatives of the defendant had suggested that Mr Taoube was in a domestic relationship with the plaintiff, and therefore declined to call Mr Taoube as a witness in the case for the defendant. The plaintiff denied there was a relationship of other than friendship between herself and Mr Taoube and his family. The CTP insurer did not seek to invoke the provisions of the MAC Act to deal with that or any other credit-related matter by seeking to cross-examine the insured driver: s 119 of Pt 4.6 of the MAC Act. 28The 5 consultant psychiatrists who gave their evidence concurrently were Dr Ishrat Ali, the plaintiff's former treating psychiatrist, Dr Klaas Akkerman, Dr Michael Prior and Dr Thomas Clark, all of whom had been at various times retained by the solicitors who had variously acted for the plaintiff, and Dr Robert Haik, who had been retained by the solicitor for the defendant. 29There was substantial agreement between the majority of those witnesses, except in respect of the evidence of Dr Haik, a matter to which I shall return when evaluating that array of evidence and also in connection with my evaluation of the credit attack made on the plaintiff through the evidence of Dr Haik. 30I will refer to the remainder of the evidence, which was of a voluminous documentary nature, where it becomes relevant and necessary to do so.

Credit overview 31The defendant mounted a broad-based attack upon the credit of the plaintiff, including an extended and prolix cross-examination that was in parts repetitive. This was a matter about which the plaintiff's legal representatives and the plaintiff herself were critical. That attack was further developed in written and oral submissions. The defendant's written submissions included an extensive section attacking the credit of the plaintiff: Defendant's written submissions, paragraphs [117] to [397]. 32The defendant submitted that the plaintiff's credit "has been overwhelmingly impugned to such a degree that the court is not in a position to accept any of the plaintiff's evidence or the medico-legal evidence" which based that medico-legal evidence. For the reasons I have identified at paragraphs [361] to [683] of my reasons, I have not accepted that submission as I found it to be overly simplistic in view of the issues raised. 33Overshadowing the defendant's credit attack on the plaintiff is the fact that the plaintiff was in an advanced state of pregnancy when she gave her evidence. She was certified to be medically unfit to attend court during a significant part of the period she was cross-examined: Exhibit "D". She concealed both of these facts for a number of days. These are matters that require consideration in the assessment of the plaintiff's credit as a witness. 34The defendant's attack on the plaintiff's credit canvassed challenges to the following 23 topics emerging from within the evidence: (1) the plaintiff's capacity to understand English; (2) the events of the accident; (3) the recorded medical histories; (4) the plaintiff's physical injuries; (5) the plaintiff's physical disabilities; (6) the plaintiff's pre-accident psychological issues; (7) the plaintiff's post-accident psychological disabilities; (8) DVD footage showing the plaintiff's activities; (9) DVD footage showing static observation of premises; (10) the claim for domestic assistance; (11) aspects of the claim for economic loss; (12) the plaintiff's living arrangements; (13) the plaintiff's medication usage; (14) driving and motor vehicle ownership; (15) the plaintiff's social isolation; (16) the plaintiff's activities of daily living; (17) plaintiff's physical presentation; (18) the plaintiff's poor recollection of events when cross-examined; (19) alleged personal relationships, including with the defendant; (20) the plaintiff's past pregnancies; (21) concealment of the plaintiff's most recent pregnancy, and the paternity thereof; (22) allegations that the plaintiff lied, told untruths and gave false evidence; (23) allegations of mendacity made by Dr Haik. 35The general method by which the defendant's submissions proceeded to attack the plaintiff's credit, was to refer to summarised statements of the medical histories the plaintiff had provided to the various medico-legal specialists who had examined her, to refer to her oral evidence in which she was said to have either adopted or provided affirmation of those histories as statements summarised by the medico-legal experts, to compare that evidence with the argued unambiguous inconsistencies in the evidence of the plaintiff as revealed by more objective evidence, and to compare those matters with the plaintiff's responses given in evidence when her evidence was confronted and tested during cross-examination. 36In seeking to sustain the attack on the plaintiff's credit, the defendant tendered voluminous surveillance evidence that involved both observational footage of the plaintiff's activities, and which also involved prolonged static surveillance footage of the various premises where the plaintiff was thought to reside. 37Portions of the static surveillance footage were the subject of some agreements reached between counsel for the parties during the course of the trial. This obviated the need for the court to view many days of uneventful surveillance footage that revealed no relevant activity. That agreement arose after counsel for the plaintiff was afforded the opportunity to view that extensive footage outside of court sitting times. There was relatively limited evidence of the activities of the plaintiff in the DVD footage that was shown. This is a matter to which I shall return when considering the submissions concerning the credit of the plaintiff. 38The credit attack on the evidence of the plaintiff was far-reaching and was obviously well planned. It threw up many issues, including peripheral issues, which the defendant sought to make contentious. 39The detail and extent of that credit attack highlighted the oversimplified portrayal of the statement of the issues that was the subject of agreement between counsel at the commencement of the trial, and which I have cited at paragraph [20] above, and which I consider could not be reasonably described as having fulfilled the obligations of the parties arising under s 56 of the Civil Procedure Act 2005. 40I have given careful consideration to the matters raised in the credit attack on the evidence of the plaintiff. In view of the breadth and detail of that attack, my approach to the analysis has been to first review what turned out to be the undisputed background and factual matters, to then review the detail of the medical evidence, and to consider the surveillance evidence and other evidence, before then setting out my reasons for arriving at my credit findings on the individual issues that arose for consideration. 41The effect of that approach has perhaps added considerably to the bulk of my reasons, but this was nevertheless necessarily required because of the nature and extent of the material, and because the findings as to the credit of the plaintiff must precede any findings concerning the nature and extent of the plaintiff's injuries, her disabilities, and the consequential matters relating to the assessment of her claims to entitlement to damages. 42My findings on the issues that I have identified as calling for decision, are summarised in the paragraphs that follow.

Summary of findings 43On Issue 1, on the matter of the credibility of the evidence of the plaintiff, I have found that in some respects, but not overwhelmingly so, as was submitted by the defendant, her credit has been shown to have been damaged on a number of matters that were largely peripheral to the true issues calling for decision. I have not accepted the defendant's blanket submission that the plaintiff's claim should be rejected in its entirety, and that the claim should therefore be dismissed due to her evidence being discredited. My reasons for those findings appear at paragraphs [361] to [683] of my reasons. 44On Issue 2, I have found that the accident in question involved two sequential collisions, each being of some force, which caused damage to the vehicle in which the plaintiff was a passenger. My reasons for such findings appear at paragraphs [684] to [693] of my reasons. 45On Issue 3, I have found that as a result of the cumulative effects of the respective collisions, in addition to minor grazing to her right knee, the plaintiff suffered a minor injury to her head, and sustained soft tissue injuries to her neck, her shoulders, her abdomen, her chest, her thoracic and lumbar spines, and she was subjected to the effects of jarring from the respective impacts of these collisions. My reasons for such findings appear at paragraphs [694] to [756] of my reasons. 46On Issue 4, I have accepted that the plaintiff has been left with ongoing disabilities of a chronic nature from her soft tissue injuries. I have also found that she has also developed a severe psychological reaction following the collision, and as a result of the effects of her injuries and disabilities. I have accepted the preponderance of the medical evidence to the effect that the plaintiff has developed a chronic post-traumatic stress disorder, or PTSD, with an associated major depression, and that she has been left with a specific phobia associated with motor vehicle travel. My reasons for such findings appear at paragraphs [757] to [842] of my reasons. 47On Issue 5, I have assessed the plaintiff's entitlement to damages in the total sum of $102,704.19 which after deduction of a statutory defence for payments made pursuant to s 83 of the MAC Act in the amount of $422,020, results in a judgment in her favour in the amount of $98,483.99. My reasons for such findings appear at paragraphs [843] to [939] of my reasons.

Assessed heads of damage 48The damages submissions of the parties are listed below, together with the paragraph references to my assessments of the various individual heads of damage that were claimed by the plaintiff. The plaintiff's claim was for the assessment of 4 heads of damage, as follows: Head of Damage claimed by plaintiff Plaintiff's Submissions Defendant's Submissions Award Paragraphs (a) Future loss of earning capacity $150,000 $Nil $25,000 [846] - [874] (b) Past domestic assistance $159,712 $Nil $33,352.14 [875] - [917] (c) Future domestic assistance ($678,672) $Nil $37,500 [918] - [934] (d) Past out-of-pocket expenses $6,852.05 $6,852.05 $6,852.05 [935] - [943] Totals ($995,236.05) $Nil $102,704.19

49The figures which I have included in parenthesis in the above tabulation, are the result of calculation of the elements of the claim as was submitted on behalf of the plaintiff. 50The defendant has conceded that the plaintiff had incurred an amount of $6852.05 for past out-of-pocket expenses, but argued that after applying the statutory credit owing to the CTP insurer in the amount of $4220.85, pursuant to s 83 of the MAC Act, the balance of $2631.20, which consisted of the Medicare charge, was likely to be waived as a "small amount" pursuant to s 38 of the Health and Other Services (Compensation) Act 1995, thereby justifying the entry of a judgment for the defendant in the proceedings, assuming no other heads of damage attracted any monetary assessments. The plaintiff disputed those contentions and that conclusion, and I have not accepted the defendant's contention in this regard.

Procedural ruling for concurrent psychiatric evidence 51During the course of the trial, on the 15th day, and as had been indicated in accordance with the direction given to the parties at the commencement of the trial, a formal order was made for the parties to arrange for a meeting to take place between consultant psychiatrists, and for the evidence of 5 consultant psychiatrists to be given concurrently: Uniform Civil Procedure Rules 2005, Pt 31 r 35(c). That order was made in order to seek a narrowing of the issues that emerged from the various psychiatric reports and to aid in an understanding of the matters truly in dispute between the respective experts, as this related to the wider objects of s 56 of the Civil Procedure Act 2005.

Procedural motion seeking a further MAS assessment 52At the commencement of the case on 16 May 2011, Mr Cranitch SC foreshadowed that an application would be made pursuant to s 61(4) of the MAC Act seeking to set aside an existing MAS Certificate issued by Dr Enrico Parmegiani on 20 August 2009. He also foreshadowed seeking an order pursuant to s 61(6) of the MAC Act for the court to substitute its own findings in relation to the plaintiff's degree of permanent impairment greater than 10 per cent. The effect of such orders, if granted, would have enabled the plaintiff to claim damages for non-economic loss. At the outset, the defendant indicated that such a course would be opposed. 53On 8 August 2011, on behalf of the plaintiff, junior counsel for the plaintiff, Mr Campbell, ultimately sought and obtained leave to file a notice of motion in court seeking the above orders. The argument on that motion was deferred until final submissions. Ultimately, on 9 August 2011, Mr Cranitch SC appeared and announced that the plaintiff would not be proceeding with that notice of motion. Accordingly, that motion is now formally dismissed, with any costs incurred by the defendant in respect of that motion to be paid by the plaintiff.

Facts 54In the paragraphs that follow, I set out my review of the evidence and my findings on factual matters.

Plaintiff's background and pre-injury circumstances 55The plaintiff was born in Beirut, Lebanon, in 1973. She is the youngest of 8 children. By a family arrangement, she married an older cousin, an Australian citizen, in Lebanon, when she was aged 16 years. There were 3 surviving children of that marriage. Her first 2 children had died in Lebanon at the respective neonatal ages of about 20 days and 21 days, respectively due to intracranial and intra-abdominal haemorrhages when the plaintiff was aged 16 years and 17 years. 56In 1993, the plaintiff arrived in Australia to join her husband. That marriage broke down on account of her husband's gambling activities, his alcoholism and his imprisonment. The plaintiff subsequently divorced her husband in Australia. There was a history of her husband having behaved violently towards the plaintiff and the children, both before and after the divorce. 57Before the accident the plaintiff was in good health. She used to run for exercise on a daily basis. She was aged 33 years at the time of the accident. After the accident the plaintiff became aware that she was pregnant. However, that pregnancy ended in a miscarriage. The plaintiff was aged 38 years at the time of the trial. 58At the commencement of the trial, the plaintiff's surviving children were her sons aged 19, 14 and 13 years. The eldest of those children is severely disabled with cerebral palsy. As a result of the plaintiff being unable to care for that son after the break-up of her marriage, from the age of 11 years, he has been in institutional care, as it had been difficult for the plaintiff to cope with his care needs as a single parent. Before the accident the plaintiff had occasionally cared for her disabled son on weekends. This is a matter to which I shall return when assessing which psychiatric opinions should be preferred. 59Before the accident the plaintiff attended to all of her household and domestic tasks herself. She also managed her youngest son's soccer team, an activity which she ceased after the accident. To the observation of her friend Mrs Ishak, she was a happy person who coped with her family and domestic responsibilities despite the earlier difficulties she had encountered in her life. 60Before the accident, the plaintiff had been fully engaged in her child rearing responsibilities. However, in 2001 and 2004 she had also completed some TAFE courses. Respectively, these were in floristry and in language, literacy and numeracy: Exhibits "A" and "B". In 2005 she also attended TAFE and completed a 3 month computer skills course. 61At the time of the accident the plaintiff was hoping to obtain work either in a florist's shop, or in a small supermarket, working hours that were compatible with her after school childcare responsibilities. Her ultimate aim was to start her own business, and for this she needed to acquire some experience. Her only previous work experience had been to assist in her sister's jewellery shop in Lebanon. She had not ever worked in Australia in the 13 years before the accident. 62The defendant tendered some pre-accident records relating to the plaintiff from the Westmead Obstetrics and Gynaecology Clinic. These showed that in November 2004, the plaintiff was planning a pregnancy and was given some medical advice in this regard. The context of that consultation was her earlier obstetric history of some problems with childbirth, all of which had occurred whilst she was in Lebanon. In this context it was noted that subsequent pregnancies resulted in caesarean deliveries at Westmead without problems. 63At the time of the consultation in November 2004 it was noted the plaintiff was "currently with another partner for 3 years" and was fearful of being pregnant because of possible complications of caesarean section. The nature of that previous relationship was not explored in the evidence as it was not relevant to any matter in issue. The notes of the Westmead clinic indicated that some reassurance was given to the plaintiff on that occasion: Exhibit "6", Tab 3, page 12. This is a matter to which I shall return in outlining my credit findings concerning the evidence of the plaintiff. 64At the time of the accident, and at the time of the trial, the plaintiff resided in Department of Housing accommodation. The plaintiff's living arrangements were a matter that the defendant went to significant lengths to make the subject of credit challenges to the plaintiff's evidence, including through extensive surveillance evidence, matters to which I shall return in due course in connection with my credit findings. 65On 31 October 2006, which was the day before the accident, the plaintiff had lodged a request with the Department of Housing seeking relocation of her accommodation. This was because she was being harassed by her ex-husband whom she said was on drugs and was violent: Exhibit "6", Tab 4, pages 13 - 14. 66The context of that application was that on 20 October 2006 the plaintiff apparently ascertained that her ex-husband had just been released from gaol and had been sitting outside her house. The unchallenged evidence is that she had an apprehended violence order against him at that time. On 20 October 2006, a general practitioner, Dr Sellathurai, gave her a prescription for a medication, the name of which was difficult to decipher. When she returned to see Dr Sellathurai on 31 October 2006, a history was recorded in the notes at Exhibit "6", Tab 5, page 17, which I interpret to read as follows: "Still feeling v agitated & having nightmares since starting Luvox." 67This matter, and the prescription for Luvox, was a matter that was not made the subject of cross-examination of the plaintiff and it was not a matter upon which the expert psychiatrists were asked to comment. The evidence did not disclose the intended psychopharmalogical or any other possible actions of that medication, and in view of the state of the evidence, it is not permissible for me to draw any conclusions as to what that medication was prescribed for, one way or the other: Strinic v Singh [2009] NSWCA 15.

Trial interrupted by "indisposition" of plaintiff - undisclosed childbirth 68During the course of the trial, on the 5th day, namely Friday 20 May 2011, the plaintiff was excused from giving evidence in order to obtain medical assistance because she was "stressed and physically ill". The proceedings started on that day with senior counsel for the plaintiff making statements to the court that were of some significance to the plaintiff's credit. For that reason I shall set out those statements, which were made in the following terms, and which appear at T223.24 to T223.34: "CRANITCH: My junior had a communication from my solicitor a short while ago before we left to come down here saying the plaintiff is not feeling well and is feeling stressed and is not sure that she is going to be able to give evidence today. I'm waiting for my solicitor to come and give me instructions about that because he speaks her language. So it may well be, your Honour, that the plaintiff is not up to giving evidence today. I'm not quite sure what the problem is. I understand it's some stress issue but given the nature of the case being run by my learned friend, I want to make sure she's on top of her ability to give evidence." 69The above statements by senior counsel, which were made on the plaintiff's instructions, were reiterated at T225.42, in the following terms: "CRANITCH: Yes, thank you, your Honour. As I indicated this morning, the plaintiff has told my instructing solicitor and I've now had a chance to confirm (sic for confer) briefly with her - that she's not, that she doesn't feel she could give cogent evidence today and, your Honour, I wonder if I might ask her a few short questions about that, once the interpreter has been sworn?" 70After the interpreter and then the plaintiff were sworn, at T227.5 to T227.32, the following short evidence was led from the plaintiff as to the nature of her most recent indisposition: "Q. Ms Khalil, before Court commenced this morning, you spoke to your solicitor and you indicated to him that you might have some difficulties about giving evidence today. Is that correct? A. INTERPRETER: Yes. Q. And, as I understand from having spoken to you very briefly outside the Court, you are stressed and depressed and you feel physically ill. Is that correct? A. INTERPRETER: Yes. Q. And you indicate to me you did not feel you would be able to give your full attention to the questions being asked of you today? A. INTERPRETER: Yes. Q. Do you think you will be in a better position to attend to giving evidence if you were able to come back on Monday and not give evidence today? A. INTERPRETER: Yes. Q. Was that a yes? I'm sorry? A. INTERPRETER: Yes. CRANITCH: Yes. Sorry, well, that is the evidence, your Honour. HIS HONOUR: Yes. Are you contesting any of that, Mr Fitzsimmons? FITZSIMMONS: I have no questions, your Honour. THE WITNESS WITHDREW" 71The reasons given by the plaintiff for seeking an adjournment were not further explored at that time, and the requested adjournment was granted as it was clearly indicated and appropriate. 72On the following Monday, 23 May 2011, which was the 6th day of the trial, the plaintiff returned to court. The cross-examination of the plaintiff then continued for another 2 days before, on the 8th day of the trial, counsel for the defendant indicated that subject to reviewing some hospital notes produced at the Registry, he had concluded his cross-examination of the plaintiff: T337.50 - T338.1; T343.35. 73At that point Mr Fitzsimmons took the opportunity of reviewing some further hospital notes that had been produced to the Registry on subpoena. He then continued with his cross-examination of the plaintiff. That cross-examination proceeded on the assumption that the plaintiff was still pregnant, which Mr Fitzsimmons positively put, as follows, at T338.20: "FITZSIMMONS Q. The position is that you are currently pregnant aren't you? A. INTERPRETER: I was. Q. You were pregnant at the time you went to hospital a number of weeks ago weren't you? A. INTERPRETER: Yes. Q. That was the condition for which you went to hospital wasn't it? A. INTERPRETER: I had a very sore stomach before that, yes. Q. No, Ms Khalil, please. The evidence you gave the other day when I asked you some questions about what the condition was, you said it was a condition with your abdomen. Do you remember that? A. INTERPRETER: Yes, yes, the stomach, yes. HIS HONOUR: Isn't that where pregnancy usually appears? FITZSIMMONS Q. Why didn't you disclose, Ms Khalil, that in fact you were pregnant at the time? A. INTERPRETER: You asked me, "Why did you go?" and I told you I had a problem with my abdomen. Q. Who's the father of the child? CRANITCH: I object to that, your Honour. HIS HONOUR: Mr Fitzsimmons, what is the relevance of that question? FITZSIMMONS: Your Honour, I'd like to deal with it in the absence of the witness, your Honour." 74A discussion then ensued to the relevance of the question that had been asked concerning the paternity of the plaintiff's child, which until that time, was still assumed to be an unborn child. In due course I rejected the paternity question as being improper because it was irrelevant to the stated issues in the case, and irrelevant to any fact in issue, amongst other grounds: s 41(1)(b) and s 135(c) of the Evidence Act 1995: see separate ruling given on 25 May 2011: T350.1. 75Two days later, on 25 May 2011, and on the assumption that the plaintiff was still pregnant, Mr Fitzsimmons resumed his cross-examination of the plaintiff. 76In those events it later emerged that the plaintiff's evidence as to having had "a sore stomach" and to having had a problem with her "abdomen" had not been entirely candid. The plaintiff's subsequent explanation for the way the evidence of her recent childbirth emerged, and for the plaintiff not mentioning the fact that she had a recent caesarean section delivery was that she was simply addressing the questions that had been asked of her. This is a matter to which I shall return in setting out my credit findings. 77In the course of that additional cross-examination, a dramatic and surprising revelation then occurred, in which it transpired that the plaintiff had been delivered of a child by caesarean section on 20 May 2011. As these events are of some considerable relevance to the assessment of the credit of the plaintiff, for convenient reference and context, I have set out in full the relevant tract of her cross-examination, appearing from T352.43 - T355.41 as follows: "FITZSIMMONS Q. Ms Khalil, do I understand your evidence to be that since 6 May, you've had a further two admissions to hospital where you've gone by ambulance? Is that right? A. INTEPRETER: Yes. Q. When were those admissions? A. INTEPRETER: I don't remember the date after that, but I remember the last one was on 20 May. Q. That was last Friday, when you were excused from your attendance at Court in the morning? A. INTEPRETER: Yes. Q. And when was the occasion before that? A. INTEPRETER: I don't remember exactly the date. Q. Well, Ms Khalil, just so you understand, you went to hospital on 6 May 2011. This hearing started on 16 May 2011. Was it some time between 6 May and 16 May? A. INTEPRETER: Yes. Q. For the first of those visits - that is the first visit since after 6 May - to which hospital did you go? A. INTEPRETER: The same hospital, Liverpool Hospital. Q. Are you sure about that? A. INTEPRETER: I'm not sure whether twice or three times, but it was twice probably. Q. Ms Khalil? A. INTEPRETER: I can't remember exactly. Q. Ms Khalil, I just asked you a question about an attendance at hospital that has occurred in the last two weeks. Do you understand? And you said it was Liverpool Hospital. Was it Liverpool Hospital or not? A. INTEPRETER: Yes. Q. How many days was it after 6 May that you went on the second occasion? A. INTEPRETER: I don't remember. I don't remember how many days after. Q. And for what condition did you go on the second occasion? A. INTEPRETER: The same thing. I had abdomen pain. Q. What was your condition that took you to the hospital? A. INTEPRETER: Because I was pregnant and I felt pain in my abdomen. Q. How long did you stay at hospital on that occasion? A. INTEPRETER: Couple of hours and I was released. Q. and then the third occasion, as I understand, was last Friday. Is that right? A. INTEPRETER: Yes. Q. And to which hospital did you go on that occasion? HIS HONOUR: She's already said the same hospital, Mr Fitzsimmons. I reject the question. We mustn't have repetition. FITZSIMMONS Q. Did you go to Liverpool Hospital last Friday? HIS HONOUR: I reject the question. FITZSIMMONS: Well, your Honour, with respect, the answer that the witness gave earlier was that in terms of Liverpool Hospital, she did not know whether it was still three occasions. HIS HONOUR: You have already established from prior questions this morning and the answers to those questions that all of her attendances were at the same hospital, and we've identified it as Liverpool. And I therefore reject the repetitive cross-examination. FITZSIMMONS Q. Ms Khalil, what was the condition for which you went to the hospital last Friday? A. INTEPRETER: The same thing. I had pain in my abdomen and I went to hospital. Q. How long were you there on that occasion? A. INTEPRETER: I was - I'm still - until now I'm there but they let me come so I can come here. They let me out of hospital so I can come in here. They give me some release to come here. FITZSIMMONS: Sorry? CRANITCH: That's very dangerous. I'm just making the comment it's very dangerous. FITZSIMMONS Q. Ms Khalil, the position is that at the time that you first went to hospital a number of weeks ago, you were about 37 weeks pregnant, correct? A. INTEPRETER: I don't remember how - how many weeks, but I was admitted to hospital. Q. You're still pregnant, aren't you? A. INTEPRETER: No. Q. Have you had the child, Ms Khalil? A. INTEPRETER: Yes. Q. When did you have the child? A. INTEPRETER: Friday. [Emphasis added] HIS HONOUR Q. Do you mean by that answer last Friday, which was 20 May? A. INTEPRETER: Yes, actually the 20th. HIS HONOUR: Well, I'm just wondering whether we should proceed in these circumstances. CRANITCH: Your Honour, I suspect she might also have had the child by caesarean section, which is even more interesting. HIS HONOUR: Well, in my quick look through the clinical notes, I saw there were four prior caesarean sections, so it's a reasonable assumption that that would be so. Ms - well, I'll leave it to counsel. CRANITCH: Well, your Honour. I need to talk to my client and frankly I think it's very dangerous that she's here. HIS HONOUR: Yes, well, Mr Cranitch, I think you should speak to her on that issue and I'm going to adjourn for a moment. CRANITCH: Thank you, your Honour. HIS HONOUR: So you can do so. Let me know when you're ready. THE WITNESS WITHDREW SHORT ADJOURNMENT HIS HONOUR: What's the position? CRANITCH: Your Honour, I did speak to the plaintiff. The plaintiff is not well, needless to say. She has had a Caesarean section. HIS HONOUR: I must say, she wasn't looking terribly-- CRANITCH: She hasn't been looking well for the last few days and I understand why. However, Your Honour if the cross-examination was confined to another half an hour or so, she'd much rather get it finished, obviously. But I'm told and I accept from my learned friend that the impact of this news has a significant bearing upon other sectors of the case and I accept that." 78In this way, bizarrely, and much to the surprise of the cross-examiner, and very much to the surprise of the plaintiff's own counsel and solicitors, given that on the second day of the trial, at T71.43, I was informed by Mr Cranitch SC that the plaintiff was not pregnant, it transpired, that on 20 May 2011, at Liverpool Hospital the plaintiff had been delivered of her sixth and fourth surviving child by caesarean section. 79It is plain that until the plaintiff was asked in cross-examination to confirm that she was still pregnant, she did not volunteer the fact that she had very recently been delivered of her last child. The interpretation of that evidence is a matter to which I shall return in stating my credit findings. 80After these revelations, the proceedings were then stood over to 26 May 2011. A medical certificate was then tendered to show that the plaintiff was not fit to attend court from 20 May 2011 until 2 June 2011: Exhibit "D". The proceedings were then stood-over in order that they be resumed again on 2 June 2011, in conformity with that medical certificate. 81The medical certificate that comprised Exhibit "D" was not challenged by the defendant. In my view that certificate of the plaintiff's medical unfitness to attend court raised a possible question of the reliability of the evidence given by the plaintiff during the certified period of her unfitness to attend court on the hearing days consisting of 23, 24 and perhaps 25 May 2011. This is a matter to which I shall later return in stating my credit findings. 82The foregoing circumstances led to an assertion by counsel for the defendant to the effect that the plaintiff had deliberately concealed the fact of her latest pregnancy out of an alleged concern on her part, that the fact of her pregnancy might have been perceived to have an adverse influence on the outcome of her claim for damages for loss of earning capacity: T369.16. This too is a matter to which I shall return in my consideration of the challenges the defendant made to the plaintiff's credit. 83On 2 June 2011, the cross-examination of the plaintiff resumed: T367 - T390. Notwithstanding the dramatic events that had transpired as described in the preceding paragraphs and extracts, the plaintiff was not re-examined on any issue: T389.50 to T390.1. 84As a result, there was no evidence obtained from the plaintiff as to her physical or emotional state when she gave her evidence on the days in respect of which she was certified as being unfit to attend court. This turned out to be a matter of some significance because the defendant directed submissions that were critical of the content and credibility of that testimony.

Evidence of the events of the accident 85The plaintiff's account of the circumstances of the accident was that she was a passenger in a vehicle that had entered the roundabout in question when her vehicle was hit by another vehicle in that roundabout. She said this caused her vehicle to then spin and hit a telegraph pole: T24.5 - T24.21. The plaintiff's account of the events of the collision, as was summarised by the preponderance of the various medical and allied examiners who had assessed her, was in broad terms, as stated by those examiners, and that evidence was generally consistent with the plaintiff's own description. 86The plaintiff stated that she and her children had to be cut free from the vehicle wreckage by Fire Brigade personnel following the accident. That evidence was not challenged. 87On 8 November 2006, the plaintiff completed, or more correctly, was assisted to complete, a Motor Accident Personal Injury Claim Form: Exhibit "1". In answer to Question 15 on that form, which called for the plaintiff to provide a description of the accident, she stated: "I was a passenger in a car travelling along Gladstone St Cabramatta towards a roundabout in John St. As the car entered the roundabout, it was hit by another car". 88In her answer to Question 14 on that form, the plaintiff, or more correctly, someone on her behalf, provided the following diagram of the accident scene, which provided some added perspective to the relatively bland description of the circumstances as provided by the plaintiff's answer to Question 15 in Exhibit "1": 89Without the above diagram, and without the additional material contained in the police report relating to the accident, the circumstances of the accident could well have been viewed as being of only minor consequence. On page 19 of Exhibit "1", the Motor Accident Personal Injury Claim form, where a brief description of the damage to the vehicle was called for, that damage was simply described as being to the "front end". 90The unchallenged description of the circumstances of the accident as contained in the police COPS report, which was tendered as part of Exhibit "6" at Tab 1, was as follows: "... About 7pm on Wednesday the 1st of November 2006, Veh1 was travelling north on Gladstone Street in Cabramatta, about to enter a roundabout at the intersection with John Street. At this time Driver1 noted Veh2 approaching along Gladstone Street toward him on the other side of the roundabout. Veh2 entered the roundabout and turned across the path of Veh1. Veh1 was unable to stop and swerved to the right, but still collided lightly with the rear nearside of Veh1 just behind the rear wheel. This caused Veh1 to swerve again to the left. The passenger in Veh1 screamed, which caused Driver2 to panic and accelerate. Veh1 then collided with Obj3, causing slight damage to Veh1 and no visible damage to Obj3. ..." 91That report described the plaintiff as having sustained a severe neck injury, of having been trapped in the vehicle, and of having to be released from the vehicle by Fire Brigade personnel as set out in the following extract that I have emphasised below, comprising page 2 of the police report, which was located at Tab 1 of Exhibit "6", and which included the following statement: "... When police attended, the passenger in Veh 1 [the plaintiff] informed police that she was feeling pain in her neck and leg. An ambulance attended, as well as fire brigade (Rescue), who extracted the passenger from Veh 1 by cutting the "B" pillar..." 92The police report had described the damage to the front of the plaintiff's vehicle as being minor or slight, and it stated that there was no visible damage to the power pole. Whatever the extent of the damage to the plaintiff's vehicle in those events, it appears that there was sufficient concern over the plaintiff's injuries that arrangements were made for the Fire Brigade to cut the B pillar on the passenger side of the vehicle in order to free the plaintiff from her entrapment in the wreckage of the vehicle.

Claimed injuries 93In her oral evidence the plaintiff said that after the collision she went numb, started to shake, and felt completely terrified: T24.25. The plaintiff said she hit her head on the dashboard, all her body was aching, she noticed pain on her left side, including her hand, her upper arm and her leg, and her left knee was aching and numb. She said she was unable to move: T25.18. she said she was aware of her children screaming: Report of Dr Prior 23 September 2009. She said a paramedic gave her morphine and placed her in a neck brace: T7.27; T24.28 to T25.35. 94Dr Faithfull, a medico-legal expert, raised the alternative possibility that the plaintiff may have in fact struck her head on the door of the vehicle. The plaintiff also claimed to have suffered a blow to her left knee when that knee hit the dashboard in the collision. She also claimed to have suffered an injury to her left shoulder, as well as straining injuries to her cervical, thoracic and lumbar spines. 95In the Motor Accident Personal Injury Claim form that was prepared by someone on her behalf before it was completed by the plaintiff signing it on 8 November 2006, the plaintiff listed her injuries in more simplistic terms as being to the neck, back, right shoulder and shock: Exhibit "1", page 12, Question 25. It appears from the content of that form and from the plaintiff's evidence, that someone had assisted her in completing the details required by that form, following which she signed the document. 96Before arriving at my findings on the nature, extent and the ongoing effects of the injuries the plaintiff sustained in the accident, it is necessary to review the plaintiff's evidence as a whole, together with the relevant detail within documentary evidence including the initial assessments and the treatment of the plaintiff, as well as the summaries of the medical histories and any related evidence on those matters.

Initial assessment and treatment of the plaintiff 97The plaintiff was first assessed by ambulance personnel at the scene. The ambulance transport report shows that the ambulance officers attended to the plaintiff (and I interpolate, to her children as well) over the course of some 49 minutes of attendance before departing the scene for the journey to Liverpool Hospital. She remained at that hospital for 2 days, before discharging herself because of her stated need to attend to her parental responsibilities. 98Whilst there was no explanation from within the ambulance report that confirmed the attendance of the Fire Brigade at the scene, it seems possible that the departure of the ambulance from the accident scene may have been delayed by the need to cut the plaintiff free from the wreckage of her vehicle. 99The ambulance report recorded that at the scene, the plaintiff complained of neck pain with sensory loss in both arms and legs, the left and right regions of her upper back, abdominal pain and chest pain. It was recorded that she had a full recall of events of the accident and it was recorded that she denied a loss of consciousness. An intravenous cannula was inserted, and the plaintiff was given a number of drugs, including methoxyflurane and morphine. The ambulance report recorded her as having worn a lap sash seatbelt. 100The diagrammatic representation within the ambulance report of the plaintiff's sites of pain was initially difficult to read because of the quality of the photocopying and due to hole punching of a part of the page. On 15 March 2011, an undamaged copy of that document was tendered: Exhibit "9". I interpret the markings on the diagram in Exhibit "9", and its predecessor, to show the plaintiff had pain in the neck, both shoulders, the right side of the chest and abdomen, her left lower chest, and to either her left groin, pelvis or left upper thigh region. 101It is apparent that the above summary of the notations on the ambulance report do not necessarily represent a complete picture of the sites of the plaintiff's complaints of pain at the scene of the accident. I consider that to be the position in view of the evidence of Dr Faithfull, at T463.30, in which he explained that where ambulance officers were concerned with matters such as a cervical pain with sensory loss to the arms and legs, a complaint of pain in the knee "might actually be lost". 102The Liverpool Hospital clinical notes concerning the plaintiff's admission on the day of the accident reveal that the plaintiff had been assessed by a triage nurse at 20:13 hours on 1 November 2006 which was just 2 minutes after she had been taken off the ambulance stretcher at Liverpool Hospital: Exhibit "9". 103The nursing assessment note of the emergency department triage record sheet stated: "LOW SPEED C/O NECK PAINS AND PINS AND NEEDLES TO ALL LIMBS CHEST PAIN WORSE ON INSPIRATION ABDO PAIN TRAUMA TEAM ACTIVATED 5MG MORPH AND 10MG MAX VIA CDA." 104The Liverpool Hospital discharge summary, which appears to have been written up retrospectively, probably because the plaintiff had signed herself out of hospital earlier than was planned, confirmed that various imaging studies had been carried out in the form of plain x-rays, ultrasounds and CT scans of the cervical spine, abdomen and pelvis. 105The diagrammatic form within the nursing notes, that was intended to be completed by the nursing staff to record the sites of complaints of pain, had not been filled in. It is speculative as to whether information as to the location of pain sites would have been available to the nursing staff at that initial stage as the plaintiff had earlier been given doses of the painkilling medication morphine. 106A similar pain site diagram completed at a secondary survey carried out by a medical examiner at a later but unstated time, noted mild tenderness in the sternum, bilateral tingling in both hands, mild tenderness of the upper thoracic spine, moderate tenderness of the right side of the cervical spine, and tenderness of the lumbar spine. 107Whilst the plaintiff was an inpatient at the hospital, and in addition to the above observations, there were notes made by medical staff of several physical surveys carried out on the plaintiff's condition. Those surveys had been carried out by a surgical registrar. The first of these surveys was at 20:30 hours on 1 November 2006, and the second one was untimed. There was no evidence called to elucidate as to whether or not, or if so to what extent, the plaintiff would still have been affected by the earlier administration of morphine at these times. 108The first survey identified the plaintiff's complaints of chest, back and neck pain. The notes of the second survey appear at page 29 of Exhibit "6". The notes of the plaintiff's complaints taken at that second survey require some interpretation. They reveal that the plaintiff was tender over her entire spine. The surgical registrar, Dr Kozmen, drew an annotated freehand diagram in the notes following his physical examination of the plaintiff. An extract of that diagram is as follows: 109The above diagram is open to interpretation. I interpret the notation of the words "non tender" in juxtaposition to the diagram of the plaintiff's head and face to mean that the plaintiff's head, or at least her face, was physically examined, following which a conclusion was drawn to the effect that this examination elicited no responses consistent with tenderness in that region. This begs the question as to why the plaintiff's face or head was examined in the first place. 110The two interpretations that immediately arise are firstly, that the examination in question was part of a routine examination that was ordinarily carried out in accordance with a hospital or medical protocol in such circumstances. A second interpretation is that there may have been some complaint or indication of a head or facial injury which made such an examination relevant or necessary, and which resulted in an examination of that area of her body. 111Either of these two explanations are possible. No medical evidence was directed at the interpretation of this note. It is not permissible for me to draw inferences on these matters in order to prefer one speculative interpretation over another, without a valid basis for doing so. In considering the above diagram for its significance, it seems to me that such a basis exists, as appears from the rest of those notes and the further diagnosis within. 112In my view the "non tender" handwritten notation under present review was most probably made as a result of a medical need to examine that area. I consider it was unlikely that the examination in question would have been undertaken if the plaintiff had not received, or had been thought to have received, an injury to her face or head. 113This leaves a question as to why an examination of the plaintiff's head or face was not undertaken at an earlier time such as on arrival at the hospital or by ambulance personnel at the scene. In this context, it is possible the plaintiff had not initially complained of a head or face injury. Alternatively, the fitting of a hard collar by ambulance staff may have been influential as to whether such an examination was fully possible. 114It is apparent that according to the ambulance records, the plaintiff was given a number of drugs between 19:30 hours and 19:40 hours on 1 November 2006, including morphine. Furthermore, a reading of pages 36 - 40 of the hospital notes shows that between 20:19 hours and 21:40 hours on 1 November 2006 the plaintiff was given some further doses of morphine. 115No evidence was called on the duration of the therapeutic action of the various doses of morphine that had been given to the plaintiff, or of the effects of such doses, either individually or as an accumulation, on general awareness of pain, discomfort, concentration, or consciousness. In the absence of such evidence I can only proceed upon a commonsense analysis that does not draw upon any medical or scientific assumptions that are not in evidence: Adelaide Stevedoring Co Ltd v Forst [1940] HCA 45; (1940) 64 CLR 53, at pages 563-564 and 569; Strinic v Singh [2009] NSWCA 15. 116On that approach, I consider that it is possible that the effects of the earlier administration of the painkilling medication morphine may not have initially enabled all of the plaintiff's complaints of pain to be fully documented as to the respective locations of such pain. 117Reference to the rest of the diagram of the second physical survey of the plaintiff by the surgical registrar on 1 November 2006 also provides some assistance to interpreting the above "non tender" reference in connection with the diagram of the face as it is replicated on the same page in connection with an examination of the plaintiff's upper and lower legs, where the notation "non tender" also appears. The entire diagram is as follows: 118My interpretation of the notes and symbols in that regard suggests that the surgical registrar appears to have determined that in respect of both of the plaintiff's legs, her pulses (perhaps pedal pulses) were normal, as were the neurological findings on examination. 119Absent from the notes of that second survey was any diagrammatic representation of the plaintiff's upper limbs. This assists me to draw the conclusion that the examination undertaken at that second survey was probably directed to those parts of the plaintiff's body that raised some concern over injury. In this regard, on a commonsense analysis, it seems reasonable to assume that the earlier notation of the sensation of pins and needles in all of the plaintiff's limbs was an obvious reference to a possible spinal injury, which may be an explanation as to why there was no detailed survey of the plaintiff's upper limbs. In any event, it is not necessary to decide this point. 120Having regard to the timing of that second survey, or the timing of the first survey for that matter, both of which followed injections of morphine, it may well have been the case that the plaintiff's complaints of pain may not have been fully identified at the times she was examined. This is a matter that could be of significance in considering the nature of the attack on the plaintiff's credit as well as being of some reliance to the findings concerning Issue 3. 121For present purposes, it is sufficient to say that because of the "non tender" notations on the diagram I have referred to, it would be inappropriate to simply reject outright the proposition that the plaintiff sustained an injury to her head as claimed.

Subsequent treatment received by the plaintiff 122After her discharge from hospital, the plaintiff saw her general practitioner, Dr Rahman, who referred her to an orthopaedic surgeon, Dr Maniam, and to a psychiatrist, Dr Ali. The plaintiff also attended the Westmead Traumatic Stress Clinic for treatment of her post-accident psychological problems. These matters are described in the ensuing paragraphs and in the chronological sequence in which they have arisen.

Chronology of medical and allied assessments 123In the paragraphs that follow, after setting out a review of the initial x-rays, ultrasounds and CT scans taken in hospital, I have also set out a chronological account of the ensuing medical and allied assessments of the plaintiff that have been undertaken by the various treating doctors, medico-legal experts who were retained to examine and assess the plaintiff at the request of the various solicitors for the respective parties, including for the CTP insurer and the Motor Accidents Authority ["MAA"] in the form of the Medical Assessment Service ["MAS"] assessor's reports appointed by the MAA. 124The necessity for review of the historical detail involved in this approach arose from the nature of the defendant's credit attack upon the plaintiff's case. That attack was largely reliant upon summaries of the plaintiff's medical histories prepared by the various medico-legal examiners who had provided reports, concerning the plaintiff's case. 125This approach is also required as a convenient pre-cursor for resolving matters of conflicting medical opinions within the voluminous medical reports and evidence as to the nature and extent of the plaintiff's injuries and disabilities due to the accident. Various radiological reports tendered by the plaintiff 126The 10 post-accident reports of radiological investigations undertaken of the plaintiff whilst she was at Liverpool Hospital were tendered as part of the plaintiff's evidence bundle: Exhibit "C", pages 144 - 154. These investigations variously comprised x-rays, CT scans, MRI scans and ultrasound scans taken of the plaintiff's cervical, thoracic and lumbar spines, her shoulders, her chest, abdomen and pelvis. 127A review of pages 152 -154 of Exhibit "C" show, that whilst the plaintiff was at Liverpool Hospital on 1 November 2006, various imaging studies were performed on the plaintiff as follows. (a)At 20:17hrs on 1 November 2006, which was a little over an hour after the accident, a mobile x-ray machine was used in the hospital to take supine x-ray scans of the plaintiff's chest, pelvis and/or sacroiliac joints, perhaps whilst the plaintiff was in the casualty department: page 153 of Exhibit "C". The reporting radiologist, Dr Tew, advised "No focal bony abnormality seem". (b)At 20:51hrs on 1 November 2006, x-rays were taken of the plaintiff's cervical, thoracic and lumbar spines: page 152 of Exhibit "C". This was ambiguously reported as "No definite acute fracture is identified". It was further observed that "Mild osteophytic lipping is noted in the mid and lower dorsal column". Dr Saks, the reporting radiologist advised "Correlation with the clinical site of concern must be made". (c)At 21:50hrs on 1 November 2006, 3 different types of CT scans were taken of the plaintiff. These were first, non-contrast CT scans taken of the plaintiff's cervical spine, secondly, non-contrast CT scans taken of the plaintiff's abdomen and pelvis, and thirdly, CT scans taken of the plaintiff 's abdomen and pelvis with contrast. 128It is of some relevance, to the task of making findings as to the nature of the injuries the plaintiff received in the accident, to note that these investigations were carried out in light of the clinical history of the plaintiff having been involved in a motor vehicle accident, with associated upper midline tenderness, with tingling in both arms, as well as a generalised abdominal tenderness. The formal comment on these scans by the reporting radiologist, Dr Archer, was that there were: "No definite findings of acute cervical spine or intra-abdominal traumatic injury". Dr Rahman - plaintiff's family doctor 129On 5 November 2006, some 4 days after the accident, the plaintiff consulted her general practitioner, Dr Bassel Abdul Rahman, who provided a short historical letter dated 6 December 2007 to the plaintiff's former solicitor. 130That letter, which was tendered by the defendant, referred to Dr Rahman's findings on examination as comprising tenderness over the plaintiff's cervical spine with mild restrictions in neck movements without neurological deficits. Dr Rahman also described tenderness over both humeral heads with restriction of shoulder movements. He described prescribing strong analgesic medications, and noted that the plaintiff had required a cortisone injection for the shoulder, which I infer from the context of the 5th paragraph of Dr Rahman's letter, was to her left shoulder. He also noted that the plaintiff also received some physiotherapy treatment. There was no report of the detail of that treatment. 131Dr Rahman diagnosed the plaintiff as having a whiplash injury and supraspinatus tendonitis of the left shoulder. He predicted a very good prognosis, with the need for further physiotherapy to the neck and shoulder. 132On 9 November 2006, Dr Rahman issued a medical certificate that followed his examination of the plaintiff on 5 November 2006. In that certificate, he stated that he had diagnosed the plaintiff to have sustained a whiplash injury and an injury comprising a muscular lower back strain and a right shoulder strain: Exhibit "1", page 17. 133There were no further letters tendered from Dr Rahman and it is not known whether the plaintiff's present solicitors had asked him to issue further updating letters or reports concerning the plaintiff. Neither party called Dr Rahman to give oral evidence on factual matters concerning history or treatment, however, his patient clinical records for the period up until 2 May 2010 were tendered: Exhibit "6", Tab 9, pages 47 - 75. Bankstown Women's Health Centre 134On 9 November 2006, which was just 9 days following the accident, the plaintiff attended at the Bankstown Women's Health Centre. The referral of the plaintiff to that centre was made by an officer of the Department of Housing who was processing the plaintiff's application for housing relocation from Villawood to another suburb, which was considered to be possibly safer for her. 135At the time of the plaintiff's attendance at the centre, it was noted that she was "extremely distressed as she explained that her ex-husband had again been released from gaol and was now harassing her". At that time it was also noted that the plaintiff and her children were "extremely frightened and vulnerable as the ex-husband has a long history of extreme violence for which he has been gaoled several times". The report went on to record that the plaintiff had reported that her ex-husband had in the past tried to kill her, and that he had physically attacked the children. As a result, the officer of the Department of Housing recommended the plaintiff be moved from her current housing and to another area as soon as possible: Exhibit "6", Tab 8, pages 45 - 46. Dr Maniam - treating orthopaedic surgeon 136On 1 December 2006, at the referral of Dr Rahman, the plaintiff was assessed by Dr Vijay Maniam, an orthopaedic surgeon. In his report dated 19 October 2007, Dr Maniam noted the x-rays and ultrasonography that accompanied the plaintiff had findings of significance in the form of osteophytes at the level L3/4, and supraspinatus tendonosis. He did not explain the significance of those findings in terms of aetiology. 137Dr Maniam diagnosed the plaintiff's problems to be a musculo-ligamentous strain of the cervical, thoracic and lumbar spines and traumatic bilateral impingement in the shoulders. At that time his focus for treatment of the plaintiff was her shoulders, and this included prescribing anti-inflammatory medication. 138Neither party called Dr Maniam to give oral evidence on factual matters concerning the history he had taken from the plaintiff or the treatment he had provided, if any. 139Dr Maniam's clinical records for the period December 2006 until 17 January 2011 were tendered: Exhibit "6", Tab 11, pages 76 - 93. 140Dr Maniam's handwritten clinical records are very neatly written but they are in places difficult to decipher. Nevertheless, it is apparent that on the first consultation with the plaintiff, in December 2006, he recorded her symptoms as relating to the neck, the lumbar spine and the left shoulder. Those were observations he made again in February and April 2007. 141On what appears to be 22 February 2007, significantly, Dr Maniam made the handwritten notation "knees ". This suggests at that time Dr Maniam examined both of the plaintiff's knees and found no abnormality or complaints of pain in either of her knees. This note was not the subject of cross-examination or submissions. It is unchallenged evidence which is available for consideration on the timing of onset and causation of the plaintiff's left knee complaints. 142Subsequently, in September 2007, Dr Maniam noted the plaintiff had "sore legs". The copy of his records in Exhibit "6" were incompletely copied in the left margin and suggested that the plaintiff had "married again". This was not a matter that was taken up with the plaintiff in cross-examination. A subsequent side note made by Dr Maniam in August 2010 referred to the fact that the plaintiff was on a single mother's pension. These matters were not reconciled or clarified in the oral evidence. Subsequently, on 15 March 2012, a better copy of that page of Mr Maniam's records was tendered: Exhibit "10". My interpretation of the diagrammatic content of that exhibit revealed the clarification that it was the plaintiff's husband who had remarried, not the plaintiff. 143In November 2007, Dr Maniam recorded that the plaintiff had "pain in both legs" in addition to the previously recorded complaints concerning her neck, shoulder and lumbar spine problems. 144In early 2008, on what appears to be an indecipherable date in January 2008, Dr Maniam recorded the plaintiff's complaints of pain in both knees. I interpret the juxtaposition of the symbols "++" with the reference to the left knee as being an indication that the left knee was worse than the right knee. Dr Maniam ordered an MRI scan of the plaintiff's left knee in March 2008. At that consultation, Dr Maniam prescribed Tramal, Voltaren cream and a left knee support. I interpret Dr Maniam's notes to contain reference to sprained anterior and medial cruciate or collateral ligaments of the plaintiff's left knee. 145Subsequent entries in Dr Maniam's clinical notes make further references to the plaintiff having ongoing left knee problems. Dr Pierides - occupational medicine consultant - first report 146On 20 June 2007, at the request of the CTP insurer, the plaintiff was examined by Dr Lew Pierides, a consultant in occupational medicine. In his report to the insurer dated 22 June 2007, Dr Pierides recounted a short summary of the events of the accident as the plaintiff having been in a vehicle that was hit as it went through a roundabout, resulting in the vehicle spinning into a power pole, and necessitating the plaintiff being cut out from that vehicle by fire brigade personnel. 147The most remarkable thing about the report of Dr Pierides is that nowhere in the historical section of his report did he record a history from the plaintiff as to the nature and extent of any specific injuries she had sustained at the time of the accident. 148Nevertheless, Dr Pierides went on to consider the plaintiff's complaints of neck pain, shoulder pain, and low back pain. In describing his findings on examination of the plaintiff, Dr Pierides referred to the plaintiff as exhibiting pain behaviours and grimacing when he examined her cervical spine. He also described the plaintiff's efforts at shoulder movements during his examination as being "feeble". 149When Dr Pierides came to address the specific question of "functional findings on examination" as had been asked of him by the CTP insurer, he referred to the absence of any evidence of "significant ongoing injury". He went on to comment: "There was apparent restriction of left shoulder movement but no evidence of ongoing injury. The examination was marred by pain behaviours". 150When Dr Pierides addressed the further question of "[whether] the patient's condition [is] consistent with the alleged injuries and disabilities", he responded by saying: "She no doubt had a significant jarring after the subject accident and would have been in some pain in various areas as a result of the impact and the spinning of the vehicle and the jolt when it hit the power pole. I do believe though that at 8 months post injury, her condition has resolved". That statement requires comparison with a statement made by Dr Pierides in a later report. 151It is not clear as to precisely what areas of the plaintiff's body Dr Pierides had in mind when he was referring to the pain in the above context, and therefore it is not clear as to precisely what the "condition" (which I interpolate to mean injury) was, which he thought had resolved. 152In this first report, Dr Pierides went on the express the view that: "There was a significant degree of embellishment in her presentation". It is not clear from his report as to what he was referring to in justification of this remark, and it therefore remains unexplained, although it is clear that in this context, Dr Pierides was expressing scepticism of the veracity or genuineness of the plaintiff's complaints. 153Although Dr Pierides' report contained an acknowledgement of the Expert Witness Code within Sch 1 of the District Court Rules, which had by then been superseded by the Uniform Civil Procedure Rules 2005, it is plain that his opinion was not compliant with that code because he had not stated the reasons for the opinions he had expressed: Sch 7, cl 5(c) of the Code. 154Furthermore, despite the fact that annexed to the report of Dr Pierides was a signed document entitled "Code of Conduct Annexure", he did not set out in his report a list of the documents which had been provided to him within the "correspondence" letter of instruction by which his report had been commissioned, as was required by cl 4 of that annexed Statement. The few words Dr Pierides had written by hand on that section of the form were almost illegible. I interpret them to read "As per letter" which is of no assistance in identifying exactly what materials Dr Pierides had been given for the purpose of assisting him with conducting his examination of the plaintiff, and for preparing his first report. 155In addition, although Dr Pierides had circled the portion of cl 7(a) of the form of the Code that stated "I have not made any assumptions to arrive at my opinions", that statement was plainly incorrect on reading his report. In contradiction of that statement, examples of some unexplained assumptions made by Dr Pierides included statements such as the plaintiff not having any "significant ongoing injury": (report page 5), as well as his unexplained belief that the plaintiff's condition had resolved 8 months post-injury, notwithstanding her continuing complaints of ongoing symptoms at least in the neck, lower back, left hand, and her shoulder movements: (report pages 2-3), and his stated assumptions that the plaintiff's efforts in compliance with his examination were "feeble", and his unexplained statement that her presentation included a "significant degree of embellishment" (report pages 3 and 5), in circumstances where, in fairness, the maker of such opinions is obliged to explain them, and provide supporting reasons. 156There were no reasons of that character within this first report of Dr Pierides. 157Notwithstanding the fact that the plaintiff's legal representatives did not seek to challenge these opinions expressed by Dr Pierides, including by seeking to cross-examine him, I consider that the content of this first report by Dr Pierides is nevertheless open to a critical analysis to assess what, if any, probative value should be given to this report. 158I will consider and take into account the above matters that I have identified when assessing the medical evidence overall for its reliability and probative value. Dr Mahony - assessing orthopaedic consultant 159On 20 December 2007, at the request of her former solicitor, the plaintiff was examined by Dr Graeme Mahony, a consultant orthopaedic surgeon. In his report dated 2 January 2008, Dr Mahony summarised the history of the occurrence of the plaintiff's accident as involving a collision to the driver's side rear of the vehicle in which she was a passenger, causing that vehicle to spin and hit a power pole, resulting in the plaintiff feeling dazed. 160Dr Mahony described the plaintiff as having injuries comprising bruising to the frontal portion of her head and to her shoulders, an injury to her neck, radiating to the occipital area and to her shoulders, a numb feeling in her left ring and little fingers, an injury to the upper back and chest, an injury to the lower back radiating to her feet, and a feeling of pins and needles and numbness in her legs. 161At the time of Dr Mahony's examination, which was just over a year post-accident, he recorded the plaintiff's ongoing complaints as being in line with those reported injuries. He also noted that the plaintiff reported being stressed and avoided driving. 162On his examination of the plaintiff, Dr Mahony noted restrictions in the extremes of the plaintiff's neck movements due to guarding, restriction of movement in both shoulders, and guarding of the muscles of the back. 163Dr Mahony reviewed various imaging scans. He noted that an x-ray of the plaintiff's neck taken 5 days after the accident, showed slight narrowing of the intervertebral foramina between C2/3 and C4 on the right side, and between C4/5 and slightly between C5/6 on the left side. He also noted that a CT scan of the plaintiff's cervical spine appeared to show a slight disc bulge at the level C6/7. 164Dr Mahony was of the opinion that the plaintiff had developed symptoms referrable to strains and nerve root irritations of the cervical, thoracic and lumbar spines. He also considered the plaintiff had symptoms of a rotator cuff lesion of the left shoulder, with supraspinatus tendonitis with impingement, and capsulitis of the right shoulder. He also suspected the plaintiff had a right carpal tunnel syndrome. 165On 12 February 2008, Dr Mahony provided some comments on some further imaging scans which had been sent to him by the then solicitor for the plaintiff. He said of an ultrasound report of the plaintiff's left knee taken on 22 January 2008, that it suggested the plaintiff had an injury to the left medial collateral ligament of the left knee and that she had a semi-mebranosis bursitis of the (left) shoulder which he said would confirm the presence of a rotator cuff lesion. 166Dr Mahony could not be called to give evidence to clarify his opinions because he had died before the hearing. Dr Davis - plaintiff's occupational medicine consultant 167On 3 March 2008, at the request of her former solicitor, the plaintiff was examined by Dr John Davis, a consultant in the field of occupational medicine. In his report dated 10 March 2008, Dr Davis summarised the history of the accident as involving a collision in a roundabout resulting in the plaintiff's vehicle spinning, and a subsequent front end collision with a power pole, followed by the plaintiff experiencing chest pain from the seatbelt, left knee pain from injury, a feeling of numbness in the whole body, and pain in the neck and the back. 168After describing the initial treatment received by the plaintiff, Dr Davis listed a comprehensive range of physical and psychological complaints that had been made to him by the plaintiff. 169Following his physical examination of the plaintiff, Dr Davis recorded his findings of guarding of the right paravertebral muscles of the plaintiff's cervical spine, and tenderness of the inter-spinous ligaments at the levels L4-S1. He also observed the plaintiff had a left-sided antalgic gait. 170Dr Davis diagnosed the plaintiff's injury to have involved the upper and lower facet joints in the cervical and lumbar spines, leading to the development of chronic soft tissue injury, as well as injury to the joint capsules of those areas of the spine. He also identified a tendon injury to the left shoulder and trauma to the left knee. He considered that the plaintiff's injuries were consistent with the history she had given to him. He also observed that the plaintiff had what he described to be an Adjustment to Injury Disorder. 171Dr Davis identified a significant number of work and domestic restrictions for physical activity that adversely affected the plaintiff. 172Dr Davis was not called or required to give oral evidence. Dr Clark - plaintiff's assessing consultant psychiatrist 173On or about 5 March 2008, at the request of her solicitor, the plaintiff was examined by Dr Thomas Clark, a consultant psychiatrist. In his report dated 5 March 2008, Dr Clark summarised the history of the accident as involving a collision between moving vehicles forcing the plaintiff's vehicle into collision with a power pole, unexpectedly flinging the plaintiff forward by which she banged her head on the windscreen. 174Dr Clark summarised the subsequent history as being that the plaintiff recalled she thought she was about to be killed, and of her being shocked, and had experienced an acute state of panic, following which she was aware of an initially bruised head, some head and neck pain, some left leg pain and swelling of a wrist. 175Dr Clark summarised the plaintiff's ongoing complaints as getting "stressed out", experiencing pain, panic symptoms, palpitations, nightmares, insomnia, nervousness, upset, prone to being startled, shaky, hypervigilance, intrusive recollections of the accident, disturbed sleep patterns with persistent insomnia, night terrors, mood fluctuations and avoidance of driving. He also elicited further complaints of flashbacks, tearfulness and varied concentration. 176Dr Clark's diagnosis was of PTSD and severe depression, leading to the development of what he described as a shock reaction or an Acute Stress Disorder, with a specific phobia for driving, and a Major Depression, according to the DSM-IV-TR formulation. He related these conditions as being directly caused by the accident. 177Dr Clark also gave oral evidence concurrently with other psychiatrists, and I shall also refer to that evidence in due course. Dr Marsh - MAS Assessor appointed by MAA 178On 29 May 2008, at the request of the MAA, the plaintiff was assessed by Dr Nigel Marsh, a consultant occupational physician. In his report of the same date, Dr Marsh certified that the plaintiff had suffered injury to the neck, mid back, low back and left shoulder. He also found that the plaintiff's right shoulder problems were as a result of referred pain from the neck rather than from a specific injury to the right shoulder. Dr Marsh concluded that these injuries had become static and were unlikely to remit despite treatment. 179Dr Marsh also concluded that the plaintiff exhibited considerable exaggerated pain behaviour and he noted some inconsistencies between his findings and some previous assessments. He gave two examples of this, but obviously had in mind others, but which could not be identified because he only mentioned them in passing as coming from "Other reports on file" and which remained unidentified in his reasons. 180Dr Marsh's MAS certificate of determination did not include any reference to the plaintiff's left knee problems being caused by the motor accident in question. In that regard, at page 7 of his report, Dr Marsh stated that he had been able to persuade the plaintiff to flex her left knee beyond 80 degrees, and he said that he was unable to effectively test her left knee for stability because of the plaintiff's complaints of pain, on any attempted movement. 181As a MAS Assessor, Dr Marsh was not compellable as a witness, and he was not called to give evidence. Dr Parmegiani - MAS Assessor appointed by MAA - first report 182On 29 May 2008, at the request of the MAA, the plaintiff was assessed by Dr Enrico Parmegiani, a consultant psychiatrist. In his report and certificate of determination dated 19 June 2008, Dr Parmegiani found that the plaintiff's conditions of chronic PTSD and Major Depressive Episode were caused by the motor accident in question. He also found that these conditions had not stabilised at the time of his assessment of the plaintiff. 183In his capacity as a MAS Assessor, Dr Parmegiani was not compellable as a witness, so he was not included in the concurrent psychiatric expert evidence session. Dr Ishrat Ali - plaintiff's treating psychiatrist 184On 10 September 2008, some 22 months after the accident, at the request of her treating general practitioner Dr Rahman, the plaintiff consulted Dr Ishrat Ali, a consultant psychiatrist, for treatment of her psychological problems. In his 5 March 2009 report to the solicitor for the plaintiff, Dr Ali provided a summarised history as told to him by the plaintiff, in which she said she had been in "a bad accident and her car was written off". 185Dr Ali recorded the plaintiff's psychological symptoms at the time of his first examination of her and stated that these included anxiety, depressed moods, insomnia which at times required medication, episodic crying, irritability, poor concentration and some weight loss, frequent dreams about the accident which were frightening to her, flashbacks to the accident, and of having developed a fear of travelling. He described these symptoms as having their onset since the accident, and fluctuating in their intensity. He also noted the absence of any history of past family psychiatric problems. 186On the basis of his examinations of the plaintiff, which had taken place at frequent clinical intervals over time, Dr Ali's concluded diagnosis was that the plaintiff had a PTSD which was the direct result of the accident. He concluded that there were no other factors to account for her symptoms and he therefore concluded that the accident was directly responsible for the plaintiff's psychological symptoms, which he had recorded. 187Dr Ali was of the view that the plaintiff's ability to carry out her daily domestic activities had been affected by her depression. He also noted that her social life had been badly affected, as had her relationships with significant people in her life. 188Dr Ali was of the opinion that the plaintiff's concentration had also been badly affected, and that she would find it hard to cope with work. He was of the view that the plaintiff's depressive and post-traumatic symptoms had persisted, and would continue indefinitely, including to the point of not being able to handle full-time employment. He also expressed the view that the plaintiff's ability to lead a normal life was significantly impaired, and that she would need constant help. These are matters to which I shall return when making my assessment of the plaintiff's entitlement to damages. Professor Harris - defendant's orthopaedic consultant - first report 189On 2 December 2008, at the request of the solicitor for the defendant, the plaintiff was examined by Dr Professor Ian Harris, a consultant orthopaedic surgeon. In his report dated 11 December 2008, Professor Harris accepted that it was likely the plaintiff had sustained multiple soft tissue injuries in the accident in question. He excluded the degenerative changes seen in the plaintiff's spine from being accident related. However, in expressing that view, he made no comment on whether those degenerative changes had in any way been affected or aggravated by the trauma of the accident. 190Professor Harris stated that the bursitis in the plaintiff's left shoulder may be accident related, but he excluded the ligamentous injuries to the left knee as being more recent, and not due to the accident of 1 November 2006. 191Professor Harris stated, and it was not challenged, that the plaintiff's current symptoms (which he stated at page 2 of his report to be central lumbar back pain, central posterior neck pain, generalised left shoulder pain, generalised left knee pain and decreased sensation in her left arm) cannot be explained by her injury on 1 November 2006. He did not explain in detail the reasoning that underpinned that statement, which is a matter that goes to the weight of his opinion generally. 192Professor Harris' reasoning for that view appeared to involve the assumption that any injuries sustained at that time would have healed within several weeks or months. That reasoning appears not to differentiate between the entities of frank injury and the quite separate question of whether there are any resultant disabilities that flowed from those injuries. 193Professor Harris was not called to give evidence to explain any aspect of this, or any of his subsequently expressed opinions. Dr Pierides - defendant's occupational medicine consultant - second report 194On 11 December 2008, at the request of the solicitor for the defendant, the plaintiff was re-examined by Dr Pierides, the consultant occupational physician. In his second report, which was dated 12 December 2008, Dr Pierides again did not record any history of specific injury suffered by the plaintiff. He referred to the plaintiff's current complaints of back pain, left knee pain and neck pain with radiation into the left hand with reported numbness of the ring and little finger. Later in his report, he also described the plaintiff's restricted left shoulder movements. 195Consistent with his earlier opinion expressed on 22 June 2007, Dr Pierides stated that he did not believe the plaintiff had any ongoing physical injury (which I take to also refer to disability in this context as that was the question that had been asked of him) related to the subject accident. The basis for that opinion was the assumption that it would be reasonable for the plaintiff to have some ongoing effects for some 8 - 12 weeks after the accident due to jarring. Dr Haik - defendant's psychiatric consultant - first report 196On 3 February 2009, at the request of the solicitor for the defendant, the plaintiff was examined by Dr Robert Haik, a consultant psychiatrist. In his report dated 9 February 2009, Dr Haik stated that the plaintiff's case was an exceptionally difficult one for him to determine from the psychiatric perspective. 197In his first report, Dr Haik adopted what I consider was a sceptical view of the plaintiff's presentation and history. He suspected Mrs Khalil maintained a role of abnormal illness behaviour for reasons unconnected with the litigation. 198There were aspects of Dr Haik's opinion critical of the plaintiff, which required analysis from the standpoint of procedural fairness. That analysis will be undertaken in connection with determining which of the psychiatric opinions should be accepted in this case, and for what reasons. 199Dr Haik drew upon the records of the plaintiff's general practitioner and the hospital records to suggest that the plaintiff was mendacious in her description of her circumstances. Dr Haik also drew upon other material that was the product of his own factual research or understanding in order to base some highly critical remarks concerning the plaintiff's history, without having first given the plaintiff the opportunity to comment on those matters. This raised a question of procedural fairness. The plaintiff's submissions criticised Dr Haik's opinions as being biased against the plaintiff. 200Dr Haik also gave oral evidence concurrently with other psychiatrists, and I shall also refer to and analyse that evidence in due course. Dr Matalani - plaintiff's assessing occupational medicine consultant 201On 12 March 2009, at the request of her solicitor, the plaintiff was examined by Dr Elias Matalani, a consultant occupational physician. In his report of the same date, Dr Matalani recorded the summarised history of the accident as involving the vehicle in which the plaintiff was travelling being struck on the right by another vehicle, resulting in her vehicle being spun around and then hitting a power pole. It was recorded that the plaintiff was thrown forward and then backwards, hitting her head and left knee in the process, on the dashboard, resulting in pain in the neck and the back, with her whole body aching, and feeling numb. 202In his report, Dr Matalani described the results of investigations as revealing a left supraspinatus tendonitis and impingement in the left shoulder, and minor posterior disc bulges at the levels T10/11 and T11/12, and low grade sprains of the anterior cruciate and medial cruciate ligaments of the left knee. 203Dr Matalani also summarised the plaintiff's ongoing problems relating to the neck, left shoulder and left upper limb, with stiffness in the shoulder and numbness in the left ring and little fingers. He also recorded the history of constant lower back pain with radiation, and pain in the left knee, precipitated by prolonged walking and standing, with symptoms being aggravated by cold weather. He also recorded complaints of disturbed sleep, and difficulty with household duties, and noted the plaintiff was affected by depression. 204Dr Matalani observed the plaintiff to have a slow antalgic gait, with limping favouring the left leg. He observed guarding of the paravertebral muscles and the left trapezius muscles around the region of the neck, and pain and tenderness in the lower spine, with restriction of movement. He noted an inability to squat on account of left knee pain, and left shoulder problems. 205Dr Matalani expressed the opinion that the plaintiff had suffered soft tissue injuries and musculo-ligamentous strains of the neck and back, and a contusion injury to the left knee, together with left shoulder tendonitis and bursitis, with impingement. He related the plaintiff's right shoulder problems to the neck injury. He thought the plaintiff had developed a chronic pain syndrome with a guarded long-term prognosis. He considered that the motor vehicle accident had been a substantial contributing factor to the development of her current disabilities. 206Dr Matalani considered the plaintiff's condition was unlikely to change, and he considered that she was unfit for a range of work and domestic activities. 207Dr Matalani was also called to give oral evidence on the 12th day of the trial as the defendant's representatives had required him for cross-examination on his reports. 208The discernable approach taken by the defendant to the testing of Dr Matalani's evidence appeared to me to raise 7 topics, ranked as to significance, as follows. 209First, the assumption-based nature of the opinions of Dr Matalani was confirmed; secondly, the cross-examiner sought to obtain from Dr Matalani some factual evidence aimed at trying to contradict the factual evidence as was related by the plaintiff; thirdly to seek to identify timing of complaints and what might have been expected to be raised by the plaintiff in connection with her complaints of head, left shoulder and left knee problems; fourthly, the cross-examiner sought concessions from Dr Matalani that the left knee problems were not related to the accident; fifthly, the defendant sought comments from Dr Matalani on some segments of DVD footage taken of the plaintiff's activities; sixthly, Dr Matalani was asked some questions about his views as to the timing of onset of the plaintiff's left shoulder problems, and lastly, confirming the manner in which he had constructed his report. 210On the first topic, in answers to questions put to him at the conclusion of the defendant's cross-examination of him, Dr Matalani confirmed that his opinion was in part dependant upon the matters reported to him by the plaintiff, but he also qualified this by stating that he did not just look at the reported symptoms, but also he looked at the whole picture, which included investigation results, an assessment of the presentation, and the information available to him: T515.25 - T526.30. These were not controversial propositions and hardly needed restatement or confirmation in the context of expert evidence. 211On the second topic, Dr Matalani confirmed the history given by the plaintiff that she had "essentially ... not driven since the accident" because "she was too scared to drive": T490.1 - T490.12. Dr Matalani was unable to indicate from either his report or from his recollection, whether, as a matter of fact, the plaintiff had actually been wearing a knee guard on the day he had examined her: T491.47. These are matters to which I shall return in connection with my credit findings. 212On the third topic, Dr Matalani made the proper concession that it would have been expected that the plaintiff would have reported to the hospital that she had struck her knee on the dashboard of the vehicle in the accident: T495.46. What was absent from the discussion on this point was the timing and dosages of the pain killing medication morphine, and the timing and likely painkilling duration or effect of such medication, considered in conjunction with the timing of the various medical surveys or physical assessments of the plaintiff's condition whilst she was in hospital. There was also an assumption implicit in the line of questioning that the plaintiff did not mention any such problems whilst in hospital. 213On the fourth topic, whilst Dr Matalani agreed that the first recorded report in January 2008 of left knee problems was suggestive of a more recent injury than November 2006, and he would have expected an earlier report of such problems by the plaintiff, significantly, he was not prepared to be dogmatic in expressing a view that there must have been another injury after the subject motor vehicle accident: T496.45 - T498.1. 214On the fifth topic, the defendant sought Dr Matalani's comments on the DVD footage of the plaintiff taken in September 2009 in circumstances where he had last seen her on 12 March 2009. There were obvious logical difficulties and issues of fairness associated with such an exercise. On his examination on 12 March 2009, Dr Matalani had observed the plaintiff to have had what he had described as an antalgic gait which favoured the left leg. He defined antalgic to mean abnormal: T500.2. When this was explored Dr Matalani did not know that the meaning of an antalgic gait included a pain-avoiding gait: Dorland's Illustrated Medical Dictionary, 28th Ed, WB Saunders, 1988, p 90. 215In any event, on 12 March 2009 he had observed the plaintiff walking at the time of his examination and recorded his observation as outlined above. In viewing the DVD taken on 21 August 2009 from 14:54hrs, he stated he had observed a subtle limp with some favouring of the left leg. He was unable to comment on whether the visual images he was shown were distorted by possible distance and lens magnification factors:T502.35 - T502.45. 216In respect of the second segment of DVD footage shown to him from 15:09hrs, Dr Matalani also confirmed the presence of a subtle limp. Dr Matalani agreed with the proposition that this segment, although showing a limp, was "very different" to the manner in which the plaintiff had presented to him on 12 March 2009: T504.12 - T504.40. The logical difficulty with this evidence was taken up with the cross-examiner at T504.49 - T505.10 as follows: "HIS HONOUR: Mr Fitzsimmons, isn't there a problem with that question. Dr Matalani saw the plaintiff on 12 March 2009, and you're asking him to comment on a visual observation from September 2009 without the usual accompaniment that goes with a medical examination, namely a discussion between doctor and patient, and reactive questions. FITZSIMMONS: I don't understand what your Honour is saying, I'm sorry. HIS HONOUR: Very well. We'll leave it until submissions. FITZSIMMONS: Thank you, your Honour, I will." 217The cross-examiner then sought to make analogies between what Dr Matalani had seen in his consultation with the plaintiff in March 2009 and what he expected in the way of "perhaps to be some deterioration". The evidence on this topic at T508.15 - T509.1 was as follows: "Q. Doctor, what you were told was that the plaintiff had these particular problems, for example, with ambulating, correct? A. Yes. Q. And that after a period of walking, her symptoms were aggravated or made worse, correct? A. That's correct. Q. So the position was that you would expect, would you not, given that history as being told to you, that a period of walking of the timeframe that we've seen here, but given the history that she gave to you, you would expect there perhaps to be some deterioration in her ability to walk and ambulate, do you agree? A. That's correct, yes. Q. From what you can see from the start of that film to the end, there was no such deterioration, if there was any problem at all, do you agree? A. There was no deterioration, that's correct. HIS HONOUR Q. In relation to that last answer, what questions would you expect you would've asked the plaintiff as to how she felt if you were comparing your observations on the film with your observations from your clinical examination? In other words, what questions would you be seeking to clarify for the purpose of adumbrating upon that opinion? A. I would have asked her if she had any rest breaks, if she had the opportunity to stop and rest during that walk. Obviously she's been walking for about 25 - the period is 25 minutes, but we really don't know what happen for the whole of the 25 minutes, had - had she had the opportunity to stop, to walk, to sit down, was she in pain? I couldn't see her facial expression, whether she was in pain or not. But of course, yes, some people do walk in pain as well, that would - you'd expect them to limp. But there was no - there was not enough indication on the facial expressions, whether she was in pain or not. And whether she was taking any painkiller at the time, and whether she was wearing any knee support. So they're the number - sort of questions I would have asked." 218Dr Matalani indicated that at the time of his consultation with the plaintiff, he had not enquired of her as to when she had taken her last dose of pain killing medication: T510.15; T511.15. 219On the sixth topic, Dr Matalani stated that he had not obtained from the plaintiff a history of the mechanism by which she had injured her left shoulder but he said he had obtained a history of the car being spun around and of her experience of her pain being everywhere: T513.3. He did not agree with the proposition put by the cross-examiner that if the plaintiff's shoulder had been injured, this would have been likely to have been the subject of complaint because of associated problems of mobilisation. He explained his disagreement on the basis of the complicating factor of there having been an associated neck injury, and because in that context, restricted shoulder movements was a matter of degree: T513.5 - T513. 220The last topic raised with Dr Matalani simply confirmed that when he had examined the plaintiff, he had dictated the notes of history taking and of his findings on examination in her presence, and then he had later dictated the summary of the results on investigations, and had then sat down to gather his thoughts for the dictation of his opinions. None of those events were either controversial or remarkable. 221In reviewing the answers given by Dr Matalani in answer to questions put to him in cross-examination, including the observations he had made of the 3 segments of DVD footage shown to him in court, I do not read his evidence as involving any material change in the opinions he expressed in his report, consistent with his statement to that effect at the commencement of his oral evidence: T489.22. Dr Parmegiani - MAS Assessor appointed by MAA - second report 222On 7 August 2009, the plaintiff was re-assessed by Dr Parmegiani at the request of the MAA. Dr Parmegiani then issued a further MAS certificate on 20 August 2009, in which he confirmed his assessment that the accident caused the plaintiff to have a PTSD and Secondary Depression. 223Dr Parmegiani considered the plaintiff's description of her emergent "symptoms consistent with a diagnosis of Post-Traumatic Stress Disorder is not inconsistent with the nature of the motor vehicle accident in which she was involved": Exhibit "3", page 249. Dr Parmegiani also found that the severity of the plaintiff's symptoms indicated the presence of a secondary depression in the plaintiff: Exhibit "3", page 249. 224However, Dr Parmegiani expressed some doubts about the genuineness of the plaintiff's presentation, based upon the following factors: (a)His view that there was a lack of co-relation with the plaintiff's physical presentation at his assessment, with her claims of amotivation, anergy and social isolation. His apparent basis for that conclusion was the plaintiff's prompt responses to his questions without psychomotor retardation, irritability or cognitive dysfunction. How he came to that conclusion through interpreted language at that consultation is not explained in his report; (b)He thought the plaintiff's reported weight loss of 2kgs per month (which at Exhibit "3", page 248, he deduced to be 100kgs over the 50 months since the accident) was unlikely, given her "current body shape". The metabolic or physical basis for that opinion was not fully explained. He appears to have taken the plaintiff literally, hence his mathematical conclusion; (c)He doubted the plaintiff's history that she had attended his examination with another person because "this person was never sighted": Exhibit "3", page 249. The plaintiff's history as cited was not inconsistent with a companion being outside, waiting for Dr Parmegiani's consultation to conclude. Dr Parmegiani's comment does not of itself contradict the plaintiff's case that she needed to be accompanied when leaving her home; (d)He thought the plaintiff's spontaneous smile was contradictory of her claim that she avoided contact with other people, and also contradictory of her reported constant feelings of anger and irritability; (e)He thought the plaintiff's mobile telephone ring tone, which was that of a crowing rooster, required some complex programming skills unlikely to be found on the telephone of someone suffering from a profound depression: Exhibit "3", page 249. I cannot accept the logic of that statement as it was not established that the plaintiff programmed that ring tone herself. 225In conclusion, at Exhibit "3", pages 249 - 250, Dr Parmegiani stated: "While I believe that when taken in isolation, each of these factors may not raise significant doubts about the genuineness of the presentation, when added together, they would justify serious questions about the veracity and severity of her symptoms." 226It is plain from page 9 of his report dated 20 August 2009, that Dr Parmegiani was influenced by Dr Haik's report of 9 February 2009, which was critical of the plaintiff and of the case that is sought to be made on her behalf: Exhibit "3", pages 250 - 251. 227Dr Parmegiani nevertheless concluded that the plaintiff should be seen as someone who was pre-disposed to developing a psychiatric illness following the trauma of the accident. In making that conclusion he then stated at pages 251 - 252 of Exhibit "3": "It is my impression, however, that while those symptoms of psychiatric illness may be present and understandable, the severity of these symptoms and the degree to which they limit her daily function; are inconsistent with the clinical presentation displayed at assessment. Thus while I continue to favour the diagnosis of Post-Traumatic Stress Disorder with some secondary symptoms of Depression, I am much less convinced of the severity of her symptoms, and their impact on the calculation of her whole person psychiatric impairment. She has been under the care of a psychiatrist for a number of months now, with what she reports as having no benefit whatsoever. In the present circumstances, I do not believe her condition is likely to improve significantly over the next 12 months, and I would therefore consider it stabilised. It is possible that Ms Khalil may benefit from further psychological intervention, and ongoing treatment with antidepressant medications, but given her response so far, her prognosis must be considered as at best, guarded." 228Those views of Dr Parmegiani stand to be evaluated with the other psychiatric and lay evidence. The plaintiff's submissions were critical of Dr Parmegiani's altered stance on the plaintiff's assessment, arguing that his opinion was tainted by Dr Haik's unsatisfactory opinions. Dr Prior - plaintiff's consultant psychiatrist 229On 21 September 2009, at the request of her solicitor, the plaintiff was examined by Dr Michael Prior, a consultant psychiatrist. In his report, which was dated 23 September 2009, Dr Prior summarised in much greater detail than any other medical report, the history of the accident as provided to him by the plaintiff. He did so in quotation marks as follows: "... another car hit us; the car spun; we went into a power pole; straight away I was very scared; my legs were numb; there was pain in my body; the kids screaming Mum Mum Mum!!; the ambulance, the police and the fire cut me out of my side; I was in too much pain and I felt I would die; I was a bit dizzy and shaky; my heart was racing; I got very scared; I thought I was dying and I worried about my kids too; the police and the fire brigade took my kids out; the kids were scared and sick". 230Dr Prior reviewed the multiple previous psychiatric diagnoses made before he made his own assessment, and he noted these to have been PTSD, depression and specific phobia for driving. He noted that the plaintiff had been receiving treatment from Dr Ali for about a year and-a-half, initially at fortnightly intervals, then monthly. He also reviewed her history of taking medication, and of having received treatment from a psychologist at Westmead, a Professor Lee, also in conjunction with the post-accident psychological needs of her children. Neither party tendered any reports from Dr Lee (spelt elsewhere as Le). 231Dr Prior recorded the plaintiff's underlying physical symptoms as comprising unremitting and plateaued chronic pain perception in her neck, her left shoulder, left knee and lower back, with temporary exacerbation occurring during cold weather conditions. 232Dr Prior recorded the plaintiff's psychological symptoms as including not being able to do anything, or enjoying her children, because of pain, unhappiness, a pervasively depressed mood, anhedonia, feeling worse at night, impaired concentration and memory, reduced sleep, self-confidence, self-esteem and appetite. He also recorded the plaintiff as having no energy, and always being stressed and nervous, and of having ongoing symptoms of anxiety, intrusive distressing recollections and nightmares on a daily basis, and reduced participation in her usual events. Dr Prior described the plaintiff as having a dysphoric affect. 233Dr Prior's diagnosis was of PTSD with a Co-morbid Major Depressive Disorder caused by the motor vehicle accident. He arrived at that diagnosis from the history, his mental state examination of the plaintiff, his consideration of the relevant diagnostic criteria for the conditions he had identified, and by eliminating the unfulfilled criteria for competing differential diagnoses. In the Whole Person Impairment section of his opinion, Dr Prior justified his conclusions with references to cited quotations from the history provided by the plaintiff, and which were co-related to the required assessment criteria. 234Dr Prior was of the view that the plaintiff was not fit for entry into the workforce for the foreseeable future, and that she would require support in the domestic setting. He thought that on the basis of his examination of her, she was consistent in her presentation, and was not exaggerating. He considered the plaintiff's prognosis to be guarded. 235Dr Prior also gave oral evidence concurrently with other psychiatrists, and I shall also refer to that evidence in due course. Dr Akkerman - plaintiff's assessing psychiatric consultant - first of 2 reports 236On 29 September 2009, at the request of her solicitor, the plaintiff was examined by Dr Klaas Akkerman, a consultant psychiatrist. This was the first of 2 such consultations and reports by Dr Akkerman. In Dr Akkerman's report of the same date, he recorded a constellation of psychological symptoms recounted to him by the plaintiff. His mental state examination of her revealed she had deficient grooming, her concentration was down, as was her short-term memory, she was irritable, occasionally tearful when describing the accident, she used avoidance, she startled easily, and was hypervigilant. His diagnosis was of PTSD and Major Depression of a severe and continuing nature, impeding her ability to work. His view was that her (psychiatric) prognosis was guarded. 237Dr Akkerman prepared a further report to which I shall refer in its chronological context. Dr Akkerman also gave oral evidence concurrently with other psychiatrists, and I shall also refer to that evidence in due course. Westmead Traumatic Stress Clinic 238On 23 October 2009, the plaintiff presented to the Traumatic Stress Clinic at what appears to be Westmead Hospital: Exhibit "E". The assessing psychologist noted that the consultation was for her post-trauma adjustment issues following the accident in question. The referral for this consultation was by the psychologist who had been treating the plaintiff's children. 239The assessment noted, amongst other things, that the plaintiff was restless, very anxious, very agitated, showing signs of being depressed, with poor insight and "extremely avoidant". 240The history provided by the plaintiff on this occasion included her experience of nightmares, intrusive memories, anger, frustration, poor sleep, very low mood, and having heard her children crying and screaming following the accident: Exhibit "E", page 1. Incidentally, in describing the events of the accident she had described hitting her head on the dash of the vehicle in which she had been travelling. 241These clinical notes showed that the plaintiff had attended the clinic for a number of visits between 23 October 2009 and 8 December 2009. The notes also recorded that the plaintiff had transportation difficulties, which were to a degree influential on her attendances at the clinic. Despite this, the attending psychologist noted the plaintiff was strongly motivated to pursue treatment. That psychologist noted the plaintiff was "extremely avoidant and currently cannot entertain [the] idea of doing activities currently avoided". Further commentary in 2009 from Dr Ali at request of plaintiff's solicitor 242On 12 November 2009, Dr Ali prepared a further report in the form of a commentary at the request of the solicitor for the plaintiff. That report was not based upon a specific examination. This report was simply directed at commenting upon the MAS report of Dr Parmegiani. In that regard, Dr Ali noted that it was unclear to him as to how Dr Parmegiani had reached his conclusions to the effect that the plaintiff's presentation at examination was "inconsistent" where Dr Parmegiani's report did not refer to him having carried out any specific testing. Dr Ali's point of emphasis was that nevertheless, Dr Parmegiani had expressed the view that the plaintiff was suffering from PTSD, which was essentially similar to his own view. 243Dr Ali also gave oral evidence concurrently with other psychiatrists, and I shall also refer to that evidence in due course. Dr Talley - plaintiff's assessing gastroenterology consultant 244On 23 February 2010, at the request of her solicitor, the plaintiff was examined by Dr Nicholas Talley, a consultant gastroenterologist and hepatologist. In his report dated 24 February 2010, Dr Talley confined his comments principally to his own area of specialty. 245Dr Talley summarised the plaintiff's account of the accident with the description that she had been squeezed severely in a car hit from the front, and had to be cut out from the wreckage, and that she had injured her neck, the left side of her body, and her left knee. 246Dr Talley took a history of gastroenterological symptoms of epigastric and retrosternal burning sensation unrelated to postural changes, and expressed the view that he presumed these symptoms, including abdominal cramps and pains, bloating and constipation, were due to the side effects of medications taken by the plaintiff for her reported musculo-skeletal problems, and for her psychological problems. Dr Talley noted the plaintiff looked to him to be a little depressed. From the viewpoint of his special interest in psychogenic pain syndromes, he thought the plaintiff's gastrointestinal problems may well be partly due to her psychiatric state. He considered that her gastrointestinal or other non-psychiatric disabilities would not prevent the plaintiff from working. 247Dr Talley was not called to give oral evidence. Dr Haik - defendant's psychiatric consultant - second report 248On 1 March 2010, at the request of the solicitor for the defendant, the plaintiff was to be re-examined by Dr Haik, the consultant psychiatrist. The plaintiff had failed to attend that appointed examination. 249However, Dr Haik took the opportunity to provide a commentary report to the solicitor for the defendant regarding the reports of Dr Akkerman, Dr Prior, Dr Parmegiani and Ms MacMaster that had been provided to him for that purpose. In that commentary, without evidence, Dr Haik drew attention to some adversities that he had assumed the plaintiff had encountered in her life, and as a consequence he proposed the following generalised formulation: "This unfavourable collection of life's obstacles would make almost all who suffer them despondent and glum. It is no wonder that she seeks recompense for the hand that she has been dealt as well as a determination to overwhelm all those who might oppose her goal". 250It must be observed that without having had the opportunity to fairly put that assertion to the plaintiff for her comment, the underlying assumptions for that assertion must remain speculative. Nevertheless, Dr Haik took the approach of using that comment as a basis upon which to maintain an analytical stance of scepticism towards the case the plaintiff sought to make. Ms MacMaster - defendant's consultant occupational therapist - first report 251On 4 March 2009, at the request of the solicitor for the defendant, the plaintiff was assessed in her home by Ms Margie MacMaster, a consultant occupational therapist. In her report of 6 April 2009, as would be expected, Ms MacMaster directed her comments to recommendations for domestic care rather than medical diagnosis. I will therefore defer analysis of her opinions to the portion of my reasons dealing with the plaintiff's claim for domestic assistance. 252Ms MacMaster was not called to give oral evidence in the proceedings. Professor Harris - defendant's orthopaedic consultant - second report 253On 23 March 2009, at the request of the solicitor for the defendant, the plaintiff was re-examined by Professor Harris, the consultant orthopaedic surgeon. In his report dated 25 March 2010, Professor Harris confirmed the findings on examination that he had made in his previous report. He also noted that the plaintiff was depressed and anxious. However, he opined that there was no temporal connection between the plaintiff's injury and her current symptoms and disabilities. That view stands to be analysed in conjunction with the other physical evidence. Dr Pierides - defendant's occupational medicine consultant - third report 254On 25 March 2010, at the request of the solicitor for the defendant, the plaintiff was re-examined by Dr Pierides, the consultant occupational physician. In his third report which was dated 26 March 2010, Dr Pierides described the plaintiff as having performed sub-optimal movements when she tried to move her shoulders, especially her left shoulder during the course of his examination of her. 255Dr Pierides went on to make further remarks that were critical of the plaintiff. These included statements to the effect that her gait appeared to him to be contrived; that she was a pain focussed woman who was self-limiting in her activities, and that she presented as significantly disabled in the absence of clinical evidence of any significant ongoing disability. 256Dr Pierides had assumed that the accident in question was "mild to moderate". It was not clear from his reports as to from where he had derived this assumption. However, having regard to the matters to which I have referred in my findings concerning the circumstances of the accident, the description "mild to moderate" is of no assistance to determining the nature of the plaintiff's injuries or the duration of her symptoms. 257Dr Pierides re-iterated his earlier expressed views that the plaintiff had recovered from any injuries in the accident (without defining what they were) and that such recovery would have occurred within about 12 weeks from the accident. He described the plaintiff's physical prognosis as excellent. 258It was apparent from the opinions expressed by Dr Pierides, that he had not given much, if any, consideration to any psychological factors that might have influenced the plaintiff's complaints or behaviours. In my view, his opinions have to be read in that light. Ms MacMaster - defendant's consultant occupational therapist - second report 259On 15 April 2010, at the request of the solicitor for the defendant, the plaintiff was re-assessed in her home by Ms MacMaster, the consultant occupational therapist. As was the case with Ms MacMaster's report of 19 April 2010, Ms MacMaster restricted her comments to matters concerning the claim for domestic assistance and I shall refer to these recommendations in arriving at my damages findings. Ms Cogger - plaintiff's consultant occupational therapist 260On 12 August 2010, at the request of her solicitor, the plaintiff was examined by Ms Natala Cogger, a consultant occupational therapist. In her report, which was dated 17 September 2010, Ms Cogger undertook assessments of the plaintiff's activities of daily living and provided recommendations for the provision of mechanical aids and for the provision of domestic assistance. She estimated the plaintiff's past and future needs in that regard. Those recommendations will be examined in detail in connection with my assessment of the plaintiff's entitlement to damages. 261In her assessment of the plaintiff, Ms Cogger observed the plaintiff to have demonstrated limitations with activities such as negotiating stairs, squatting, walking, reaching below knee level, repetitive movements of the right (sic) shoulder, left knee, lifting and carrying items, as well as managing repetitive domestic tasks such as vacuuming and mopping. Ms Cogger also recorded the plaintiff's report of continuous chronic pain, and loss of lifestyle, leading to depression. The areas of reported pain as recorded by Ms Cogger were in the plaintiff's neck, left shoulder, low back and left knee. 262Ms Cogger was not called to give oral evidence or to be cross-examined on her recommendations. Dr McClure - MAS Assessor appointed by MAA 263On 27 July 2010, at the request of the MAA, the plaintiff was assessed by Dr Andrew McClure, a consultant psychiatrist. In his report of the same date, Dr McClure issued his determination that the plaintiff suffered from chronic PTSD in partial remission, with an associated chronic Major Depressive episode, and Pain Disorder, with both psychological factors and a general medical condition. Dr McClure certified and determined that these conditions were caused by the motor vehicle accident in question. 264Dr McClure considered that there was exaggeration and possible malingering in the plaintiff's presentation. He also considered that the plaintiff's level of symptoms and level of impairment to be "reportedly static or minimally fluctuant". Nevertheless he considered that there was little likelihood of remission of the conditions he identified. 265In his capacity as a MAS Assessor, Dr McClure was not compellable as a witness, so he was not included in the concurrent psychiatric expert evidence session. Dr Pierides - defendant's occupational medicine consultant - fourth report 266On 3 February 2011, at the request of the solicitor for the defendant, the plaintiff was re-examined by Dr Pierides, the consultant occupational physician. In his fourth report dated 4 February 2011 Dr Pierides stated that the "history of her injury has been noted in [the] 3 previous reports". In fact, contrary to that statement, in those reports, there was no notation made by Dr Pierides of a history of the specific injuries suffered by the plaintiff in the accident. 267In this fourth report, Dr Pierides again referred to his examination of the plaintiff as being "marred" by pain behaviours, and by self-limitation. He referred to the opinion of Dr Haik, which suggested it was understandable (in a non-accident related way) as to why the plaintiff was depressed. He also focussed upon some inconsistencies identified by Ms MacMaster. 268In this report, Dr Pierides expressed the diagnosis that the plaintiff had soft tissue injuries to her cervical spine, some radiation to the left trapezius area and left shoulder, and a low back strain. He reiterated his earlier opinions that all of the plaintiff's injuries had resolved, but had possibly left her with some symptoms after 12 weeks post-accident. 269The consistency of those views, and whether those views as expressed by Dr Pierides correctly reflect the plaintiff's situation, stand to be evaluated in light of the other medical evidence. Dr Haik - defendant's psychiatric consultant - third report 270On 15 February 2011, at the request of the solicitor for the defendant, the plaintiff was re-examined by Dr Robert Haik, the consultant psychiatrist. In his report of the same date, Dr Haik reviewed some further medical reports which had been sent to him for comment. He also reiterated his earlier speculative formulation dated 1 March 2010, in which he referred to the plaintiff's despondency and glumness, and he again referred to what he considered to be her quest for recompense. 271In his third report, Dr Haik had identified the plaintiff's situation in life as being sufficient to engender a reactive depression, but he also linked that view to a speculative consideration which he described as the plaintiff's capacity for mendacity. On that basis he concluded that it was implausible that the plaintiff's alleged pain would have caused her depression. He did not explain the basis for that view. 272In expressing that view, Dr Haik had accepted that the plaintiff in fact suffers from a non-biological, that is, a reactive depression, which fits the DSM-IV criteria of Adjustment Disorder with depressed mood. 273However, Dr Haik has suggested that the plaintiff is in effect, pursuing this litigation for secondary gain. That view stands to be evaluated. Dr Klaas Akkerman - plaintiff's assessing psychiatric consultant - second report 274On 8 February 2011, at the request of her solicitor, the plaintiff was examined by Dr Klaas Akkerman, the psychiatrist. In his report dated 24 February 2011, Dr Akkerman's second assessment of the plaintiff resulted in him confirming his earlier expressed view that the plaintiff was suffering from PTSD and Major Depression. He again expressed the view that it was possible that the plaintiff would never work again. He reiterated his view that her (psychiatric) prognosis was guarded. 275I shall return to an evaluation of the evidence of Dr Akkerman in the context of my findings concerning the plaintiff's ongoing disabilities in the context of comparing the various evidence given concurrently by the other psychiatrists. Dr Faithfull - plaintiff's assessing orthopaedic consultant 276On 15 February 2011, at the request of her solicitor, the plaintiff was examined by Dr Donald Faithfull, a consultant orthopaedic surgeon. In his report dated 24 February 2011, Dr Faithfull recorded a detailed history of the events of the accident, which included an account of the plaintiff's head and left knee hitting the dashboard of the vehicle. He thought it was more likely that the plaintiff's head had hit the door of the vehicle in the accident. 277Dr Faithfull assessed the plaintiff as having suffered a whiplash injury to the soft tissues of the cervical spine, a seatbelt injury to the left shoulder, probably as a result of the left shoulder hitting the door, and some damage to the articular surface of the left knee comprising the patellar cartilage. On his examination of the plaintiff he noted her ongoing complaints of left knee, left shoulder, cervical and lumbar spine symptoms. Dr Faithfull noted that the plaintiff's current complaints affected her activities such as walking, sitting for prolonged periods, walking up and down steps, and crouching. 278Dr Faithfull expressed the opinion that the plaintiff would have difficulty in working as a florist because that work would require her to be on her feet in a shop, and he said she would have difficulty with this because of her problems in the left knee, and in the lumbar spine. 279Significantly, in his report, Dr Faithfull associated all of the plaintiff's current physical complaints, except the lumbar spine complaints, to the accident of 1 November 2006. His report implied that the lumbar problems may not have been due to the accident in question. That view has to be assessed in light of the evidence as a whole. 280Dr Faithfull gave oral evidence on the 12th day of the trial. The defendant had required his attendance for cross-examination. 281Dr Faithfull confirmed that the history he had obtained was summarised from a conglomeration of what the plaintiff had told him directly, and from what had from time to time been translated by the interpreter. 282Dr Faithfull also confirmed that for the purpose of formulating his opinions he had not been provided with the ambulance report, the hospital notes or the records of the general practitioner. He also confirmed that his opinions were based upon the history that had been provided to him by the plaintiff. 283So far as I could tell, the cross-examination of Dr Faithfull seemed to proceed along what I shall describe, for convenience, as comprising four pathways. 284The first explored the likelihood of the plaintiff having hit her head on the dashboard in the accident, the second explored the likelihood of the plaintiff having injured her left knee in the accident, the third involved a theoretical discussion on the mechanics of the operation of seatbelts and associated injury mechanisms with reference to the complaint of an injury to the plaintiff's lumbar spine, the fourth involved an evaluation of the question of whether the plaintiff had injured her left shoulder in the accident. 285Dr Faithfull stated that he found no inconsistency between the plaintiff's complaints of pain and his findings on his clinical examination of the plaintiff: T485.15. 286On considering the matters raised and discussed in the cross-examination of Dr Faithfull, I do not consider that the opinions expressed in his report were to any material degree traduced, or shown to have been faultily reasoned. 287As will appear from the reasons for my findings on the accident related injuries and disabilities, I found the evidence of Dr Faithfull both helpful and compellingly persuasive, except on the issue of the nature of the plaintiff's complaint of injury to her lumbar spine, a matter to which I shall return in my evaluation of the evidence leading to my findings on the nature and extent of the injuries sustained by the plaintiff in the accident. 288It transpired that Dr Faithfull was unaware that there had been a history of two relevant collisions, a rear-side impact between vehicles and a front impact with a telegraph pole. 289As to the first and second pathways, Dr Faithfull explained that the phenomenon of a dazed and confused state from a head injury may not necessarily be documented in an ambulance report in the absence of unconsciousness: T462.40. Similarly, he explained that if there were no apparent signs of a knee injury, a complaint of a knee pain or injury might in the context, "might come fairly well down in the list and might actually be lost": T463.30. 290Dr Faithfull also explained that the detection of a knee injury in hospital may remain undetected if the patient was laying down and was not up and about in hospital: T463.45. He explained that the subsequent detection of a knee injury by a general practitioner in the ensuing days was in part dependent upon the development of outward signs of injury, such as bruising, and the reporting of such signs, but with the caveat that such matters are not always brought to light in a time-limited consultation available to a general practitioner: T464.5 - T464.30. 291These matters were not taken up with any further evidence from the plaintiff. 292On the question of whether the plaintiff might have had an injury to her head, and whether this had been detected by observable signs, Dr Faithfull explained that sometimes such matters go undetected in a side-on collision involving the temple area, and in the case of females, it may be hidden by long hair: T476.2. Dr Faithfull was not asked questions on the diagnosis and notes comprising the Liverpool Hospital clinical records on this issue. 293Dr Faithfull was not asked to consider the possible effects, if any, or the duration of such effects, of the administration of morphine and other medications by ambulance and hospital staff on the process of seeking to obtain a full or complete pain or injury history from the plaintiff. 294Also on the second pathway, Dr Faithfull was asked to consider the imaging evidence in association with the likely timing of onset of the plaintiff's left knee complaints: T467 - T470. Dr Faithfull was taken to 2 ultrasound reports, the first in time dated 22 January 2008 ordered by Dr Rahman, being Exhibit "4", and the second in time dated 7 February 2008 ordered by Dr Maniam, being Exhibit "8". Dr Faithfull stated that the 7 February 2008 ultrasound findings were consistent with the report of the injury at the time of the accident: T468.35. 295When Dr Faithfull was shown the 22 January 2008 ultrasound report, he agreed that report "is more consistent with it being a more recent injury than an older injury". He later agreed the mention of inflammation on that ultrasound report necessarily defined the injury to the left knee as being suggestive of a more recent in origin than of longstanding origin, particularly as there was a partial tear of the medial collateral ligament: T470.5 - T470.37. Neither the cross-examiner nor the re-examiner ventured any questions seeking clarification of what Dr Faithfull understood by the cross-examiner's expression "more recent than longstanding origin", or whether his expression "more suggestive" meant definitively diagnostic. Dr Faithfull explained that "old" in this context meant more than several months, whereas "recent" meant new or acute. There were no further time frames or estimations suggested, explored or attached to that discussion. 296Dr Faithfull indicated that the MRI taken in March 2008 showed signs suggestive of an old rather than a new or acute injury. He explained that a new injury would be accompanied by oedema and inflammation around the knee, whereas the description of a sprain just meant that there has been some tearing of some ligaments more than several months beforehand, and that tearing had not healed: T468.20 - T468.30. 297As to the third pathway, Dr Faithfull explained that the operation of a seatbelt in motor vehicle accidents involving "whiplash" type injuries means that persons injured in such accidents "rarely, if ever, complain about their lumbar spine" because the seatbelt keeps the trunk straight: T472.40 - T473.2. 298In this context, the following clarification evidence was given at T473.5 - T475.9, and which I set out in full, in view of its significance: "HIS HONOUR Q. Just so I understand that passage of your report that you've just been taken to. A. Yes. Q. Doctor, at page 2 of your report under the heading of "History", you obtained the history which is summarised, that is, "The plaintiff was a front seat passenger of a sedan which was hit on the right side. She was wearing a seatbelt." A. Correct. Q. If one assumes that there are two collisions, one being the one you described and another one being a collision between the vehicle and the pole which followed the first collision, would that have any material bearing on your comment as to the injury to the lumbar spine and the seat belt retention issue? A. If the seat belt survived the first collision, then one wouldn't expect a lumbar injury. Q. Doesn't it depend upon the dynamics of forces that are resolved in the first collision and then the second? A. That's true enough. The car was struck on the right side as I understand it, so she would have been thrown to the left and that's where I thought she - why she had hit her head on the side, rather than on the dash board. The air bags did not deploy which gave me the impression that the accident was not a significant - you know, if it had hit the pole, it does tend, the air bags, if they're just front air bags, tend to deploy if the car hits either a head-on injury or runs into a tree. So that's why I thought the major - I'm just making this up now from what you've said because I didn't realise that it had hit anything else. If the major impact would be the car A hitting car B, and the more minor impact would be car B then hitting a pole, did you say? Q. Yes. A. Hitting the pole. So that's why the air bags didn't deploy. Am I explaining myself-- Q. Yes. FITZSIMMONS Q. Do I understand your evidence to be that still essentially with either, the trunk should be restrained through the use of a lap-sash seat belt? A. Yes. Q. And therefore irrespective of that, you would not expect to see any major lumbar injury? A. Yes. Q. Because I think in fact what you say at paragraph 6 of your report, is that you make mention of the fact that the plaintiff claimed that her head hit the dash board and you make a comment that "I think it is likely that her head hit the car door"? A. Correct. Q. And you make that comment, not because, given the proper restraint with the lap-sash seat belt that you would not expect, would you, for her head to hit the dash board. Correct? A. Correct. HIS HONOUR Q. The mention of major injury begs the question - does a musculoligamentous injury which I assume is what a whiplash injury to the spine means, classify itself as a major injury or not? A. It can be or it can be a minor injury. It depends on the extent of the soft tissue injury, and it depends also on the age of the patient. The more rigid the spine is when it jogs backwards and forwards, the more likely you are to get a tear of the ligaments that stabilise the cervical spine. So that's why it's important that, when you look at the X-rays, that you're looking at actually the soft tissues as well as the bone, which sometimes isn't observed. FITZSIMMONS Q. But the position is, is it not, that certainly given the restraint by the use of the lap-sash seat belt which you would not expect a head impact with the dash board? A. Not with the dash board, I wouldn't have thought. Unless, I mean, I don't know about the techniques of how well the sash - lap-sash or the safety belt holds. Q. But ordinarily, it's for that reason that in your report you are of the view that if there was any-- A. It held. Q. -- it was likely to be more a side head injury, side door rather, than with the dash board? A. Correct. HIS HONOUR Q. I suppose if the patient was dazed, they wouldn't know what hit them, would they? A. Well, I don't know whether you have been in a motor vehicle accident, I have actually, it was not my fault of course, but when you think about it afterwards and when particularly the policeman is talking to you, it does take you a little while just to go through exactly what did happen and you're trying to be as accurate as you possibly can, and you are surprised what you think you saw and, in fact, what happened. Q. Sometimes it's a matter of perception? A. Yes, yes. Well, I think you probably try to figure out, was it my fault or not. I think that's the first - well, that's the first thing I thought of anyway, even though I was, I must admit, I was actually thrown sideways. The car came at me and I was thrown sideways." 299There were two noteworthy areas within the opinions of Dr Faithfull concerning the question of the extent to which the plaintiff suffered an injury to her spine. 300The first area concerned the plaintiff's cervical injury. Dr Faithfull was of the opinion that the plaintiff had been inadequately investigated regarding her complaint of altered sensation she experienced in her little and ring fingers. Dr Faithfull felt this complaint was possibly derived from the cervical spine: T484.39. 301The second area concerned the basis of Dr Faithfull's belief that the plaintiff had not suffered an injury to her lumbar spine: T484.10. This is a matter to which I shall return in my evaluation of the nature and extent of the plaintiff's injuries on a consideration of the entire range of evidence on this point. 302In the meantime, I record my view that I do not read Dr Faithfull's general discussion on the operation of seatbelts and his evidence at T472.40 - T475.9 to say that it was not possible for the plaintiff to have sustained a soft tissue injury to her lumbar spine in the accident in question. 303As to the fourth pathway, Dr Faithfull agreed in general terms that if someone had pain and difficulty using their shoulder and arm, it would be expected that such problems would be reported in the period immediately after the accident; T477.5 - T477.15. Dr Faithfull went on to explain that this would ordinarily be expected even if the patient was sitting in bed: T477.34. I did not read that general discussion to be particularly definitive to the plaintiff's case concerning her claim of having sustained a shoulder injury. 304It was unfortunate that in the context of the ensuing discussion within the cross-examination, or for that matter re-examination, on the subject of the origins of the plaintiff's shoulder problems, the attention of Dr Faithfull had not been taken to Exhibit "6", Tab 6, page 19. That document reveals that at the accident scene, an ambulance officer had elicited a complaint from the plaintiff of pain in the region of both shoulders, as was recorded in diagrammatic form. In my view this small factual detail is a matter of some importance to determining the origin of the plaintiff's shoulder complaints. 305I have already remarked upon the fact that Dr Faithfull was not asked to consider the timing, dosages and likely duration of the therapeutic effect of those dosages of the pain killing drug morphine on the plaintiff's experience of pain, and the related issue of whether, in the light of those matters, there is a reasonable explanation for the lack of notation of shoulder problems in the hospital clinical notes before the plaintiff discharged herself from hospital the following day. 306Dr Faithfull was asked whether it would surprise him that the plaintiff's right shoulder was mistakenly investigated by MRI scanning, and he said it did not surprise him: T478.31. The plaintiff believed it was a mistake: T88.24. However, the diagram within the ambulance report indicates the right shoulder was also painful. The investigation of the right shoulder either may or may not have been a mistake, as was suggested by the defendant, although the plaintiff believed it to have been a mistake: T88.37. Professor Harris - defendant's orthopaedic consultant - third report 307On 22 February 2011, at the request of the solicitor for the defendant, the plaintiff was re-examined by Professor Harris, the consultant orthopaedic surgeon. In his report dated 24 February 2011, Professor Harris reiterated his view that there were no underlying physical diagnoses to link the plaintiff's current symptoms, which had not changed, to the injury of 2006. 308Professor Harris expressed the diagnostic comment that the plaintiff's multiple areas of pain were without an attributable underlying pathological diagnosis. In that regard, he stated that as the plaintiff's symptoms had not significantly changed over the last few years, it was unlikely that her symptoms would significantly change in the future. Ms MacMaster - defendant's consultant occupational therapist - third report 309On 23 February 2011, at the request of the solicitor for the defendant, the plaintiff was re-assessed in her home by Ms MacMaster, the consultant occupational therapist. Again, in her report of 28 February 2011, Ms MacMaster concentrated on the questions associated with the plaintiff's need for domestic assistance. I shall consider her report in the context of an evaluation of the claim for damages for domestic assistance.

Joint report following meeting of psychiatrists 310Following the order for the psychiatric experts to meet, not all of the psychiatrists were able to meet for the purpose of preparing a joint report. That position would most probably have been different if the parties had considered the need for such a meeting to be arranged before the hearing. In the hybrid circumstances that prevailed, only Dr Ali, Dr Haik and Dr Akkerman were able to meet. Their joint report, in its variously corrected versions, became Exhibits "F" and "G". The joint report of those experts addressed the following 5 questions that were formulated by the parties:

1. Does the Plaintiff suffer from a diagnosable psychiatric condition as a result of the motor vehicle accident on the 1st November 2006?
2. What is the condition?
3. Do the circumstances of the motor vehicle accident fulfil criteria A1 of DSM IV?
4. What accident circumstances have you relied up (sic) in forming that opinion.
5. What evidence have you relied upon in forming any psychiatric opinion in this case? 311The experts answered those questions as follows: (a)As to Question 1, Dr Ali and Dr Akkerman answered yes, and Dr Haik answered no; (b)As to Question 2, Dr Ali answered PTSD, Dr Akkerman answered that the plaintiff had PTSD with depression, and Dr Haik answered that the plaintiff did not have a psychiatric condition; (c)As to Question 3, Dr Ali and Dr Akkerman answered yes, and Dr Haik answered no; (d)As to Question 4, Dr Ali and Dr Akkerman relied on the history and the background documentation, and Dr Haik relied upon the Liverpool Hospital file that indicated the collision was "minor" and was of "low speed"; (e)As to Question 5, Dr Ali and Dr Akkerman relied on the history and the background documentation, and Dr Haik relied upon the history, "the material life" of the plaintiff, "inconsistencies and contradictions", her behaviour at interview, the lack of her response to treatment, and the absence of "clear evidence of any physical injury lesion" that would explain "her many unrelenting symptoms". 312Ideally, a joint report from such experts would have been better planned in advance rather than being implemented "on the run" during the course of the trial. It was a procedure the parties ought to have considered and pursued well before the hearing so that steps could have been taken to ensure that all relevant participants would be available. However, in the circumstances, the hybrid arrangement made during the course of the trial was the best that could have been achieved in the prevailing circumstances, and it served as a useful precursor for identifying the issues for the concurrent expert evidence session which followed. 313The underlying assumption posed by the parties in Question 3, namely, the DSM IV criteria was in my view unnecessarily limiting, as the relevance of those criteria seemed to be directed at determining whether the plaintiff was entitled to claim damages for non-economic loss. The DSM IV criteria seemed to me to be of only limited relevance to determining whether the plaintiff's condition justified an award of damages for economic loss and domestic assistance.

Concurrent evidence of 5 psychiatrists 314The 5 consultant psychiatrists, but not including the 2 non-compellable MAS psychiatric assessors, gave their evidence concurrently on the 14th day of the trial: T534 - T603. The concurrent evidence format allowed these witnesses the opportunity of addressing precisely the same questions and issues, as well as providing the opportunity of asking questions of each other if they wished to do so, as well as considering and commenting on the evidence given by their colleagues. The legal representatives of the parties also had the opportunity of cross-examining the respective experts on their opinions. The claim by the defendant of procedural unfairness has to be viewed in the light of those matters. 315The context of the concurrent expert evidence session revealed a polarisation of two bodies of opinion within the views of the respective psychiatrists. Essentially, on the one hand, Dr Haik maintained his view that the plaintiff did not have a diagnosable psychiatric illness due to the accident in question, whereas Dr Akkerman, Dr Prior, Dr Ali and Dr Clark each considered that the plaintiff did have such an illness. 316Whereas Dr Akkerman, Dr Prior, Dr Ali and Dr Clark considered that the plaintiff the plaintiff had PTSD with major depression due to the effects of the accident, Dr Haik was prepared to concede the plaintiff might have a psychiatric illness, but he considered it was more probable than not that her illness was in existence before the accident as a result of many years of hardship, which was a cause that was different to the one that implicated the effects of the motor vehicle accident in question. 317When the basis for these polarised views of the experts was explored, it became apparent that Dr Haik had made a judgment that there were "many many" mounting inconsistencies which indicated to him that the plaintiff was not a truthful historian. He believed the plaintiff was mendacious, and he raised the spectre that the mendacity he imputed to her, may have been for financial or secondary gain on her part. 318It therefore became important to identify the basis for the differing views of the experts. That basis soon became apparent from the answers of the experts to the questions that they had been asked to consider. 319The common ground amongst the psychiatric experts was that the diagnosis of any psychiatric illness in the plaintiff was dependant upon an acceptance of her account of her history. In this regard, the experts took differing approaches. 320The approach taken by Dr Haik was to apply a focus upon what he described as untruths or inconsistencies in the plaintiff's presentation. He also relied upon some factual assumptions from the results of some research he had undertaken, which led him to the adamant view that the plaintiff was not a truthful historian. The defendant harnessed those views in order to ultimately base a submission that the assumptions supporting the claimed diagnosis of PTSD in the plaintiff should not be accepted. 321The contrary approach taken by Dr Akkerman, Dr Prior, Dr Ali and Dr Clark was to reject the adamant views of Dr Haik in favour of a more benign view of the plaintiff's history. In this alternative approach, these witnesses viewed the alleged inconsistencies against the background of the diagnosed presence of PTSD and depression, which required more tolerance or allowance for inaccuracies within the history of the plaintiff. 322As the two different points of view were irreconcilable, in order to identify which of the views, or aspects of the views, were to be preferred, it was necessary to delve into the underlying assumptions which underpinned these respective bodies of opposing opinion. 323Dr Haik gave a number of reasons for his differing opinions. It is therefore convenient to first identify the reasons that Dr Haik gave for his dissident views in order to later align those reasons with the explanations of the other experts. Although this task involved the analysis of significant detail, that exercise is necessarily required in order to achieve engagement with those views in order to evaluate them, to enable me to arrive at my findings on the nature and extent of the plaintiff's accident related disabilities in my consideration of Issue 4. This approach requires that the many elements that were raised in the evidence be identified for that evaluation and analysis. 324Dr Haik identified a formulation by which he suspected that the accident had afforded the plaintiff an opportunity to perhaps be relieved of her many pressures as a result of claims of disablement both physical and psychological: T537.20. Dr Haik said he had concluded that the plaintiff had "gilded the lily" in an attempt "to find reparation for a very hard life": T560.1. Dr Haik said he came to that view because "the physical findings [were] unable to support her symptoms": T560.5. 325When those physical matters were explored with Dr Haik (at T560.20), he gave the example that he thought "there should have been evidence of damage to her left shoulder, but there wasn't according to the MRI": T560.20; 326Although Dr Haik ultimately conceded that the subject of physical effects of the claimed injuries was not within his qualifications to comment, he nevertheless stated his expectation to be that as the plaintiff was relatively young, his understanding was that of the case of young people generally, soft tissue musculo-ligamentous injuries of the spine generally get better: T560.35 - T560.46. 327In the order in which Dr Haik's reasons and assumptions appeared in his oral evidence, his reasons were as follows: (a)The plaintiff's psychological or psychiatric problems were more probably than not as a result of many years of hardship, for which she was now seeking financial or secondary gain, those asserted hardships being: (i)An arranged marriage in her early life at age 15 to a man who was twice her age: T536.38; (ii)Her 2 first-born children in Lebanon died soon after birth: T536.50; (iii)Her third child was born with severe cerebral palsy: T537.1 (iv)Her husband was not a good man in the sense of his gambling, his drinking and his poor supply of money: T537.2; (v)She divorced her husband in 2001 to live by herself and her two subsequently born children: T537.4; (vi)She developed no further [romantic] relationships: T537.5; (vii)She has had to live in Department of Housing accommodation: T537.6; (viii)She has had to rely heavily on social security for an income: T537.7; (ix)She relinquished the care for her disabled child as the accident provided her with the opportunity to do so, which Dr Haik asserted to have been the cause of some ambivalence in the plaintiff: T537.15; ["the hardships"] (b)The collision in question was a low speed collision: T536.32; (c)He could find no evidence in the ambulance or hospital report that the plaintiff had to be cut out of her vehicle, and when he asked her about the details, she could not remember: T538.2; (d)No significant physical abnormalities were found at Liverpool Hospital in relation to the plaintiff: T536.33; (e)There was no subsequent evidence that emerged of a physical disorder that might serve to objectively explain the plaintiff's subjective complaints: T536.34; (f)Dr Haik assumed that PTSD did not exist in the plaintiff because of the nature of the accident as a causal stressor: T536.36; (g)The plaintiff's reported nightmares or repetitive intrusive disorder are "very stereotyped" and do not meet the criteria for PTSD: T536.40; (h)Dr Haik was concerned that Mrs Khalil has exaggerated out of all proportion, and his view was that she had exaggerated "hugely", the matters set out on page 3 of his report: T543.33; (i)Dr Haik's view was that the plaintiff was telling "untruths" (T540.24; T557.27; T581.48) or inconsistencies (T549.40; T550.49; T557.30; T558.25; T559.7; T581.42; T582.1; T592.50; T593.4) which he characterised as mendacity on her part (T540.30; T540.47; T554.35), as follows: (i)the history of the timing of her obtaining a floristry certificate and going to commence work in a floristry shop when the TAFE certificate was obtained in 2001, and not in 2005, compared to the different story obtained at the second interview of the plaintiff intending to obtain work in a small supermarket: T540.25; T557.35 - T559.3; (ii)the history of the plaintiff not driving, although it transpired that she owned two cars: T540.32; (iii)the history of the plaintiff not having had sex since 2005, yet there were a number of documented pregnancies in the clinical records that suggested otherwise: T540.35; (iv)he thought the plaintiff had exaggerated in respect of a number of matters, such as her weight loss (T543.33; T601.10). 328Against the views of Dr Haik, the experts with opposing views to his opinions expressed their opposing opinions to that effect as follows: (a)The severity of the accident is an irrelevant matter, and what actually mattered was what the patient thought was happening: Dr Akkerman, T538.10; (b)The inability to remember details of the event in the context of a sudden car accident is quite common, and varies enormously between individuals: Dr Akkerman, T538.14; (c)There was no evidence of a decompensatory psychiatric illness in the plaintiff before the accident: Dr Akkerman, T538.20; (d)The plaintiff developed her symptoms straight away (after her accident) and these were consistent (with an accident related cause): Dr Akkerman, T538.23; (e)The plaintiff presented to Dr Akkerman consistently, on two occasions a year and a half apart, with symptoms consistent with PTSD and major depression, in circumstances that suggested to him she was genuine: Dr Akkerman, T538.25; (f)A mental state examination revealed the plaintiff displayed the observable symptoms of both major depression and PTSD: Dr Akkerman, T538.30; (g)Dr Akkerman's clinical experience enabled him to recognise the indications of PTSD when he examined the plaintiff on two occasions, namely the presence of depression, avoidance, brevity in describing the key events, rather than attempts to impress severity of symptoms, the startle reaction and hyper-vigilance: Dr Akkerman, T538.30-T538.40; (h)Dr Ali agreed with the above views of Dr Akkerman, and added to them by way of emphasis to the effect that the severity of the accident is not relevant, because it is the perception of the person involved that is the important factor: Dr Ali, T538.48 - T539.5; (i)Dr Ali noted, as the plaintiff's former treating psychiatrist, that in his view the plaintiff had all the symptoms of PTSD, and that these were resistant to treatment: Dr Ali, T539.10; (j)Dr Prior confirmed that PTSD could arise from what might otherwise be considered to be a relatively trivial accident, and it is the subjective experience of the individual that counts: Dr Prior, T539.20; (k)Dr Clark agreed with the above formulation, and he added the further factor that the plaintiff's children had been involved in the accident, and that they were injured: Dr Clark, T539.30; 329On the subject of what Dr Haik had described as the plaintiff's "untruths", the experts whose views differed from those of Dr Haik pointed to the following important factors that should be taken into account in considering those matters in a more benign fashion than the approach taken by Dr Haik: (a)Human behaviour is considered to be very complex, and it is not uncommon for people with a psychiatric diagnosis to provide information that is not quite correct, especially in the context where memory and concentration are affected, and where an examination by an expert for the opposing side of the litigation may be perceived to be stressful: Dr Akkerman, T541.5; (b)Dr Ali agreed with Dr Akkerman's above view, but added that the plaintiff had concentration problems, evidenced by forgetting appointments, amid inconsistencies in history, does not necessarily negate a diagnosis of PTSD: Dr Ali, T 541.15; (c)Dr Prior agreed with the above views of Dr Akkerman and Dr Ali: Dr Prior, T 541.30; (d)Dr Clark also agreed, but added that certain inconsistencies of history, for example with regard to the plaintiff's private life and her sexual life, could be understandably concealed from a psychiatrist, especially where questioning on such subjects in that context could be traumatic in itself: T541.40; (e)There was insufficient evidence that the plaintiff was malingering in her presentation: Dr Akkerman, T542.40; 330The foregoing matters are of some relevance to the assessment of the plaintiff's credit because Dr Haik had agreed that the plaintiff did in fact have a psychiatric disorder, albeit that he thought it pre-dated the accident: T535.45. 331The cross-examination of Dr Haik by Mr Cranitch SC revealed a number of statements made by Dr Haik that required cautious evaluation in the process of determining which opinions should be preferred. Those statements were as follows: (a)Dr Haik had based his opinions that were critical of the plaintiff on matters that had not been canvassed with the plaintiff in his successive consultations with her, (or in her evidence), namely his view that she had given him an untrue history to the effect that Beirut was unaffected by the actions of warring factions in a civil war that was occurring during her time of residence there, and he chose not to believe her statement that the area of Beirut that she had been in was unaffected by civil war at the time. This was a matter Dr Haik decided to treat as an "inconsistency" in the plaintiff's presentation:T548.40 - T550.49; (b)Dr Haik used information available to him from what he described as his own "personal background" to form the view the plaintiff had presented him with an inconsistency regarding her association with a particular Christian religion in Lebanon in connection with the factual circumstances of her marriage as a teenager, without first affording the plaintiff an opportunity to provide a correction of his limited view of the facts in that regard: T551.1- T552.47; (c)Dr Haik acknowledged that these matters, which he had regarded as apparent inconsistencies, were only discovered by him after his first consultation with the plaintiff had concluded, yet he refrained from raising them for clarification or discussion with the plaintiff at his second consultation with her. He took that position for the stated reason that he believed the plaintiff was not going to give him a different answer on the same point on the second interview if such matters were to be raised by him: T553.25 - T554.10; (d)Dr Haik considered that the plaintiff's statements made to him about whether or not she had sexual relations since 2005 in light of her pregnancy in 2007, and in May 2011, should be considered as indications of inconsistency and mendacity on her part: T554.35; (e)Dr Haik rejected the notion that it may have been out of a sense of embarrassment that the plaintiff had withheld the fact that she had been sexually active, and instead, Dr Haik postulated that the plaintiff probably simply chose not to disclose such matters because she did not want him to know she was sexually active:T554.50 - T555.37; (f)Dr Haik reiterated his position that the plaintiff had adopted her symptoms for secondary gain, namely not having to be responsible for her disabled child, and this position was revealed to be based on assumptions which he had not delved into with the plaintiff in order to give her the opportunity to explain herself on those matters of concern to him and in respect of which he had formed an adverse view of the cause of her problems: T555.50 - T557.22. 332The experts with opposing views to Dr Haik also proffered the following views on some of the above matters raised by Dr Haik: (a)Dr Ali offered the opinion that, allowing for minor variations that always arise in the context of taking psychiatric histories, there were no relevant inconsistencies in the plaintiff's presentation throughout the period he was treating her, and he did not think she was malingering: Dr Ali, T545.22 - T545.33; (b)In connection with the plaintiff's concealed pregnancy, Dr Akkerman stated that sometimes pregnancy can have profound effects on mental functioning, and the post-natal period is the time where often things "go wrong more than previous", which, from the context, I took to be a reference to mental functioning, although from the plaintiff's presentation to Dr Akkerman in February 2011, he did not think this was a factor that had a bearing on her ability to give evidence: Dr Akkerman, T546.10 - T546.40; Dr Ali, T546.40 - T546.4; (c)Dr Clark was of the view that the plaintiff's cultural background needed to be taken into account, including considerations of what he identified as Christian values of modesty and shame, which were possibly relevant to her concealment of her pregnancy. Dr Clark's statement to that effect was interrupted by counsel, but I infer from his partial answer he was alluding to the potential for the plaintiff's response to the opportunity to disclose her pregnancy to be an exaggerated one, which in the context in which that word was used, I took to mean that magnified emotional factors might have operated: Dr Clark, T547.15. 333In my view, little, if any, weight should be placed on Dr Haik's reasoning that the plaintiff had given him an untrue history of the consequences of the civil war in Beirut. This is because the plaintiff's account of not being relevantly affected by those events was not only a matter that was peripheral to the issues in this case, and her account of those events was not otherwise inherently improbable, but more importantly, Dr Haik had not afforded the plaintiff the opportunity to comment on his contrary view of her account, and in taking that course, he denied the plaintiff procedural fairness. Furthermore, the plaintiff's account was not relevantly contradicted or challenged in evidence. 334Similarly, I attach little weight to Dr Haik's use of his "own personal background" knowledge of Christian religions in Lebanon in an inappropriate manner to form the basis of criticism of the plaintiff's account of her history of an arranged marriage as a teenager. In my view, not giving the plaintiff the opportunity to correct his views of those events, or to at least have a discussion on his own limited understanding on such matters, Dr Haik has also denied the plaintiff basic procedural fairness on a matter of some importance to her case - her credit. The matter of the plaintiff's age at the time of her marriage was not relevantly put to her as a credit challenge to her account of her history where her account of her history was not otherwise inherently improbable. 335In my view, the denial of procedural fairness in the above two instances was exacerbated by the fact that Dr Haik did not, at his subsequent consultations, give the plaintiff an opportunity to explain her account of the events upon which he had based an adverse view of her truthfulness. I found his reasons for not giving the plaintiff that opportunity - namely, his belief that she would not give him a different answer - to be unconvincing, and involving a spurious form of reasoning that was a plainly unacceptable basis for reasoned expert opinion, especially on matters of credit. 336I considered Dr Haik's characterisation of the plaintiff's reticence to discuss her earlier sexual relationship in 2004 and 2005 and her pregnancies in 2007 and 2011 as evidence of her mendacity, to be a too simplistic form of analysis as it failed to consider cultural factors and any consideration of the Christian values of modesty and shame as matters of that nature that were identified by Dr Clark in his evidence. In my view, the absence of such a consideration from Dr Haik's analysis leads me to reject his approach to this issue in favour of the reasoned approach identified by Dr Clark. 337On my analysis of the medical and other evidence, I consider that Dr Haik's postulation that the plaintiff had adopted her symptoms for secondary gain should also be significantly discounted. This is because first, he failed to explore that assertion with the plaintiff to enable her to fairly consider it and respond as part of the process of forming a balanced reasoned view, and secondly, no suggestion to the effect of that opinion held by Dr Haik was relevantly put to the plaintiff in the course of cross-examination in accordance with the requirements of procedural fairness: Browne v Dunn (1894) 6 R 67. 338On behalf of the defendant, between T561 to T598, Mr Fitzsimmons directed his questions in cross-examination of Dr Akkerman, Dr Ali, Dr Prior and Dr Clark. The cross-examination of those experts was principally directed at some 16 areas of the history that had been provided by the plaintiff at the various consultations with those experts. That evidence was augmented by some comments that were added by Dr Haik in the course of the concurrent expert evidence session. 339The detail of those 16 areas is outlined in the paragraphs that follow and which are identified under the following subject headings. (1) History given in English 340It was confirmed that the plaintiff was able to provide a history to the experts without the aid of an interpreter: Dr Akkerman, T561.5; Dr Ali, T561.30; Dr Prior, T 562.1; Dr Clark T562.19; (2) Whether plaintiff sustained a head injury 341The issue of whether or not the plaintiff had reported having hit her head in the accident was variously described as follows: Dr Clark stated that the plaintiff said to him she was flung forward in the accident and banged her head on the windscreen: T562.50; Dr Prior said she had indicated that she had not sustained a head injury: T563.14; Dr Akkerman indicated that the plaintiff had a head injury it must have been a relatively minute one: T563.35; Dr Ali indicated the plaintiff was "much shaken" but he thought there was no head injury as such: T563.40; Dr Haik said there was no history given to him of loss of consciousness: T564.15; (3) No real change in symptoms over time 342Dr Akkerman and Dr Prior obtained histories from the plaintiff to the effect there had been no real change in her symptoms over time: T564.30 - T565.25; whereas Dr Clark obtained a history of a change for the worse rather than a change for the better: T565.35; whereas Dr Ali had obtained a history that there was only a slight change for the better with medication: T565.50; (4) Plaintiff living alone with her children 343The plaintiff had not given any of the psychiatrists a history of other than living alone with her 2 children aged 13 years and 11 years: T566 - T567; (5) Plaintiff's social functioning 344In terms of her social functioning, on 21 September 2009, the plaintiff had told Dr Prior: (a)She had no energy, no interest in putting on make-up or dressing in other than pyjamas, unless she had to go out to doctor's appointments: T568 - T569; (b)Friends encouraged her to wash and occasionally have her hair done: T569.5; (c)She had not driven since the motor vehicle accident because she was very scared, even as a passenger: T569.35 - T570.5; (d)She essentially never the left her bedroom during the day, and was often angry with her children: T570.30 - T571.5; (6) Plaintiff's description of being housebound 345In terms of the history given by the plaintiff of her getting out of the house, it was reported that she had variously said: (a)She had to go out with a support person: Dr Akkerman, T571.35 - T572.1; (b)On occasions she went to school with her children, suggesting there was some variability in the pattern of this reported activity: Dr Clark, T572.15; (c)She rarely went out of the house, and spent all day in the bedroom or the lounge, basically spending all day in bed but leaving the room to go to the toilet: Dr Haik. T572.20. (7) Difficulty driving or travelling in motor vehicles 346In terms of the history given by the plaintiff of her driving a vehicle or being a passenger in a motor vehicle since the accident, it was reported that she had variously said: (a)She had never driven since the accident: Dr Prior, T572.35; Dr Akkerman, T573.26; Dr Haik, T573.50; (b)She gets very sweaty when she is in a car: Dr Clark, T573.47; (c)She had told Dr Ali that she had missed his appointments because she had no-one to drive her to his rooms: Dr Ali, T574.30. (8) Possible effect of medication on plaintiff's evidence 347A question arose as the possible effects of psychotropic medication on the plaintiff's ability to answer questions. This question arose in the context of the credibility of some of her answers to questions put to her in cross-examination which she answered to the effect "I can't remember". Dr Akkerman was of the view that antidepressant medication was restorative of memory after a settling down period: T575.5. Dr Clark drew attention to a reactive element to depressive illness and cast doubt upon the response to antidepressant medication: T575.30. Dr Haik considered that there was no relevant cognitive abnormality present: T575.35. Dr Ali noted that there was no deficiency or deterioration in the plaintiff's memory whilst he had been treating her: T576.9. (9) Plaintiff's personal relationships 348The defendant sought confirmation of the history the plaintiff had recounted to the experts concerning her personal relationships. The evidence obtained in the course of those questions was confirmatory of the written reports, and was a follows: (a)Dr Prior confirmed the plaintiff had not told him she was in a relationship at the time he saw her: T576.27; (b)Dr Akkerman confirmed that the plaintiff had told him she had been single since her divorce, essentially for 9 years: T576.47 - T 577.16; (c)Dr Clark confirmed that the plaintiff had told him her libido had been affected since the accident and that she preferred to be alone: T577.25 - T578.10; (d)Dr Haik reiterated the history as having been given to him to the effect that since the divorce in 2004 (which he should have known from her statement that was provided to him that it was 2003), the plaintiff had a "one night stand" that resulted in an accidental pregnancy, but there had been nothing subsequent to that: T57815. (10) Diagnosis, to a degree dependent upon history 349The experts were cross-examined with the aim of trying to establish that the diagnoses they had arrived at was dependent upon the veracity of the plaintiff's descriptions of her symptoms and her situation: T578.28 and following. In this regard: (a)Dr Prior agreed that if it were shown the plaintiff had "driven on numerous occasions" and had in fact gone out for a walk to her children's school, these matters were of significance and could affect his opinions: T579.45 - T580.20. The effects of such matters on Dr Prior's opinions was not further explored, nor was the definition of the descriptor "numerous", in terms of its significance to the extent to which this would affect the diagnosis; (b)Dr Akkerman was less emphatic on the effect of such matters, and indicated that he would need to know more about the circumstances, such as whether nobody was available to pick up the plaintiff's children from school, and whether the plaintiff was compelled to go herself out of desperation. He also drew attention to the need to be informed of patterns of regularity and the context, including with the driving issue, before definitively commenting upon such matters: T580.45 - T581.33; (c)Dr Haik again referred to these matters, namely the plaintiff leaving the house without a support person, and of having driven, as inconsistencies: T581.50; (d)Dr Prior agreed that if it could be shown, for example, in 2009, that the plaintiff was "regularly attending and visiting someone else's home on a regular basis", this would be something inconsistent with what he had been told: T583.10. These matters were not further defined for him in order to enable him to express a more informed opinion; (e)Dr Akkerman explained the foregoing qualifying element identified by Dr Prior by drawing attention to the need to specify the frequency of going out (and I interpolate - how she went out, and with whom she went out, and why): T583.18; (f)Dr Haik again referred to the history he obtained that the plaintiff "really doesn't go out with anyone except when she is driven by Mr Taoube to the psychiatrist and that's it", and her history that she doesn't use either of her cars except for the one time that she had driven into a tree: T 583.25. (11) Relevance of consistency of symptoms to diagnosis 350The defendant attempted to secure from the experts a concession that material variations or inconsistencies in the history would have an impact on their opinions: T 583.30 and following. Whilst there was general agreement on the validity of that proposition, at T 584.15 and following, Dr Akkerman added what I considered to an important rider to the significance of matters of inconsistency, or variations in history in contrast the views of Dr Haik that were not qualified by any such riders. That evidence, which followed a course of argument at length between T584.15 and T593.41, just before the conclusion of the concurrent expert evidence session, concluded to the following effect: (a)people with major depression can at times appear to behave "normal" even though they have a significant psychiatric disorder, and staying in pyjamas is not a necessary diagnostic requirement: Dr Akkerman, T584.5 to T585.4; (b)consistency of complaints and presentation is a relevant matter concerning the basis for psychiatric diagnosis: Dr Prior, T586.16 to T586.50; (c)mental state examination is an important part of psychiatric evaluation: Dr Akkerman, T588.46 to T589.10; T591.29 to T591.44; (d)it is possible that a person who has been inaccurate or who has been not entirely truthful could still have a psychiatric diagnosis: Dr Akkerman, T591.19 to T591.21; (e)there is an important difference between arriving at a psychiatric diagnosis and using the requirement assessment criteria for making an impairment rating according to systemic legal criteria: Dr Akkerman, T592.30 to T592.45; Dr Clark, T593.19 to T593.35. (12) Importance to diagnosis of appearance of plaintiff 351The fundamental issue that emerged from the concurrent expert evidence session is that the appearance of the plaintiff was an important matter that had to be taken into account in making an assessment and arriving at a psychiatric diagnosis. This was explained by Dr Akkerman at various places in his evidence as being based upon an assessment of her appearance, including in the context of a mental state examination, and the improbability of the plaintiff having had the sophistication or the ability to consistently fool four experienced psychiatrists, including one who had treated her on over 12 occasions: T588.46 - T589.9, a matter that was later referred to generally as clinical acumen: T593.39; (13) Importance of clarifying assumptions concerning relationships 352Dr Akkerman drew attention to the need to make accurate assumptions in testing the plaintiff's history in the particular respects in which the defendant sought to impugn her credit. This was evident in areas such as how one defines "single": T594.41 - T594.50, and "relationship": T 595.44. Dr Prior added that it was important to know how the plaintiff became pregnant, for example whether this had occurred in the course of a domestic relationship or a rape: T596.6, or whether a relationship was being maintained: T596.14. (14) Dr Haik's opinion on reliability of plaintiff's evidence 353Towards the end of the expert evidence session, Dr Haik restated the importance of the question of the reliability of the evidence of the plaintiff in the following terms, at T601.8, as follows: "WITNESS HAIK: I can't accept that it would be significant based upon the fact that the plaintiff is somebody who does exaggerate. For example, I read in Dr Parmegiani's report that she said she'd lost 100 kilograms, which can't possibly be right. So from the other perspective when she says she's only driven a few times, that could be many more times in the same way she has lost far less than 100 kilograms. It's a matter of exaggeration from both perspectives, if I may say so." (15) Opinions of other experts on views of Dr Haik 354That statement from Dr Haik led to a series of questions in interchanges with the witnesses, including Dr Haik, which on analysis, ultimately turned out to be of great significance. The evidence in question was as follows: "CRANITCH: Thank you, doctor. In relation to her wellbeing, I want you to assume that we've heard from a number of witnesses who have independently corroborated that she does spend most of her time at home and in the words of a woman who knew her quite well as a neighbour and used to regularly look after her for the year or so after the accident, she was very changed and stayed indoors and wasn't engaging. If you accept that evidence to be true, is that consistent with the sort of condition that she has? WITNESS AKKERMAN: Yes. CRANITCH: I want you also to assume that she was said by this woman - this is a Ms Ishak - that she needed help with washing and any other matters around the house. Is that consistent with a person suffering from posttraumatic stress disorder? WITNESS AKKERMAN: Yes. WITNESS CLARK: Yes, and depression. CRANITCH: And depression, Dr Haik. WITNESS HAIK: Could you ask the question again? CRANITCH: Yes. HIS HONOUR: Before you ask the question again, I think we got some non-verbal responses from the people at the bar table. CRANITCH: I think they all agreed. HIS HONOUR: As long as that's noted. I think everyone but Dr Haik agreed who is now asking that you ask the question again. WITNESS HAIK: You mentioned Ms Ishak. CRANITCH: This is a Ms Ishak who was a neighbour who was called to give evidence. Her evidence was about Ms Khalil from a period of time after the accident until she moved to this house at Revesby, about which much has been said, and that she would visit her nearly every day or every second day and that she found her needing help because she observed that things weren't getting done around the house such as washing and so forth. And when she was asked about her emotional wellbeing, she commented that she had changed - "I don't know what happened to her, mentally or something. She's different. Before I used to know her." And her physical capacities were described as different, completely different it seems, a big difference than before. When asked to give an example, this woman said, "Before she used to paint the house, wash the, you know, everything - like the woman she'd do at home. But now she's, like, lazy to do - not energy, not different" - is how she described her. Dr Haik, is that consistent with a woman suffering from a psychiatric condition? WITNESS HAIK: If Ms Ishak can be considered a reliable witness, yes, it is. CRANITCH: It's not suggested that she's otherwise, doctor. WITNESS HAIK: You are not suggesting? CRANITCH: It is not suggested that she is otherwise than a reliable witness. Does that accord, doctors, with your opinion? WITNESS AKKERMAN: Yes. WITNESS HAIK: Yes." (16) Whether plaintiff was likely to have been in pain when she gave her evidence 3 days after a caesarean section, and on the days that immediately followed 355At the conclusion of the concurrent expert evidence, at T602.39, I asked a question of the experts aimed at seeking to ascertain if they had a relevant view on whether the plaintiff was likely to have been in pain at the time when she gave her evidence in the period shortly after her operation for caesarean section. In the course of those events, the following occurred: "HIS HONOUR: Yes. I just have a couple of tidy up questions, gentlemen, before you go. One of the bizarre things that happened in this case was the plaintiff gave evidence when she was at the end stage of her pregnancy, on a Friday afternoon she shot herself off to hospital to have a caesarean section delivery and on the Monday, she presented herself back to Court where she had her cross-examination continue without initially informing anyone that she'd gone off and had a baby that way. Putting aside the bizarre sequence so described, what I am interested in is whether any of you feel qualified to express a view as to whether or not the plaintiff could have been in some sort of pain after a caesarean section delivery on the Monday and whether that might have had some influence in the way in which she gave her evidence on that day? FITZSIMMONS: I object. HIS HONOUR: Yes, why do you object? FITZSIMMONS: Well, your Honour, as I understand, questions have already been fielded in this, questions were asked of the psychiatrists as to whether that pregnancy and going off and having a pregnancy (as said) and coming back would have affected the evidence she gave and the answer was no, and -- HIS HONOUR: You don't want me to be informed on this issue, is that what you're saying? FITZSIMMONS: No, your Honour, in my respectful submission - I'm sorry, your Honour's smiling, is there -- HIS HONOUR: I was just quizzical as to why you don't want me to be informed on this issue." 356In relation to this last matter, in the submissions that followed, Mr Fitzsimmons persuaded me that on reflection, the question should not be answered because the expert opinions that were explored in the concurrent evidence session related to matters of credit concerning the basis of their respective assessments of the plaintiff, and not the credibility of the plaintiff's answers given in evidence. 357My initial impression which led to the question being asked was that it may have been helpful to have obtained the views of the experts on the question of whether the plaintiff was likely to have been in pain when she gave her evidence after she had the caesarean section. This was because part of her cross-examination occurred in the period during which she was certified to be medically unfit: Exhibit "D". However, on reflection, there was an obvious difficulty with any purported answer to the question that I had posed in the absence of a specific history in the form of some further underlying evidence from the plaintiff on a number of facts relevant to that issue. Such evidence would have had to have included whether, and if so in what quantity, and to what effect, had the plaintiff been given, and had been taking painkilling medication following her caesarean section, amongst other matters. Instead, I will have to form my own conclusions on the limited material that is available. 358Potentially those matters could have been taken up in a re-examination of the plaintiff, but there was no re-examination of the plaintiff on any subject. I therefore do not need to consider why that was the case in this instance, as it was a matter for professional and forensic judgment on the part of the plaintiff's representatives, a matter upon which I should not speculate or intrude. 359I now turn to an evaluation of the issues calling for decision as outlined at paragraph [24] above.

C. FINDINGS ON ISSUES CALLING FOR DECISION 360The first issue to be determined is that of the credit of the plaintiff.

Issue 1 - Credit of the plaintiff 361At paragraph [34] in the introduction to these reasons I identified some 23 areas of the plaintiff's evidence that were canvassed in the course of the defendant's attack upon her credit. It is necessary that I set out my credit findings on those matters before any consequential findings can be made on the issues concerning the events of the accident, the plaintiff's injuries, any accident related disabilities, and the assessment of the plaintiff's entitlement to damages: Issues 2-5. 362The defendant attacked the plaintiff's credit on matters that were connected to the events of the accident, the plaintiff's complaints of both a physical and psychological nature, personal conduct issues, as well as some other peripheral matters. In the paragraphs that follow, under the respective headings replicated from paragraph [34], I set out my findings on each of those areas where the defendant made attacks on the credit of the plaintiff.

Credit attack (1) - Plaintiff's capacity to understand English 363During the course of the trial, from time to time, the defendant referred to the plaintiff's resort to the use of interpreters. The implication raised by the defendant was that the plaintiff had a sufficient capacity in the English language for her to give her evidence without interpreters, as was on occasion demonstrated by the plaintiff's spontaneous answers in the English language when cross-examined. 364In that regard the suggestion was that the plaintiff used the facility of interpreters opportunistically in order to gain more time in which to think about her answers on matters of challenge to her evidence. This credit point was emphasised by the defendant pointing to the occasions on which the plaintiff was able to adequately communicate with the various medical examiners whom she had seen without the assistance of an interpreter. 365I do not accept that credit attack for the reasons that follow. 366First, I did not gain the impression that during her evidence the plaintiff was using the facility of interpreters as a ploy to gain time to think about her answers. I considered that her answers to most questions were reasonably prompt through the interpreter. My assessment gave no indications insofar as I could tell, of any delaying conduct on the part of the plaintiff of the kind asserted on behalf of the defendant. 367Secondly, I considered that on the occasions that the plaintiff was able to provide answers in English, this was in relation to relatively simple questions that permitted spontaneous answers without an interpreter, as might have been expected of someone who had been in this country since 1993, and who had made attempts to improve her English language skills by undertaking a TAFE course for that purpose. 368Thirdly, as the courtroom setting was formal and unfamiliar, where the questions were asked in English, which was not the plaintiff's first language, and in circumstances where she knew her evidence was being seriously challenged on multiple topics, I considered that the plaintiff's resort to the use of an interpreter when giving her evidence was a reasonable course for her to take. The procedures of the court can be confronting and the requirement is for accurate communication. The plaintiff was clearly frustrated by the process of repetitive cross-examination. Given these matters, as well as the plaintiff's limited education, I considered that the plaintiff's use of an interpreter was not unreasonable in the circumstances. 369Fourthly, whilst there is no rule of law that establishes a right or an entitlement for a witness to give evidence through an interpreter, the issue is one for the discretion of the trial judge: Dairy Farmers Co-Operative Milk Co Ltd v Aquilina [1963] HCA 59; (1963) 109 CLR 458, p 464, [13]. In this case there was no application made by the defendant seeking to require that the plaintiff give her evidence in English as best she could without the assistance of an interpreter. Given the nature of the credit issues canvassed in the proceedings on the evidence adduced, it is doubtful that any such application would have succeeded. 370In a multicultural society the practice is that courts make some allowances for cultural factors in the consideration of issues for determination where witnesses are from a different cultural and ethnic background to that with which the court is familiar: Goodridge Areospace Pty Limited v Arsic [2006] NSWCA 187; (2006) 66 NSWLR 186, at [21]. Furthermore, as has been authoritatively observed, an increasing number of litigants in Australian courts must rely on interpreters and it would be a grave reflection on the administration of justice generally if this was thought to impose serious disadvantage, and I interpolate in this case, on the defendant: Oceanic Sun Line Special Shipping Company Inc v Fay [1988] HCA 32; (1988) 165 CLR 197, per Wilson and Toohey JJ, at [35]. 371Accordingly, I do not accept the credit challenge to the effect that the plaintiff had unreasonably resorted to the use of an interpreter as a ploy to gain thinking time whilst she gave her evidence. I saw no indication in the evidence that would support such a proposition.

Credit attack (2) - Events of the accident 372The defendant has placed some significance on the "low speed" nature of the collision and the relatively moderate amount of damage to the vehicle in which she was travelling, and the absence of damage to the telegraph pole, to suggest the accident in which the plaintiff was involved, was not a significant one. 373An examination of the exhibits and the transcript reveals that the "low speed" nature of the accident, as was assumed by some of the defendant's medical experts, notably Dr Haik and Dr Pierides, appears to originate from an unattributed hearsay opinion contained in the hospital clinical notes: Exhibit "6", Tab 7, page 21. 374The issue of a low speed collision was not a specific matter put to the plaintiff in cross-examination for her comment on her perception of the events. This is a matter to which I shall return when setting out my findings on Issue 3 concerning the nature of the injuries the plaintiff sustained in the accident. 375For present purposes, it is sufficient to record that a body of expert psychiatric opinion was to the effect that it was the plaintiff's perception of the events of the accident which was the relevant psychiatric consideration, and not the force of the collisions themselves. 376Accordingly, I do not see that a true credit issue emerges from the plaintiff's account of the circumstances of the accident, especially where the professional assessment of the ambulance personnel was that the plaintiff was injured, and where it was thought to be necessary that the Fire Brigade were engaged to cut the plaintiff and her children free from the wreckage of the vehicle.

Credit attack (3) - Content of recorded medical histories 377The defendant sought to challenge the accuracy of the histories summarised by the various reporting doctors by referring to those histories and comparing them to other sources of information concerning the plaintiff in order to point to apparent inconsistencies. In my assessment that approach was largely concerned with peripheral matters that did not involve the key issues in the case such as the manner in which the accident occurred, the immediate effects of the accident upon the plaintiff, and her resultant injuries, disabilities and her claimed losses. 378In my view, the approach taken by the defendant to attack the plaintiff's credit on specific matters of comparison was of necessarily limited value having regard to the considerations outlined in Mason v Demasi [2009] NSWCA 227; and Container Terminals Australia Ltd v Huseyin [2008] NSWCA 320. 379The relevant passages from the judgment of Basten JA in Mason v Demasi [2009] NSWCA 227, appear at paragraphs [2] - [4], as follows: "2 First, the trial judge was invited to discount the appellant's oral testimony on the basis of accounts given to various health professionals, which appeared inconsistent either with each other, or with her oral testimony, or both. The difficulties attending this kind of exercise should be well-understood; as explained in the Container Terminals Australia Ltd v Huseyin [2008] NSWCA 320 at [8], such apparent inconsistencies may, and often should, be approached with caution for the following reasons, amongst others: (a) the health professional who took the history has not been cross-examined about: (i) the circumstances of the consultation; (ii) the manner in which the history was obtained; (iii) the period of time devoted to that exercise, and (iv) the accuracy of the recording; (b) the fact that the history was probably taken in furtherance of a purpose which differed from the forensic exercise in the course of which it was being deployed in the proceedings; (c) the record did not identify any questions which may have elucidated replies; (d) the record is likely to be a summary prepared by the health professional, rather than a verbatim recording, and (e) a range of factors, including fluency in English, the professional's knowledge of the background circumstances of the incident and the patient's understanding of the purpose of the questioning, which will each affect the content of the history. 3 The fact that, in the present case, none of the health professionals was called to give oral evidence as to the matters in issue may not itself be a point of significance. It is unlikely that cross-examination would have advanced any issue in dispute; the witness being likely to have no relevant recollection of taking the history, the oral testimony would be largely limited to an assertion of usual practice. 4 Thirdly, and more significantly, it was quite possible that the elements of florid expression and exaggeration in the applicant's oral testimony (and in some of the recorded histories) may have been a function of her psychological state. This was not something that the trial judge could readily assess without expert assistance, but it was a possibility that should not have been ignored. On one view, the pre-attack records (particularly the notes of Dr Hamad) were devoid of the flamboyant language found in post-attack accounts." 380In my view, the approach taken by the defendant in this case, in pointing to apparent inconsistencies in the evidence of the plaintiff compared to the summarised histories in the medical reports, involves an overly simplistic exercise that ignores the cautions that were identified in the authorities cited above. 381In particular reference to the present case, not all of the relevant health professionals who summarised the plaintiff's history were called to give evidence of the circumstances of the relevant consultations at which the history was summarised. The circumstances of the consultation, the time devoted to history taking and the accuracy of the recording of information, the focus of the summary, and the questions that elicited the summarised histories, were not identified. It was not suggested that the historical accounts as summarised and as relied upon by the defendant were verbatim accounts, as well as the other factors referred to by Basten JA in paragraph [2] in Mason v Demasi. 382Moreover, it is difficult to discern from the summaries relied upon by the defendant, and it was not explained by evidence, as to whether some relevant aspects of the summarised histories relied upon by the defendant were a function of the plaintiff's psychological state. In this case I consider that matter to be of some significance, given that all the psychiatrists who were called to give evidence agreed, putting to one side the polarised views as to its nature and cause, that the plaintiff had a psychiatric condition: Mason v Demasi, at [4]. 383The alleged inconsistencies in the matters of history summarised in the medical reports and which are relied upon by the defendant as credit issues were principally concerned with peripheral matters such as: (a)whether the plaintiff had correctly filled in the personal injury claim form regarding her pre-accident arrangements for employment, given that the form had been filled in for her; (b)matters to do with the plaintiff's description of pre-accident work intentions; (c)what the plaintiff had said to various medical assessors about her intended employment; (d)where the plaintiff lived and with whom she lived; (e)her evidence as to her medication intake; (f)the plaintiff's history of driving motor vehicles after the accident; (g)the content of the plaintiff's personal injury claim form. 384I have concluded that these peripheral matters were somewhat remote from the central issues in the case as identified by the parties, namely, the circumstances of the plaintiff's injury, the nature and extent of the plaintiff's injuries and disabilities, and the extent of the plaintiff's entitlement to damages. 385I consider the point taken by the defendant concerning the content of the plaintiff's personal injury claim form is of diminished significance as the plaintiff has explained, satisfactorily in my view, that the form in question was filled out on her behalf and she was assisted in that regard, albeit with a degree of misunderstanding: T52.18. 386Nevertheless, since the defendant has focussed a great deal of attention upon those matters in an endeavour to discredit the plaintiff's evidence, it is necessary that I deal with them under the subject headings that follow. Where those credit attacks are based on matters of recorded history, these will be evaluated according to the evaluation criteria identified in Mason v Demasi by Basten JA at [2] to [4].

Credit attack (4) - Plaintiff's physical injuries 387The only challenge the defendant made through cross-examination of the plaintiff's account of the injuries she claimed to have received in the accident concerned her claim that she had suffered an injury to her head and to her left knee. I do not consider that challenge to so much involve a matter of credit, but rather, a simple matter of fact that stands to be examined in the context of Issue 3, and which requires a separate consideration of the evidence as a whole on its own merits, but with credit factors in mind.

Credit attack (5) - Plaintiff's physical disabilities 388Significantly, the defendant sought to challenge the plaintiff's evidence concerning her physical disabilities by reference to medical opinions and to DVD surveillance footage showing some observations of the plaintiff's physical activities. The DVD footage was employed by the defendant for two separate purposes, each of which had credit implications for the plaintiff's case. 389One such purpose was to seek to demonstrate that the plaintiff was not as affected as she claimed. The other such purpose was to seek to establish that the plaintiff was untruthful in describing her place of residence, which is a matter which also affected the veracity of her claim for damages for domestic assistance, a matter that requires separate consideration. 390The identification of the plaintiff's ongoing physical disabilities is the subject of my separate consideration of Issue 4 in conjunction with findings of her disabilities overall, which is to be made on a consideration of the medical evidence.

Credit attack (6) - Plaintiff's pre-accident psychological issues 391A question arose from within the documentary evidence tendered by the defendant as to the plaintiff's pre-accident psychological state. This question related to the plaintiff's state of mind on the day before the accident, and it appears, for some 10 days beforehand. This was in the context where the plaintiff's general practitioner recorded an observation and a history that the plaintiff was still feeling very agitated and was having nightmares, and that some medication had been prescribed for her at that time, quite possibly psychotropic medication. 392This was apparently due to the plaintiff learning that her ex-husband had earlier been released from gaol. At around that time the plaintiff had applied to the Department of Housing for relocation in other accommodation because of concerns over the safety of herself and her children. 393Unfortunately, the defendant did not put any of that material to any of the psychiatrists who gave oral evidence. As a result, that material stands to be evaluated upon its face, without the benefit of any commentary from the psychiatrists as to whether those events had any material impact on their expressed opinions. 394The question that emerges from this pre-accident material is whether those events have any causative relevance to the plaintiff's diagnosed psychiatric condition for which a claim is made in these proceedings. 395Whilst that question must be primarily evaluated in the context of assessing the plaintiff's claimed accident related disabilities, it also has some relevance to her credibility because she claimed that before the accident she was well, and this material relating to her pre-accident situation appears to represent an objective source of history or observation that suggests she may have had some pre-accident psychological problems. 396The defendant did not call expert medical opinion on those matters. The expert evidence is otherwise silent on this question, apart from the opinion of Dr Haik, which, so far as I am able to ascertain, was based not on this material, but upon other considerations that he had assumed. In the absence of such expert evidence, I consider that the analysis of this question must be approached with a commonsense analysis: Adelaide Stevedoring Co Ltd v Forst [1940] HCA 45; (1940) 64 CLR 538. 397On such an approach, I consider that no relevant credit issue arises from the material suggesting the plaintiff had a relevant and long-lasting pre-accident psychological state. That view is based upon the unchallenged evidence of Mrs Salwa Ishak which was to the effect that before the accident the plaintiff was a happy person whereas afterwards she was sad: T416.43-50; T417.40-45. Instead, the material simply stands to be evaluated in the context of a causation analysis of the plaintiff's emotional state following the accident. 398As the evidence of Mrs Ishak was not glaringly improbable, and was not otherwise challenged, I consider that it should be given due and significant weight and accepted: Whalan v Kogarah Municipal Council [2007] NSWCA 5. As a consequence of that consideration, in my view, no true credit issue arises from the evidence of the plaintiff's pre-accident psychological circumstances. 399In identifying my view to this effect, I have not overlooked the content of the opinions of Dr Haik that were critical of the credit of the plaintiff, and which adverted to his view of the plaintiff's pre-accident hardships as factors of relevance to her claim, and to his view of the plaintiff's asserted mendacity. Those matters relied upon by Dr Haik for his analysis are the subject of separate consideration of the factual basis of Dr Haik's opinions, and as to which medical opinions should be accepted.

Credit attack (7) - Post-accident psychological disabilities 400The defendant did not directly challenge the plaintiff to assert she did not have a psychiatric condition or disorder. Instead, the defendant's primary approach on this issue was to attack the credit of the plaintiff in order to assert that her evidence could not be believed concerning her account of her ongoing disabilities, which included any claimed psychiatric or psychological disorder. 401The defendant's alternative position, which emerged from the evidence of Dr Haik, involved the dual propositions that, against the plaintiff's background of having had a life of hardship, the accident provided the plaintiff with the opportunity to seek secondary gain, which he identified as the opportunity to relinquish her involvement with her disabled son's care, and the opportunity for the asserted pursuit of monetary reparation for her hard life, as well as an asserted component of mendacity on the part of the plaintiff. 402In my view there are difficulties with each of those approaches, and I consider that those difficulties stand in the path of acceptance of either of them. 403In the paragraphs that immediately follow, I set out my reasons for not accepting the defendant's primary proposition that the plaintiff should not be believed as to the nature of her symptoms. 404First, the defendant's primary submission ignores the observation of Mrs Ishak who gave unchallenged and not otherwise improbable evidence to the effect that since the accident, there has been a significant change in the plaintiff's situation in that she has changed and has become a sad person. It was not put to the plaintiff that she feigned disability in her dealings with Mrs Ishak. 405Secondly, the defendant's primary submission ignores the fact that in the opinion of all of the psychiatrists, the plaintiff has a diagnosed psychiatric condition, putting to one side the dispute as to its cause. All of the experts accepted this, except Dr Haik who sought to attribute a pre-accident cause for that condition. The discernment of the cause of that condition is not only a matter of whether the plaintiff is accepted, but rather, the issue is dependent upon which body of expert opinion should be accepted as to the underlying cause of the plaintiff's psychiatric condition. 406In that regard, the options are either: Dr Haik's formulation of secondary gain, in which he argued that the accident provided the plaintiff with an opportunity to relinquish the burden associated with the weekend care of her disabled son (with or without a component of argued mendacity) or, the formulation maintained by the other psychiatrists to the effect that the plaintiff suffers from PTSD with depression as a consequence of the accident. 407The resolution of those competing options is a matter that requires analysis of the medical opinions and the basis for those opinions rather than by following a convenient but overly simplistic approach, in which the defendant calls for a blanket rejection of the plaintiff's evidence in order to avoid the more onerous requirement of engaging with and dealing with the content of inconvenient psychiatric opinion. 408In this latter regard, in the present case, the overriding caution that has been identified by Basten JA in Mason v Demasi at [4] requires consideration of the factor of the plaintiff's acknowledged psychiatric condition. 409Having due regard to that factor, in the present case, this necessarily precludes a blanket rejection of the plaintiff's credit concerning her psychological illness unless analysis of the medical evidence requires such rejection. In this regard, I consider it to be procedurally wrong to approach the analysis in the simplistic fashion of only seeking to determine whether the plaintiff should be believed. There may be cases where such an approach may be justified, but this is not such a case. 410Accordingly, instead, I propose to proceed to analyse the cause, nature and extent of the plaintiff's acknowledged psychological problems as identified and as agreed by all the psychiatrists in the context of the claim for disability in connection with my consideration of Issue 4.

Credit attack (8) - DVD evidence of plaintiff's activities 411The defendant arranged for extensive surveillance to be undertaken of the plaintiff and her premises between 21 October 2010 and 11 May 2011, using the services of two different investigation companies. These efforts yielded very little evidence of the plaintiff's activities. 412Aside from the static investigations, which involved the positioning of a fixed DVD camera for prolonged periods of time, attempts at real time observation of the plaintiff were made on about 32 separate days, involving some 233.75 hours of surveillance. That surveillance identified some 19 occasions on which DVD footage was taken of the plaintiff, and the sum total of that footage amounted to some 84 minutes of non-continuous footage. The longest component of that footage was for a little under 13 minutes. 413Having carefully viewed the surveillance footage where the plaintiff appears, and having reviewed that footage on a number of occasions, as well as having considered the content of that footage when aligned for comparison against the plaintiff's evidence and the particulars of her claim, I have concluded that the DVD evidence does not discredit her evidence as claimed by the defendant. 414At best, the footage reveals the plaintiff to be seen standing and walking on occasions. In that footage the plaintiff is shown to be walking slowly, and in my interpretation of her walk as shown on that footage, she is seen to be walking with a relatively slow and deliberate gait, with a slight limp, in which one leg appears to be favoured. 415Relevant to the assessment of this evidence, which in my view shows only mild and limited activity, is the plaintiff's evidence that her limp appears to be less evident or pronounced when she wears a knee guard. Also relevant is the evidence of Dr Matalani, who saw and was asked to comment upon the relevant portions of the film that was relied upon by the defendant. 416Although Dr Matalani agreed that the plaintiff's appearance in selected segments of the DVD footage taken on 21 August 2009 was very different to her presentation at his examination of her on 12 March 2009 (T504.41) which was 5 months earlier, significantly, he also stated that his observations of the DVD detected a subtle limp in the plaintiff's walking, which involved a favouring of her left leg. He also stated that different parts of the DVD showed the plaintiff to be limping to differing degrees, and in some segments, of the DVD footage, he said that her limp was difficult to discern. When that evidence is aligned with the plaintiff's evidence concerning the wearing of a knee guard, that difficulty in discerning a limp diminishes the significance of the DVD footage. 417Given the DVD footage of the plaintiff walking (and paraphrasing out the double negative embedded within the cross-examiner's question) Dr Matalani was asked to agree that over time, that is, during the period in which the plaintiff was shown to be walking as demonstrated on the film, he would "expect there perhaps to be some deterioration in her ability to walk and ambulate". 418Whilst Dr Matalani agreed with the cross-examiner's proposition and he said that he saw no such deterioration evident within the footage shown to him, it is not entirely clear how that deterioration could have been reasonably detected by only viewing the medium of the DVD footage and without the benefit of additional information. The relevant extract of his evidence on this matter was at T508.30 - T509.1, as follows: "... FITZSIMMONS Q. From what you can see from the start of that film to the end, there was no such deterioration, if there was any problem at all, do you agree? A. There was no deterioration, that's correct. HIS HONOUR Q. In relation to that last answer, what questions would you expect you would've asked the plaintiff as to how she felt if you were comparing your observations on the film with your observations from your clinical examination? In other words, what questions would you be seeking to clarify for the purpose of adumbrating upon that opinion? A. I would have asked her if she had any rest breaks, if she had the opportunity to stop and rest during that walk. Obviously she's been walking for about 25 - the period is 25 minutes, but we really don't know what happen for the whole of the 25 minutes, had - had she had the opportunity to stop, to walk, to sit down, was she in pain? I couldn't see her facial expression, whether she was in pain or not. But of course, yes, some people do walk in pain as well, that would - you'd expect them to limp. But there was no - there was not enough indication on the facial expressions, whether she was in pain or not. And whether she was taking any painkiller at the time, and whether she was wearing any knee support. So they're the number - sort of questions I would have asked." 419The importance and probative value of Dr Matalani's evidence, in which he assented to the proposition that there were no signs of deterioration evident in the scenes in the DVD of the plaintiff walking, obviously has to be weighed against the significant qualifying remarks expressed in Dr Matalani's last answer as cited above. 420As the full range of those qualifying matters or questions were not canvassed with the plaintiff in cross-examination, I do not read the cited concession by Dr Matalani to the effect that he saw no sign of deterioration in the plaintiff's gait on the DVD footage, which was limited in its terms, to form a relevant basis for eroding the credit of the plaintiff on the evidence adduced. 421Based on those considerations, and the very limited activity of the plaintiff as shown on the DVD footage, I therefore conclude that the DVD footage relied upon by the defendant showing activity on the part of the plaintiff represents relatively benign material, which does not relevantly traduce or contradict the evidence of the plaintiff. I therefore find that the credit of the plaintiff has not been damaged by the appearance of any of the physical activities of the plaintiff as shown on the DVD footage in which her image appears. 422I now turn to consider the credit implications of the static DVD footage.

Credit attack (9) - Static DVD evidence of observation of premises 423In addition to the DVD evidence depicting activity on the part of the plaintiff, the defendant obtained approximately 432 hours of static DVD footage of premises where the plaintiff was variously thought to reside. The relevance of that evidence was to the matter of the plaintiff's living arrangements and the related issue of domestic assistance that the plaintiff claimed to have received. There were 4 continuous sequences of static surveillance, as follows. 424First, premises at 17-21 Lansdowne St, Canley Vale were continuously filmed over a period of approximately 56 hours between 3.31pm on Sunday 1 November 2009 and 11.37pm on Tuesday 3 November 2009. The summary of the surveillance report of that filming was as follows: "The results of the static surveillance footage indicate a number of persons to be residing at 17-21 Lansdowne Road, Canley Vale NSW, notably a female believed to be the Claimant, matching the provided description and photographs. She was observed a number of times in the front vicinity of the residence accompanied by a male of possible Middle Eastern background, described as being of a large build, of medium height with a shaven head, aged approximately 45-50 years. The Claimant mostly remained at the residence upon the male's departures, however on two occasions was noted to depart as the passenger, in a dark coloured Daewoo Nubira sedan, NSW Reg. XEZ993." 425Secondly, premises at 9 Hedlund St, Revesby were continuously filmed over a period of approximately 170 hours between 12.55pm on Saturday 20 February 2010 and 3.02pm on Saturday 27 February 2010. The summary of the surveillance report of that filming was as follows: "The static surveillance period served to indicate that no persons currently reside at the stated address. On Wednesday 24 February at approximately 9.30am, the Claimant attended the residence as the driver of a white vehicle. She was noted to open the windows and appeared to collect the mail from the mailbox on two occasions The Claimant closed the windows and departed at approximately 1.55pm on this day, and was not observed to attend the residence on any additional occasions. At no time was the Claimant observed in the company of other persons. The only other activity noted was that of a young female child who attended the residence on a bicycle in the evening of the second day. She appeared to approach the front door of the residence however did not appear to enter, departing 1 minute later. In addition, we noted the brief presence of an unidentified maroon coloured vehicle parked in the driveway of the residence on our fifth day; however no occupants of the vehicle were sighted. We further noted no activity during the night time periods. In the evening of Wednesday 24 February, a neighbour was observed to place her council garbage bins at the kerb however no one was sighted placing the bins from the stated residence at the kerb for collection." 426Thirdly, premises at 9 Hedlund St, Revesby were continuously filmed over a period of approximately 85 hours between 3.53pm on Tuesday 13 April 2010 and 4.41am on Saturday 17 April 2010. The summary of the surveillance report of that filming was as follows: "The results of the static surveillance footage indicate that no persons appear to currently reside at the stated address on a full time basis. On Thursday 15 April 2010, a silver Mazda 323 vehicle arrived at the residence at near to 7.30am, driven by a male of solid build aged in his late 40's, of whom had been previously observed in the company of the Claimant. Please refer to the below activity table which outlines the activities of this male. We note that although we were unable to specifically observe the Claimant on the static surveillance footage, we did identify her to be in the company of the male on this day, as noted in our manned surveillance period which was carried out in conjunction. The male was additionally sighted briefly attending the residence on Wednesday 14 April, near to 8.00pm. He was not observed in the company of any other persons however we note it was dark and thus made viewing and identification difficult. We did not observe any of the vehicles that were associated with the Claimant in previous surveillance periods. We also note that the silver Mazda 323 vehicle had not been sighted previously." 427Fourthly, premises at 22 David St, Mt Pritchard were continuously filmed over a period of approximately 121 hours between 9.40am on Friday 6 May 2011 and 10.35am on Wednesday 11 May 2011. The summary of the surveillance report of that filming was as follows: "The static surveillance footage indicates one adult female (believed to be the Claimant) and one adult male (referred to herein as Male 1) to be residing at the stated address, along with at least two teenaged (sic) males, referred to as school-aged males for the purposes of our report. Male 1 made regular departures in a white Toyota Camry, which was routinely parked in the driveway. The registration plate of this vehicle was not in view. The Claimant was observed travelling as passenger on only three occasions during this period of surveillance. On the first day, Friday 6 May 2011, an ambulance arrived at the residence at 5 04pm. The ambulance parked in the driveway and therefore concealed any activity occurring between it and the front door. The Claimant was not sighted again until the following morning at 9 09am when she alighted as passenger of the white Toyota Camry driven by Male 1. He retrieved at least two bags from the rear seat before they entered the residence. In addition to the two school-aged males there were a number of other similarly aged young males visiting the residence. On Sunday 8 May 2011, a visiting adult male collected two school-aged males who returned later in the day, and a female visitor arrived and stayed for approximately 1 hour." 428None of the above periods of static surveillance produced any evidence showing the plaintiff doing anything that could reasonably be seen or described as being contrary to her evidence, or contrary to the histories as summarised by the specialists who examined her for the purpose of providing reports in the proceedings. 429In my view, the relevance of the static surveillance material was limited to the question of whether the plaintiff relevantly misrepresented where she was living, and if so, whether that conclusion has damaged her credit in the proceedings, which is the next topic for analysis in my review of the credit attack upon the plaintiff.

Credit attack (10) - Claim for domestic assistance 430The defendant submitted that the plaintiff's evidence was discredited in connection with her claim for domestic assistance. 431The defendant's submission proceeded upon the assumptions that notwithstanding the plaintiff's evidence that she required such assistance, and notwithstanding the plaintiff's histories to medical examiners which summarised her various accounts to the effect that she received such assistance from friends, the objective evidence comprising the static observation of her premises, did not confirm the attendances of her friends at the observed premises for the purpose of providing such domestic assistance. 432A difficulty with that submission is the evidence from within the investigator's notes accompanying the surveillance reports, in which it is recorded that it was known to the defendant's representatives, that the plaintiff had left her Revesby premises in October 2008: Exhibit "7". 433On behalf of the plaintiff it was submitted that irrespective of where she was residing at any one time, a matter which was essentially her own concern (and I interpolate subject to the probity of her relationship with the Department of Housing), her evidence was that in each such place, she needed domestic assistance. It was further submitted that such domestic assistance had been variously provided to the plaintiff by her friends at each of the places where she lived. The plaintiff submitted that the actual place where the assistance was provided was therefore largely irrelevant. 434I consider those submissions made on behalf of the plaintiff to embody the correct general approach to be taken in evaluating the domestic care claim from the perspective of the credibility of the plaintiff's testimony. That said, the DVD evidence obtained from the static observation of premises still remains relevant to the question of whether the plaintiff sought to mislead the CTP insurer as to her place of residence. That is a matter that requires separate evaluation, as does the matter of quantification of the claim for domestic assistance. 435Returning to the matter of the credibility of the plaintiff's claim as to whether the plaintiff in fact received domestic assistance in the manner she has claimed, the defendant must face up to the unchallenged evidence of Mrs Ishak, Mrs Yasier and Mr Mohamed Taoube to the effect that the plaintiff was in fact provided with such domestic assistance. That evidence was not traduced by cross-examination. 436In my view, in light of the fact that the evidence described above was not relevantly challenged by confronting those witnesses with assertions to the effect that their evidence was incorrect, or by putting relevant counter-assertions, it would be inappropriate and procedurally unfair to reject that unchallenged evidence that was not otherwise improbable, in favour of an adverse credit finding against the plaintiff: Whalan v Kogarah Municipal Council [2007] NSWCA 5. 437The defendant's credit submission concerning the claim for domestic assistance relies heavily upon the circumstances of the occasion when Ms MacMaster attended the plaintiff's home at Revesby and examined her there on 15 April 2010, at a time when she did not physically reside there: T168 - T172. In my view, for the reasons outlined in connection with my analysis and findings on the credit attack to do with the plaintiff's representations as to her place of residence, I do not consider the occasion of Ms MacMaster's assessment of the plaintiff to be a relevant basis upon which to consider that the credibility of the plaintiff's evidence on domestic assistance issues to have been traduced. The fact that the plaintiff was not residing at the Revesby address at the time but attended there to be assessed by Ms MacMaster can be readily explained by the terms of the defendant's solicitor's letter appointing the date, time and place for Ms MacMaster's assessment. 438I therefore reject the credit challenge concerning the plaintiff's claim for domestic assistance. 439The actual detail of the claim for domestic assistance and the monetary assessment of that claim are matters that remain to be taken up and analysed in my reasons for the assessment of the plaintiff's entitlement to damages for domestic assistance.

Credit attack (11) - Aspects of claim for economic loss 440The plaintiff made no claim for past loss of earnings because of her child rearing responsibilities. Nevertheless, the defendant sought to make a credit issue out of some incorrect particulars that had been provided to the CTP insurer by the plaintiff's previous solicitors, Keddies, concerning the plaintiff's pre-accident attempts at obtaining employment. 441The defendant referred to an erroneous description provided by the plaintiff's previous solicitor concerning the supermarket where the plaintiff had sought pre-accident work experience. The defendant's submissions sought to elevate and characterise that error into "particulars ... [that] ... were entirely false ... and ... intended to deliberately mislead the CTP insurer". 442The defendant also sought to criticise the plaintiff for failing to call as a witness her former solicitor who had assisted her in the completion of the claim form. The defendant also sought that an adverse inference be drawn against the plaintiff's credit to the effect that the former solicitor, if called, would not have assisted the plaintiff's case. 443The defendant sought to develop what were submitted to be inconsistencies in the history as summarised in the reports of medico-legal experts on matters concerning the plaintiff's economic intentions by reference to the sequence and timing of her various TAFE courses: Defendant's written submissions, paragraphs [356] - [363]. 444In my view, the defendant's attempt to set up such "inconsistencies" in order to seek to damage the plaintiff's credit, demonstrates the very same difficulties which were observed by Basten JA in Mason v Demasi, at [2] to require a cautious approach to such an exercise, because those histories were only summarised accounts. They were not verbatim transcripts of statements made by the plaintiff. In reality the summarised histories only amounted to background material that was peripheral to the matters which were the subject of the medical examinations in question, and such histories were obtained and summarised for those limited purposes. In my view, it follows that the utility of that material to form a basis for an adverse credit finding must be somewhat limited. 445When the plaintiff was cross-examined on the provision of incorrect particulars, she stated that the described errors were due to misunderstandings on the part of her former solicitors, Keddies as to her instructions. Given that the errors in question were peripheral I do not consider that the plaintiff was obliged to call evidence from her former solicitor as to the circumstances in which those errors arose. Furthermore, the evidence of the plaintiff on this issue, and for that matter any other issues, stands to be assessed on its own merits. It is not a legal requirement that the evidence of the plaintiff be corroborated before it can be accepted, which seems to be the basis of the defendant's submission. 446In any event, I do not accept the submission that the plaintiff had provided false particulars of her claim for economic loss with the intention of misleading the CTP insurer. I consider her explanation in which she invoked error on the part of her former solicitor was a reasonable one. Given that there was no claim made in these proceedings for past loss of earnings, for the reasons I have outlined, I do not regard the circumstances identified by the defendant to require a credit finding against the plaintiff on matters concerned with the claim for economic loss, contrary to what was submitted on behalf of the defendant. 447I shall return to the question of loss of earning capacity in connection with my assessment of the claim for damages.

Credit attack (12) - Plaintiff's living arrangements 448The defendant sought to make a major issue of the plaintiff's living arrangements both as to the places at which the plaintiff resided and as to the veracity of the plaintiff's claimed status as a single mother residing only with her two children. The latter point is the subject of a separate credit challenge to the plaintiff as to her relationships, a matter that is the subject of analysis in respect of credit challenge (19), commencing at paragraph [554] of these reasons. 449The defendant spent a great deal of time during the course of the hearing cross-examining the plaintiff on matters concerning her various places of residence at various times between the time of the accident and the time of the hearing. The plaintiff's submissions argued that this part of the cross-examination was lengthy, circuitous, repetitive and confusing to the plaintiff, for example, at T168 - T172. In this regard, paragraph [30] of the submissions on behalf of the plaintiff stated: "Hundreds of pages of transcript were wasted in the defendant's endeavour to establish what may well be a completely false premise". I entirely agree with the substance of that submission. 450The matters raised by the defendant were not of any direct relevance to any issue identified by the parties at the commencement of the hearing, and they were of only marginal relevance to the claim for domestic assistance. However, since the defendant sought to impugn the credit of the plaintiff on such matters, it is necessary that I briefly address the matter of the plaintiff's living arrangements in the paragraphs that follow. 451The evidence discloses that the plaintiff has resided at the following places that were provided to her by the Department of Housing: (a)At the time of the accident the plaintiff resided at Villawood; (b)After moving from Villawood the plaintiff was then given alternative accommodation in Cabramatta; (c)The plaintiff subsequently moved from Cabramatta to Revesby; (d)The plaintiff then moved from Revesby to Mt Pritchard; (e)In between the move from Revesby to Mt Pritchard the plaintiff also lived for a time in a unit in Canley Vale that had been provided to Mr Taoube by the Department of Housing. That arrangement involved a "swap" of premises and during the time the plaintiff resided at Canley Vale she still paid rent to the Department of Housing for her house at Revesby. 452The defendant identified the various addresses of the plaintiff as set out in a number of medico-legal reports to demonstrate that there were a number of recorded histories of the plaintiff living at the Revesby address with two of her children. Unfortunately, the letters of instruction to those medico-legal examiners were not tendered in evidence so it is not known whether they had been asked to specifically enquire of the plaintiff as to her address that was current at the time of the respective examinations or whether information as to the plaintiff's address was simply provided as part of the briefing materials, or whether the plaintiff's stated residential details recorded in the respective reports were drawn from the materials briefed to the experts. 453It seems to me that it would be an unlikely requirement of a specialist medico-legal examiner to ascertain details of the plaintiff's address as part of their examination of the plaintiff in addition to seeking to establish the nature and extent of injuries and disabilities that followed a motor vehicle accident: Mason v Demasi, at [2]. 454Furthermore, I do not discount the possibility that details of the plaintiff's address may have been provided to the experts in a letter of instruction as a matter of form, as is sometimes seen in such letters. Notwithstanding those possibilities, there being no relevant fact in issue in the proceedings concerning the plaintiff's address, I consider it unnecessary to examine this point in any further detail, or to decide that point. 455It seems that the true significance of the plaintiff's place of residence is in connection with the assessment carried out at the request of the defendant by the occupational therapist Ms MacMaster on 15 April 2010. 456On 26 February 2010, at a time when the defendant's representatives were aware from the surveillance reports comprising Exhibit "7", that the plaintiff was not actually staying at the Revesby address, the solicitor for the defendant sent the plaintiff's solicitor a notice requiring that the plaintiff make herself available for an assessment by Ms MacMaster at the Revesby address: Exhibit "6", Tab 25, page 176. 457At that time it appears the plaintiff was not staying at her Revesby address as she was staying at Mr Taoube's Canley Vale address. The DVD footage on the date in question shows that the plaintiff left the Canley Vale Address with Mr Taoube early in the morning and arrived at the Revesby address to await the pre-arranged assessment by Ms MacMaster, following which the plaintiff was picked up at the Revesby address by Mr Taoube and driven back to Canley Vale. 458The defendant sought to make much of the fact that when the plaintiff and Mr Taoube arrived at the Revesby address, a number of shopping carry bags, apparently containing soft drinks insofar as the contents of the bags could be identified, where brought to the house and were later taken back to the vehicle on the plaintiff's departure from the premises. The defendant argued that those events were attempts by the plaintiff to "dress-up" the house to give it the appearance of it being inhabited in order to mislead Ms MacMaster and therefore the CTP insurer. 459The submissions on behalf of the plaintiff in response have pointed out that the evidence showing the toing and froing of the carry bags with drink bottles was equivocal as those items could have been intended for use by the plaintiff (and possibly for hospitality to Ms MacMaster) whilst at the premises for the purpose of the assessment. 460Furthermore, for the reasons already identified in the evaluation of other summarised matters of history set out in other medico-legal reports, it is plain that the purpose of the assessment of Ms MacMaster's brief was not to interrogate the plaintiff as to matters of domicile, but to assess her physical capacities and needs: Mason v Demasi [2009] NSWCA 227, at [2]. 461In any event, it is difficult to see how the defendant was relevantly misled in this case as it already knew from the investigation reports it had obtained earlier, that the plaintiff was at that time, not staying at the Revesby address. 462In that regard, it is relevant to observe that the plaintiff gave evidence that she left the Revesby premises out of concern for the safety and wellbeing of her children because of nearby licensed premises and the rowdy behaviour of patrons of those premises, which she felt posed a threat to the safety of her family. 463Whilst the plaintiff's actual place of residence from time to time was of some relevance to the magnitude of her claim for domestic assistance, a matter upon which Ms MacMaster's opinion was sought, the fact remains that the bulk of the domestic activities for which the value of that assistance is claimed, related to the claimed injury-related needs of the plaintiff and the need to care for her family, and such domestic assistance needs would have been required wherever the plaintiff resided, if it is accepted that the plaintiff needed that assistance. 464There is no evidence that the plaintiff was asked to update the currency of her particulars from time to time to keep the CTP insurer appraised of her current residential address. It appears that the obligation on the plaintiff was to provide those particulars at the time of the lodgement of the claim form, and not to consistently update those particulars. Thereafter, the plaintiff had solicitors acting for her. If the CTP insurer or the insurer's solicitors needed to contact her they had a formal and effective means of doing so through her solicitors. 465The defendant sought to impugn the credit of the plaintiff arising from material produced on subpoena from the Department of Housing concerning dealings with that department by Mr Taoube and the plaintiff. On 19 May 2011, the plaintiff was granted a certificate under s 128 of the Evidence Act 1995 in respect of her evidence on those matters. 466For convenience, I shall set out my consideration of that evidence in connection with my reasoning concerning the defendant's credit challenges relating to the plaintiff's evidence of her personal relationships. 467For the present purposes, on the matter of the plaintiff's credit concerning her evidence as to her place of residence, and for the reasons that I have set out above, I consider that the defendant's credit challenge on this point raises a false issue concerning the relevance of those matters to these proceedings. 468For the reasons outlined in the preceding paragraphs, I do not consider that the defendant has successfully challenged the plaintiff's credit on the matter of her domicile at various addresses prior to the hearing. 469Instead, I consider that the defendant has viewed the plaintiff's claim generally through a prism of suspicion, and has sought to place turpitudinous interpretations upon all aspects of her situation when in reality, the evidence relied upon for this component of the defendant's credit challenge was, without more, either equivocal or innocuous.

Credit attack (13) - Medication issues 470The defendant submitted that the plaintiff gave implausible evidence that lacked credibility on the issue of her medication intake. 471To advance that submission the defendant sought to impugn the plaintiff's evidence (at T30.15 - T30.42) to the effect that at the trial she was taking the anti-depressant drug Effexor, when on the occasions of the plaintiff's visits to the antenatal clinic, on 27 April 2011 it was recorded that since 2010, she had been taking Folic Acid and Elevit: Exhibit "6", Tab 30, page 194, and on 29 April 2011, it was recorded that she was taking Elevit and, what I infer from the abbreviation in the notes was Feldene: Exhibit "6", Tab 30, page 197. 472There was no expert or factual evidence as to what the action of Elevit was, or whether this was a pregnancy related vitamin supplement as appears to be the suggestion emerging from the plaintiff's evidence, or some other kind of drug. In view of the absence of such evidence I am constrained from deriving knowledge of such matters by means other than from evidence in the proceedings, as such matters cannot be assumed to be common knowledge: Strinic v Singh [2009] NSWCA 15. 473At T384.30 to T385.21, the following evidence was given by the plaintiff on matters arising from the cited entries in the Westmead antenatal clinic notes: "FITZSIMMONS Q. Mrs Khalil, in April 2011 you attended the antenatal section of Liverpool Hospital. Correct? A. INTERPRETER: Yes. Q. One of the questions that you were asked at that time was any medications that you were taking. A. INTERPRETER: No, they asked me if I'm taking any type of vitamins for the baby. A. INTERPRETER: No they asked me if I'm taking any type of vitamins for the baby. Q. I suggest to you they asked you specifically what medications, what drugs or medications you were taking at that time? A. INTERPRETER: They didn't ask me in that manner no. Q. The only medications that you told the hospital about was folic acid and Elevit, that's the case isn't it? A. INTERPRETER: From what I understood from them they were asking me what are you taking for the baby. Q. Mrs Khalil I want to suggest that for example they asked you didn't they whether you had any allergies to any medication didn't they? A. INTERPRETER: Yes. Q. And you told them that you were allergic to penicillin? A. INTERPRETER: Yes. Q. And I suggest that they also asked you whether you were taking any other medication or drugs didn't they? A. INTERPRETER: No, they just ask me if I have an allergy or if you have suffer from high blood pressure or diabetes. Q. Were you given any advice about the taking of any other sort of medications whilst you were pregnant? A. INTERPRETER: No they didn't but they said take this type of vitamin. Q. Do you say that throughout the period of your pregnancy that you continued to take the various medications about which you've given evidence? A. INTERPRETER: Yes." 474In my view, on the basis of the above evidence, the credit submission made by the defendant is not sustained. 475For the defendant to displace the credibility of the plaintiff's evidence of her understanding of the questions asked of her at the antenatal clinic concerning her medication intake, and to thereby successfully challenge her evidence by reference to the information recorded in the clinical notes, much more is required: Mason v Demasi [2009] NSWCA 227. 476For example, it is not known as to whether the purpose of the enquiry of the plaintiff at the antenatal clinic concerning her medication intake was only in respect of allergies and pregnancy related medications. It has not been made clear as to what the criteria were for the making of notes of such matters to do with medication, such as for example, whether only medications of significance to pregnancy related issues would be the subject of an entry in the records. 477There was no evidence that the taking of Effexor was a medication that was in any way relevant to the pregnancy and worthy of record, or whether only medications of significance to the pregnancy were being noted at the time of these antenatal clinic attendances. 478In the absence of evidence of such matters, and also in view of the evidence of the experts that the plaintiff in fact had a psychiatric illness, which is a matter to be taken into account in any assessment of credit, I am not prepared to draw the conclusion sought by the defendant to the effect that the plaintiff's evidence on matters to do with her intake of medication was either implausible or not credible. In coming to that conclusion I have also had regard to the unchallenged evidence of Dr Talley concerning the side effects of the medication the plaintiff was taking at the time he saw her.

Credit attack (14) - Driving and motor vehicle ownership 479The submissions made on behalf of the defendant sought to impugn the credibility of the plaintiff's evidence in support of the contention that she had become nervous when driving motor vehicles, and that she no longer drove herself. 480The defendant's submissions referred to the summarised histories that had been prepared by the various medico-legal experts in their reports to the effect that the plaintiff had not driven since the accident, and that she was reliant upon friends to assist her with transport. Reference was also made to the plaintiff's evidence in cross-examination where she had only had two or three attempts at driving since the accident: T227.40 - T277.44. 481In support of this component of the credit attack, the defendant's submissions drew upon materials produced on subpoena and drew attention to the evidence that since the accident the plaintiff has had 6 motor vehicles registered in her name, and in the months following the accident, the plaintiff received speeding fines on 22 December 2006 and 14 January 2007. 482Attention was also drawn to the plaintiff having lodged a motor vehicle property damage claim in respect of her parked car on 9 July 2007, and that she had driven a car into a tree, and that she had requested that the insurer provide her with a hire car for 2 weeks after that accident. 483The defendant sought the inference that the plaintiff had been driving a motor vehicle both before and after that other accident, on more than just isolated occasions, as was implied by the plaintiff. 484There was also evidence that the plaintiff has on occasions been a passenger in motor vehicles when she had been driven by Mr Taoube, as well as on an occasion when she was the driver and sole occupant of a motor vehicle on 24 February 2010, as well as having travelled home alone in a taxi following her attendance at two medical appointments on 23 and 25 March 2010. The defendant also pointed to the surveillance film taken on 24 March 2010, which showed that the plaintiff had driven alone to her Revesby address on that date. 485As to the matter of the plaintiff's post-accident ownership of motor vehicles, it was argued that her evidence on this topic was "absurd" and simply not credible because her explanation in response to questions in cross-examination was to the effect that she purchased a Daewoo Lanos motor vehicle for herself to drive, but that Mr Taoube and his children used it so they could help her by driving her around as she was too scared to drive herself: T286.35 -T286.37. 486I consider the plaintiff's evidence, to the effect that she had bought a number of motor vehicles for herself but that she was too scared to drive, and therefore made them available to Mr Taoube and his children to drive her, was to a degree doubtful but was not entirely implausible: T281.16. I therefore reject the submission that the plaintiff's evidence on this point was "absurd". However, I consider that a person of the plaintiff's limited financial means, subsisting on government benefits with children to support, was unlikely to have had sufficient funds for such expenditure on motor vehicles, which she then simply discarded as being wrecks of no value: T280.49 - T281.7. This remains as an unexplained curiosity within the evidence. 487I have therefore concluded that on the matter of the plaintiff's ownership and driving of motor vehicles, the plaintiff's evidence was not entirely reliable and I should discount her evidence in that regard on the question of the extent of her need for domestic assistance comprising driving services provided by others.

Credit attack (15) - Plaintiff's claimed social isolation 488The submissions made on behalf of the defendant sought to impugn the credibility of the plaintiff's evidence to the effect that she had become socially isolated, and that she had adopted reclusive habits. 489In this regard, reference was made to the evidence in chief of the plaintiff to the effect that since the accident she stays at home all the time, sometimes lying in bed, and at other times sitting in the lounge-room: T33.33 - T33.39. 490In developing this submission the defendant's submissions made reference to the summarised histories prepared by the various medico-legal experts to the effect that the plaintiff had developed phobias for car and plane travel, was largely housebound, and spent all day in pyjamas, avoiding contact with the outside world, never or rarely left the house by herself without a support person, and spent her time in bed, depressed and crying: Defendant's written submissions, paragraphs [192] - [223]. 491The defendant's credit attack on the plaintiff's claim of social isolation was largely dependant upon a literal reading of her evidence to the effect that she rarely went out. The defendant sought to embarrass that evidence given by the plaintiff by reference to the DVD surveillance images that were tendered showing the plaintiff walking outside the confines of her premises, and by reference to the surveillance evidence that the plaintiff had been seen and had been listed as having been present on several occasions where social games of entertainment had been played at the Cabra-Vale Diggers Club. 492The first observation to be made about the component of the defendant's credit attack under present consideration is that I consider it unreasonable to view the evidence sought to be impugned in a strictly literal sense, when the claim is that the plaintiff is largely housebound and requires a support person on the occasions on which she ventured out. 493In this regard, I do not consider that when the plaintiff's evidence is taken as a whole, the cited concessions in answer to questions put to her in cross-examination (at T304.26 - T304.43) to the effect that she had been to the Cabra-Vale Diggers Club "twice or three times", and at T306.1 - T307.11, where she conceded that she had participated in a poker game at the club, was "completely inconsistent with the level of social isolation portrayed to the doctors and confirmed in her evidence". 494In my view, the defendant's submissions to the contrary are unduly dependant upon the content of summarised histories set out in medical reports that were not clearly intended by the medical practitioners to be put forward as precise or verbatim statements of detail attributed to the plaintiff. In my view the defendant's submissions along those lines proceed upon that unreasonable premise: Mason v Demasi, at [2]. 495I consider that when the plaintiff's evidence on this issue is read fairly, and as a whole, it is clear that those matters were not intended to be understood literally. For example, the plaintiff said of her visits to the club that her friends sometimes took her out for a bit of a change of scene, and sometimes she also needed to go out to see doctors: T211.44. The plaintiff stated that sometimes friends had prompted her to try to go out: T98.8. She also stated that at times she tried to improve her life and her friends encouraged her to do things for herself: T245.26 - T245.37. 496In my view, when those contextual matters are taken into account, the defendant's submission on the social isolation point is largely artificial, except perhaps for the evidence given by Dr Prior to the effect that the plaintiff had categorically, that is twice, stated to him that she never left the house by herself: T570.13. Whilst I accept that Dr Prior truthfully described this evidence to mean that he had twice confirmed that history with the plaintiff, that evidence must also be read with the qualification proffered by the plaintiff to the effect that she said "I used to try" to get out of the house, which I construe to be a reference to her making attempts at leaving her premises without such support: T248.21. 497There is some evidence which supports the defendant's proposition that the plaintiff had in effect exaggerated her evidence that she never left her house in order to attend medical examinations without a support person: Defendant's written submissions paragraphs [246] - [247], pages 64 - 66. 498However, when cross-examined on that issue, the plaintiff modified her evidence to a degree. Whereas beforehand she had made a statement to the effect that someone always attended medical appointments with her, she modified this to say "there should always be someone" with her, and she later agreed that on the occasion of an appointment with Professor Harris she went by bus or taxi by herself, and she also varied her earlier evidence and said she "never" did such things, but that she had "tried" to do so: T310.24 - T311.28. To the extent that she had made appropriate concessions, this is a matter to be weighed in her favour on credit on this issue. 499Whilst I accept that the variations in the plaintiff's evidence on these latter matters showed a degree of inconsistency in her explanations, I consider that some allowance has to be made for the fact that she was under attack, and that she was trying to reconcile, as best she could, the suggested inconsistency. I must also take into account that this evidence relied upon by the defendant was given by the plaintiff at a time when it was not disputed that she was certified as being medically unfit to attend court: Exhibit "D". 500I do not consider the plaintiff's credit to have been damaged as a result of the apparent differences in the factual explanations on this point, but rather, those variations need to be taken into account when assessing the overall reliability of her evidence on matters of disability. In my view the inconsistencies identified by the defendant do not mandate a finding that the whole of the plaintiff's evidence has been shown to be unreliable, and therefore requiring rejection. 501I have come to that view because I have also had regard to the relatively meagre results of DVD surveillance of the plaintiff, which largely supports the proposition that the plaintiff was rarely seen out of her premises despite many hours of surveillance, by which the defendant sought to obtain evidence that was contradictory of the plaintiff's claims.

Credit attack (16) - Plaintiff's activities of daily living 502The submissions on behalf of the defendant sought to impugn the credit of the plaintiff concerning her evidence that she relied upon friends for home support in her activities of daily living. 503The defendant's submissions drew upon summaries within the medical reports to the effect that the plaintiff relied upon friends to assist her with transport. The defendant's submissions also made critical reference to an aspect of the plaintiff's history to the effect that the plaintiff's friends often told her she has to change her life: Exhibit "3", page 121. The effect of those submissions was that the plaintiff should not be accepted in respect of those matters. 504A difficulty with this particular attack upon the plaintiff's credit was that it was based upon summarised histories contained in medical reports which were not verbatim transcripts, and this is a limitation on the rejection of the plaintiff's evidence by such means: Mason v Demasi, at [2]. Furthermore, when the plaintiff's attention was drawn to the summarised histories on those matters she gave explanations that were not implausible. 505Examples of such explanations are that there were times when she attempted to drive, and in fact did so in an endeavour to improve her situation: T304.16 - T304.25; she tried to improve her situation in response to encouragements from friends to try and do things for herself: T245.26 - T245.37 506The plaintiff was assessed by occupational therapists with regard to her ability to manage the activities of daily living. At the request of her own solicitors she was assessed by Mrs Cogger on one occasion and at the request of the defendant's solicitors, she was assessed by Ms MacMaster on 3 occasions. 507Mrs Cogger's report dated 17 September 2010 described the plaintiff's observed limitations in negotiating stairs, squatting, walking, balancing, reaching below knee level, repetitive right shoulder and left knee movements, lifting and carrying items and managing repetitive domestic tasks such as vacuuming and mopping. 508Mrs Cogger's report also described the plaintiff's reports of neck and left shoulder pain exacerbated by rapid body movements, movement of the left arm, or prolonged neck flexion, lifting and carrying. Similarly, Mrs Cogger reported that the plaintiff's constant, sharp, stabbing low back pain was exacerbated with weight bearing activities, bending forward from the waist, sitting and reaching for items below knee level. Mrs Cogger's report also described the plaintiff complaining of localised sharp stabbing pain in her left knee, exacerbated by weight bearing, carrying, sitting and squatting: Exhibit "C", pages 32 - 33. 509That evidence, which was in part based upon Mrs Cogger's own observations as an occupational therapist, formed the basis for Mrs Cogger's recommendations for the plaintiff to receive domestic assistance. 510The plaintiff gave no ground in cross-examination on those matters and her claim as to her need for such assistance was not inherently improbable. 511The plaintiff gave evidence that since the accident she had received domestic assistance from Mr Taoube, his children, Mrs Barakat, Mrs Habib, Mrs Ishak, and Mrs Yasier. Mrs Barakat was not called to give evidence. Mrs Habib had died before the hearing and could not be called. The other three persons gave oral evidence which I will summarise in the following paragraphs. 512Mrs Ishak described her visits to the plaintiff nearly every day or every second day whilst the plaintiff lived at Mr Pritchard: T417.23; T 418.50; T419.12. Mrs Ishak stated that at those times she would assist the plaintiff by putting the washing on the line, cleaning up, and sometimes cooking for her: T417.25; T419.33. She also described shopping for the plaintiff and looking after her baby, (T419.3) as well as providing any help the plaintiff said she needed: T419.28 - T419.29. Mrs Ishak also described visiting the plaintiff at Villawood every two weeks or so until her own family circumstances and the illness of her own husband precluded this. Mrs Ishak stated that since the accident, to her observation, the plaintiff had changed a lot, and was now unhappy and sick, with changes apparent in her physical capabilities. 513Mrs Yasier observed that since the accident in question, the plaintiff appeared to her to be very tired, and upset in her emotional state, and spent most of her time at home: T442.10 - T442.31; T443.37. Mrs Yasier stated that whilst the plaintiff was living at Villawood, she had vacuumed and cooked for the plaintiff's children on a daily basis because of the plaintiff's inability to do the housework: T442.33 - T442.48. She explained that she assisted the plaintiff after she had first tended to the needs of her own children; T446.47. 514Mr Mohamed Taoube, a son of the defendant, observed that after the accident the plaintiff was complaining of pain: T393.33. He stated that after the accident he continued to visit the plaintiff and had pushed her to do things: T394.15. I interpret the context of that evidence to be that the plaintiff appeared to be lacking in motivation to carry out tasks because of some psychological issues if not physical problems: T395.25. He described the state of the plaintiff's premises as being messier and not being as well maintained after her accident: T394.33. 515Mr Mohamed Taoube described his own provision of assistance to the plaintiff as comprising anything she needed to have done. This included washing dishes, hanging clothes on the clothes line (T394.25), making sandwiches for her sons (T397.11) and occasionally looking after her sons and get the housework done (T408.25 - T408.34). He also described occasionally driving the plaintiff around for medical appointments: T414.14. 516The evidence of domestic assistance provided to the plaintiff that I have summarised in the preceding paragraphs was not challenged in cross-examination nor was it contradicted. The low level of activity on the part of the plaintiff shown in the DVD footage is not of an extent or character that I consider to be contradictory of the plaintiff's evidence on her activities of daily living. In my view, the plaintiff's evidence and the lay evidence I have summarised was not inherently implausible. Accordingly, I am not persuaded that the plaintiff's evidence as to having required assistance with domestic tasks associated with daily living should be rejected as being inherently incredible based on analysis of the plaintiff's evidence and on analysis of the expert opinions on this topic. 517The quantification of such assistance is another matter entirely. My findings on that issue will be stated in that part of my reasons that deal with which aspects of the expert and lay evidence is to be preferred on the issue of the plaintiff's need for domestic assistance. 518In arriving at that view, I have not overlooked the evidence of Ms MacMaster. I have analysed her reports before arriving at these conclusions. My reasons for not accepting her assessment in which she rejected any need on the part of the plaintiff for ongoing domestic assistance is set out in that part of my reasons that deals with the plaintiff's claim for domestic assistance, and which evidence should be accepted on such matters.

Credit attack (17) - Plaintiff's physical presentation 519The defendant submitted that the plaintiff's physical presentation to medico-legal experts concerning her antalgic gait justified an adverse credit finding because "the surveillance evidence did not reveal any limp at all". 520I find myself unable to accept that submission in the light of my own viewing of the surveillance footage, which I have viewed on multiple occasions in the presence of the representatives of the parties, including one such viewing during the oral evidence of Dr Matalani. In my view, the plaintiff's limp was evident in the footage, as was to a degree, confirmed by the evidence of Dr Matalani. I have already set out my analysis and findings concerning the DVD surveillance evidence at paragraphs [411] to [422] of my reasons. 521Insofar as the defendant's submission under present consideration was based on the content of summarised medical histories, I have already identified the problematic nature of such a submission by reference to the remarks of Basten JA in Mason v Demasi at [2]. 522The defendant's submissions seeking a rejection of the plaintiff's explanatory evidence that her limp is less pronounced when she wears a knee guard is not based on anything other than a suspicion that the plaintiff was not telling the truth in providing that explanation. Notwithstanding that submission, there is no persuasive evidence that suggests the plaintiff was not wearing a knee guard at the time she was seen to be walking on 21 August 2009, or on any other date when filmed during DVD surveillance. 523The defendant's submissions pointed to the evidence of the plaintiff where she stated that she could not walk for more than 5 minutes: T332.40. The defendant also pointed to the surveillance footage, which showed the plaintiff walking, albeit for broken periods that totalled 23 minutes, but nevertheless for more than just 5 minutes or so at any one time on that date. 524Whilst I accept that there was probably an element of hyperbole or exaggeration in the plaintiff's evidence that she could not walk for more than 5 minutes, for a number of reasons, I consider that the evidence referred to and relied upon by the defendant as a matter of purported discredit to the plaintiff, to be relatively benign in its significance. 525First, the segments of DVD evidence are relatively short. When this evidence was compared to the context of many hours of surveillance undertaken, it does not show a pervading contradiction of the plaintiff's evidence. 526Secondly, the DVD sequences relied upon are non-continuous, and therefore the context of this evidence cannot be fairly used to contradict the evidence of the plaintiff. 527Thirdly, the cross-examination of the plaintiff on the point related to her past activity shown on the DVD relating to 21 August 2009, whereas the plaintiff's evidence of not being able to walk more than 5 minutes was anchored in the present at the time of the hearing. 528Fourthly, I considered the plaintiff's evidence to the effect she could not walk for more than 5 minutes required more than just literal consideration than that proffered by the defendant's submissions. In this regard, I have also had regard to the fact that the plaintiff gave that evidence through an interpreter, and there was evidence given on the first day of the hearing that sentence construction in the Arabic language was more complex than the shorter English translations: T46.28. 529Fifthly, the evidence relied upon by the defendant for the submission under present consideration was given on 24 May 2011, a date upon which the plaintiff was in fact certified as being medically unfit to attend court to give evidence following her recent caesarean section operation carried out 4 days earlier: Exhibit "D". 530As part of the credit submissions the defendant also relied upon the observation made in court of the plaintiff sitting for more than 15 minutes whilst giving evidence on 24 May 2011. The defendant argued that the plaintiff's explanation for this, namely that she had taken her medication, was an improbable answer given the pregnancy: Defendant's written submissions, paragraphs [352] - [353]. 531For the reasons that follow, I consider that there are a number of difficulties with that latter submission. 532First, the plaintiff's answer as given, is not inherently improbable. 533Secondly, there is no medical evidence to suggest that the taking of such medication was contra-indicated during pregnancy, even though there may be a lay suspicion that this might be so. 534Thirdly, the plaintiff's evidence that "I took my medication" was given in the context not of a current pregnancy, but where she had already had a caesarean section operation just 4 days earlier, and where it seems more than likely from a commonsense perspective that she had been given pain killing mediation following that surgery, which is well known to be major invasive abdominal surgery. 535The additional context of the answer relied upon by the defendant is that the plaintiff was at the time clearly frustrated by the process of being cross-examined at length in those circumstances and she was complaining of the repetitive cross-examination which was clearly tedious for her, and where she had said, with some exasperation, that she just wanted to finish her evidence: Day 7, T333.15. 536For these reasons I reject the defendant's submissions based on the matters concerning the plaintiff's physical presentation, as argued.

Credit attack (18) - Plaintiff's numerous "I can't remember" answers 537In final submissions the defendant sought to impugn what was described as the plaintiff's "standard response" to questions asked of her in cross-examination where her answers were to the effect of "I don't remember.": T295.4 - T295.7, to refer to just one example on Day 7 of the trial on 24 May 2011, which concerned a question as to whether the plaintiff had ever driven the motor vehicle seen on the DVD footage taken on 24 February 2010. 538In my assessment, whilst the defendant's submission to the above effect has a superficial attraction to it, on analysis, I nevertheless consider that the large majority of the plaintiff's answers where she said she had no recall should not properly form the basis of an adverse credit finding against her. My reasons for that view are set out in the paragraphs that immediately follow. 539In coming to this view I have not ignored the fact that all but one topic of the plaintiff's answers to the effect "I can't remember" (T22.46) were given in answers to questions asked of the plaintiff in cross-examination. Whilst from an advocacy standpoint, the plaintiff's lack of recall of events which formed the subject matter of questions asked of her in cross-examination may be seen to be a convenient one, I consider that in the context of this case, a less superficial analysis is called for. 540In that regard, I consider that it is necessary to distinguish between the various stages of evidence given by the plaintiff, where such answers are found, namely on days 1, 2, 3 and 4 of the trial between 16 and 19 May 2001, where she gave answers to the effect "I can't remember", and her later answers to that effect given on days 6 and 7 of the trial, between 23 and 25 May 2011. My reasons for that view are essentially threefold. 541First, I cannot ignore the fact that the plaintiff's cross-examination on significant matters between 23 and 25 May 2011 took place at times when it had later emerged that she was certified to have been medically unfit to attend court: Exhibit "D". Secondly, the nature, style and tone of the cross-examination of the plaintiff was particularly taxing, a matter that was remarked upon during the trial: T192.47. Thirdly, there were times during the cross-examination when the plaintiff was expressing her exasperation at being asked repetitive questions, where the same ground was being traversed "...This has been upsetting me so much, because saying the same thing over and over again.": T173.34, and see also T165.3 and T199.32. 542Turning to the subject matter of the cross-examination questions which resulted in answers to the effect "I can't remember", I consider that when examined, the plaintiff's inability to recall a significant number of matters of detail that was traversed, did not seem to me to be all that remarkable in the context in which that evidence arose. 543On the first day of the trial, on 16 May 2011, there was only one such instance where the plaintiff was unable to recall the events of the day when she signed the personal injury claim form Exhibit "1". She had signed that form almost 5 years earlier, on 8 November 2006. In those circumstances I considered that the plaintiff's lack of recall of those events was relatively unremarkable from a credit perspective. 544On the second day of the trial, on 17 May 2011, there were approximately 10 topics with answers from the plaintiff to the effect "I can't remember". The subject matter of the questions that evoked the "I can't remember" type responses from the plaintiff varied across a range of matters which included: (1) the plaintiff's lack of recall, in May 2011, of her 2004 visits to the Bass Hill Plaza Medical Centre (T76.14-T76.26); (2) her inability to now recall the type of car that she had in September 2009, and see T280.35; (3) her inability to precisely recall, in May 2011, what she had told her general practitioner on 16 November 2006 (T90.15 - T90.40); (4) her inability to now recall the dates on which she saw her general practitioner in November 2006 and her evidence that the wrong shoulder had been investigated (T90.6); (5) her inability to now recall the exact dates on which she had complained to Dr Maniam about problems concerning her knees (T95.33); (6) her inability to now recall the dates in 2007 and 2008 when she had complained to Dr Mahony about her knees (T96.1 - T96.13); (7) her inability to now recall what she had told Dr Haik as to when she had last showered before his examination of her in February 2009 (T99.33); (8) her inability to now recall whether, on 15 April 2010, Mrs Jamal Barakat had come to see her after Ms MacMaster had left the plaintiff's Revesby house (T114.36 - T114.47); (9) her inability to now remember the dates in October 2007 of her move from her Villawood address to her Revesby address (T120.25 - T121.6); (10) her inability to now recall the details of the March 2008 applications for her children to attend Canley Vale and Lansvale public schools (T130.11 - T130.44; T131). 545On the fourth and fifth days of the trial, on 18 and 19 May 2011, there were approximately 15 topics involving answers from the plaintiff to the effect "I can't remember". The subject matter of the questions that resulted in those "I can't remember" type answers ranged as follows: (1) the plaintiff's lack of recall, in May 2011, of whether she was in fact living at her Revesby address on 15 April 2010 and her inability to recall the events of that day when the defendant's occupational therapist attended there to assess her (T168.40 - T169.26); (2) the plaintiff's memory was affected by some confusion arising from the cross-examination, particularly as to dates (T169.31); (3) the plaintiff claimed she always had difficulty in recalling events in answer to the questions put to her in cross-examination, especially concerning dates, which led to her becoming confused (T170.1 - T170.48, T 171.45); (4) the plaintiff became upset when she perceived she was being asked "the same thing over and over again" (T173.35). (5) this latter matter requires a degree of caution because of the evidence given by Dr Akkerman to the effect that it is possible that memory could be affected in the later stages of pregnancy, and this evidence was given on the day before the caesarean section; (6) when cross-examined about the content of the DVD footage as to whether she was staying at the Revesby or Canley Vale address on 15 April 2010 in the context of repetitive questioning (T188.28, 189.09 and 191.10); (7) her inability to recall, in May 2011 whether on 29 September 2009 there was an interpreter available for the consultation she had with Dr Akkerman on that date (T193.34); (8) her inability to recall, in May 2011, the exact date of her move from the address at Canley Vale (T198.39); (9) her inability to recall, in May 2011, in the context of repetitive questioning, if she had moved from the Lansvale address to the Revesby address when the occupational therapist came to assess her (T199.34 - T200.35); (10) her inability to recall, in May 2011 the activities shown on the DVD footage of the Revesby premises in November 2010 (T200.25 - T201.29); (11) her inability to recall, in May 2011, when the house at Revesby was unattended on surveillance days (T203.15 - T204.29); (12) her inability to recall, in May 2011, details of occupancy of the Revesby premises having regard to the information on the water rates notices as to when she had returned to the Revesby address (T205.18 - T206.40); (13) her inability to recall, in May 2011, whether she lived at the Canley Vale address on various dates in 2009/2010 (T212.28 - T214.14); (14) her inability to recall, in May 2011, signing a statutory declaration for the Department of Housing on 13 November 2009 (T214.40; T218.16; T219.35); (15) her inability to recall, in May 2011, the events of the day on which she had signed the statutory declaration as to where she was living at that time (T219.48 - T220.36). 546It seems to me to be important to note that the above matters were all explored with the plaintiff in the context of her suffering from a psychological illness, and they occurred at an advanced state of her pregnancy and just before she underwent her caesarean section operation on the fifth day of the trial, namely 20 May 2011. It would be unrealistic to ignore that advanced stated of her pregnancy and the pre-occupations that would have been likely to have prevailed at the time concerning the imminent delivery of her child. I infer that from the plaintiff's past expression of fear over complications of caesarean section: Exhibit "6", Tab 3, page 12, and on a commonsense analysis. 547In my view, those matters must be seen to be relevant factors to consider when assessing whether or not the plaintiff was, by her "I can't remember" type answers, dissembling in her evidence. In my view, those factors indicate that the plaintiff should be given the benefit of the doubt from a credit perspective, and I am not satisfied that the defendant has made out the argument that the plaintiff was being disingenuous in her "I can't remember" type responses to cross-examination up until 20 May 2011. 548I now turn to a consideration of the significance of the plaintiff's "I can't remember" type answers given on the sixth and seventh days of the trial, namely 23 and 24 May 2011. First, I set out a summary of the topics that involved such answers on each of those respective dates. 549In this regard, on 23 May 2011, there were some 10 points of relevance, as follows: (1) again, in the context of repetitive cross-examination, the plaintiff could not recall the dates on which she had lived at the Canley Vale address (T 234.48, T236.14 and T 236.49); (2) in May 2011, before she was shown some DVD footage, she could not recall whether on 21 August 2009, she had walked to Lansvale public school or whether Mr Taoube had taken her there (T242.29); (3) when cross-examined on the transcript from the previous week, she could not recall being asked questions about not leaving her house without a support person (T248.40); (4) before being shown some DVD footage of Mr Taoube carrying a clothes basket in November 2009, she could recall him bringing his clothes to the premises where she lived (T249.40, T250.1, T251.20); (5) on 7 May 2011, which was some 16 days earlier, she could not recall the full details of events surrounding her return from a hospital visit, possibly from an overnight stay on that date (T258.49 - T 259.25); (6) she could not recall whether Mr Taoube had stayed at her premises overnight on successive nights between 6 May 2011 and 11 May 2011, which was only a week or so before the hearing commenced (T261.6, T269.35, T270.16); (7) in May 2011, she could not recall whether in February 2009, she was in receipt of a single parent's pension or a disability support pension (T 273.20); (8) she could not recall giving evidence a few days earlier concerning filling out a Department of Housing form at the end of 2008 (T277.18); (9) in 2011, she could not recall what type of car she had in 2008 when she had a collision with a tree whilst driving that car (T 280.35); (10) in the context of the plaintiff experiencing some frustration whilst giving evidence during cross-examination on the subject of whether, on 24 February 2010, she had driven a vehicle on her own to her home in Revesby, she said "I don't remember. I don't remember anything" (T284.46, T295.4). 550On 24 May 2011, there were some 6 points of relevance that arose, as follows: (1) when shown the DVD footage of 24 February 2011, the plaintiff was unable to identify who was driving the vehicle shown in that footage (T296.16 - T298.10). (2) in May 2011, the plaintiff could not remember exactly how many times she went to the Cabravale Diggers Club in 2008; (3) in May 2011, the plaintiff could not recall which accident she had witnessed in 2008 in the context of there having been two such accidents (T308.1 - T308.22); (4) the plaintiff could not recall in May 2011 whether, on 2 February 2011, there had been an interpreter present at the last examination she had with Dr Akkerman on that date (T313.43); (5) in May 2011, the plaintiff could not recall how many receipts she had given her solicitor for lawn mowing expenses she had incurred (T316.39 - T317.41); (6) in May 2011, the plaintiff could not recall whether on 15 February 2011, she had told Dr Haik at his examination of her, that on a "typical day", Mr Taoube's sons would come to her home and arrange breakfast her sons (T319.25). 551In respect of the 16 points of evidence listed in the preceding two paragraphs, I consider that only the 6th point relating to her evidence given on 23 May 2011 potentially reflects poorly on the plaintiff's credit. 552In relation to that matter, on the one hand, many minds may consider it is incredible that the plaintiff could not recall whether Mr Taoube had slept at her home on 6 successive nights between 6 and 11 May 2011, just a matter of weeks before she gave her evidence. On the other hand, the plaintiff's reticence to admit or discuss such matters may be explicable due to the cultural and embarrassment factors that were identified in the evidence of Dr Clark. 553Whilst that matter may have been an operative factor, more importantly I consider that in respect of all of the evidence the plaintiff gave on 23 and 24 May 2011, since it was given at a time she was certified to have been medically unfit to attend court, by which I include the need to attend to and deal with questioning, I consider that it would be unfair to make adverse credit findings on such evidence in those circumstances. In coming to that view I have specifically excluded any consideration of post-partum hormonal factors that may have operated at that stage as there was no evidence for such a view: Strinic v Singh.

Credit attack (19) - Alleged personal relationships - including alleged relationship with the defendant 554The defendant sought to create a credit issue from the evidence of the history of the plaintiff's personal relationship with the defendant, Mr Taoube. 555The areas raised by the defendant concerned first, the nature of the plaintiff's relationship with, Mr Taoube, and secondly, the detail of the history of the plaintiff's personal relationships generally, as disclosed by her to the various psychiatrists who had examined her for the purpose of the proceedings. The second matter will be analysed in the next topic of the credit attack on the plaintiff. 556With regard to the first matter raised in this component of the credit attack, namely the assertion that the plaintiff had a subsisting personal domestic relationship with Mr Taoube, the plaintiff consistently denied that she lived with, and continued to live with, Mr Taoube at the time of the trial. 557That assertion was denied by the plaintiff. On behalf of the defendant it was submitted that the plaintiff's evidence in that regard should be disbelieved. The defendant, Mr Taoube was not called to give evidence that tended to suggest that such a relationship existed. Mr Taoube's son Mohamed, who was called to give evidence in the plaintiff's case, was not asked any questions along those lines. The defendant Mr Taoube was not called to give any evidence, either voluntarily or involuntarily, along those lines. Neither of the lay witnesses called to give evidence on the issue of domestic assistance were asked questions on this subject. 558In order to address the defendant's submission it is necessary to review some aspects of the plaintiff's history. There is no dispute that before her separation and divorce from her husband, the plaintiff was in a violent and unhappy arranged marriage. Her husband had been gaoled on a number of occasions, including for family related violence. In 2001 she separated from her husband and in 2003 she divorced him. At around that time the plaintiff became friends with the Taoube family as neighbours. 559The records of the Department of Housing show that on 7 December 2001, some 5 years before the accident, the plaintiff and Mr Taoube had attended the offices of the Department of Housing to advise that they were commencing a relationship, and in that context, they requested that they be rehoused so they could live together: Exhibit "6". Tab 2, page 9. 560The evidence concerning the subsequent events of that relationship, which the plaintiff denied, and whether that intended relationship in 2001 had in fact continued, as was asserted by the defendant, is sketchy. 561The file notes of the Department of Housing Client Service Officer which form part of Exhibit "6" at Tab 2, pages 9 - 10 and which was made between 6 December 2001 and 10 December 2001, provide some evidence in summary form concerning the dynamics of the relationship between the Khalil and Taoube families at that time. The way that note dealt with those dynamics must be viewed with a degree of caution because it is a summary, and for the reasons identified by Basten JA in Mason v Demasi, at [2] concerning summarised medical histories. As that note contained conflicting accounts of those dynamics, and this was not explained by other evidence, caution and fairness requires that the 2001 Department of Housing file note should not be taken to be definitive proof of matters of the plaintiff's personal relationships, if any, that subsisted in 2006 and in 2011, in any assessment of the plaintiff's credit as a witness in these proceedings. 562At the hearing, the plaintiff denied that she was in a personal domestic relationship with Mr Taoube. Instead, she said that she had a relationship only of friendship with Mr Taoube, his wife and his children. She said that since the accident this friendship extended to Mr Taoube and various members of his family providing her with domestic assistance and to help with her children. The plaintiff has given an account to the effect that Mr Taoube has assisted because he felt guilty about the fact that the accident was his fault. Such an explanation is not implausible. 563The plaintiff gave evidence that the assistance that had been extended to her by Mr Taoube included him making his Department of Housing unit at Canley Vale available to the plaintiff and to her children in a housing swap arrangement. She also said that Mr Taoube was looking after her children whilst she attended the hearing of these proceedings. 564The details of that evidence were not taken up in cross-examination with Mr Mohamed Taoube, the son of the defendant Mr Taoube, when he gave evidence in the plaintiff's case. When the evidence of Mr Mohamed Taoube is read as a whole, there were really no challenges made to the evidence he gave on matters to do with domestic assistance provided to the plaintiff. I consider the absence of cross-examination of Mr Mohamed Taoube on those issues, and indeed the absence of any relevant cross-examination of the other witnesses called in the plaintiff's case on the domestic assistance issues, to be telling on this point relied upon by the defendant in order to seek to discredit the plaintiff. 565In my view, the stated frequency of the visits by all those domestic assistance witnesses to the places where the plaintiff resided would have placed them in a good position to be able to relevantly comment on their own observations as to whether the plaintiff was residing with the defendant Mr Taoube in a domestic relationship, as was asserted by the representatives of the defendant. 566It is clear from the various exchanges and objections that arose during the course of the trial, that each of the respective sides of the litigation had made a forensic decision not to call the defendant Mr Taoube as a witness. 567In my view, credit aside, the question of whether or not the plaintiff and Mr Taoube were in a personal domestic relationship could only relate to the claim for past domestic assistance. The plaintiff sought to tender a statement from Mr Taoube as to the nature and extent of the domestic services provided to her by him. That statement was objected to, and was rejected: T447.18 - T450.4; MFI "13". In my view, the question of whether the plaintiff and Mr Taoube were in a personal domestic relationship was irrelevant to the issues the parties had identified as calling for decision: MFI "3". 568However, that said, it was plain from the plaintiff's evidence that she was evasive in her evidence concerning the nature of her relationship with Mr Taoube. That evasiveness emerges from the range of her answers on her association with Mr Taoube and his family. She variously stated that she was visited by Mr Taoube and his family at her Cabramatta address every week: T62.10 - T62.27. When she was tested on the details of the Taoube family relationship she initially responded that she "didn't have any idea about the separation" of Mr Taoube and his wife. She later clarified this by saying she had earlier had no such idea "but now I know", and also agreed that she had known this to be the case for about two years: T63.13 - T63.29. 569That evidence was at odds with her evidence that the plaintiff knew from at least early 2008 that Mr Taoube was residing at Canley Vale and not at Cabramatta with his wife and children. 570There were some doubts raised as to how long the plaintiff had resided at Mr Taoube's unit at Canley Vale. At one point the plaintiff stated she had resided there for "a couple of months": T121.36 - T122.27; T128.12 - T129.44. 571Further doubts were cast over the truthfulness of the plaintiff's evidence that she had lived in Mr Taoube's unit at Canley Vale whilst he had lived at her home in Revesby: T129.46 - T130.4. 572When confronted with the evidence of surveillance film taken a week or so before the hearing, after initially denying that Mr Taoube had been staying overnight at the premises she occupied, she responded with answers to the effect that she could not remember and she also stated that when Mr Taoube had visited and was tired, she would not require him to leave: T260.49 - T261.11; T269.31 to T269.35; T270.3 to T270.17. 573The plaintiff's evidence concerning her relationship with Mr Taoube left me with the impression that she had been evasive on this topic of her evidence. However, that impression fell short of persuading me that the plaintiff and Mr Taoube were in a subsisting personal domestic relationship at the time of the hearing. 574It was argued on behalf of the defendant, that the "inescapable conclusion to be drawn from the objective evidence ... is that the plaintiff has resided and continues to reside with Mr Taoube", I do not consider that the evidence compelled such a conclusion, and it is unnecessary for me to decide that issue. 575When I considered whether, due to the evasiveness of the plaintiff on this topic, it was likely that there was such a relationship as alleged, I concluded that it was not necessary to decide that issue as it was not a relevant issue in the proceedings. Instead, I simply concluded that the evasive evidence given by the plaintiff on this topic detracted from her credit as a witness. 576In reaching that conclusion I have also had regard to the evidence of Dr Clark on a possible cultural explanation for the plaintiff's evasiveness in connection with her evidence of her personal relationships, including a possible factor of personal embarrassment. In my view, although such explanations were plausible, in the end result, I have concluded that the plaintiff was not entirely candid on the nature of her relationship with Mr Taoube. That said, this is well short of a finding that there was a subsisting personal and domestic relationship between the plaintiff and Mr Taoube. Nevertheless, this is a matter I must take into account when assessing her credibility as a witness.

Credit attack (20) - plaintiff's past pregnancies 577The defendant drew attention to the histories taken from the plaintiff as were summarised and recorded in various medical reports to attack the credibility of the plaintiff's account of the history of her sexual relationships as a femme sole. In this regard, the defendant referred to the summarised histories provided to Dr Haik, Dr Parmegiani, Dr Akkerman and Dr McClure to the effect that, as was variously summarised, the plaintiff was not involved in other close or sexual relationships since the accident, with one such report stating that the plaintiff said she "last had sex in 2005", and another report recording that as at 27 July 2010, the plaintiff has not had relationships with men since the accident. 578The defendant has pointed to objective evidence which suggested that the general tenor of that evidence was incorrect on account of matters recorded in the plaintiff's clinical records. This concerned the plaintiff's gynaecological history and details of a number of pregnancies that were recorded in the plaintiff's medical records after 2005. 579A question then arises as to whether that objective incorrectness should be characterised as being relevantly discrediting of the plaintiff's evidence concerning the issues calling for decision in these proceedings. 580The defendant pointed to Dr Rahman's clinical notes concerning gynaecological issues, which identified consultations that confirmed the plaintiff was "on the pill" and sought a pregnancy check on 3 July 2003: Exhibit "6", Tab 9, page 49. Those notes also recorded a history taken in what appears to be February 2004, of the plaintiff wanting to become pregnant: Exhibit "6", Tab 9, page 50. 581There is also evidence that the plaintiff had a negative pregnancy test on 13 February 2004 which begs the question as to why such a test was carried out: Exhibit "6", Tab 9, page 51. The defendant pointed to the Westmead Hospital gynaecology clinic notes which contained an entry which indicated that on 4 November 2004, the plaintiff was with a partner who had fathered 5 children and that she was planning to become pregnant: Exhibit "6", Tab 3, page 12. There is a record of a further consultation that took place on 6 May 2005, and which resulted in the plaintiff being referred to a sexual health clinic: Exhibit "6", Tab 9, page 53. 582At the consultation on 6 May 2005, the following handwritten entry appears in Dr Rahman's clinical notes: "c/o vaginal discomfort Having a long time to reach orgasm. Partner c/o pain ful (sic) penis after sex." 583Dr Rahman's notes recorded that on 17 December 2005, the plaintiff had asked Dr Rahman that she be checked for Hepatitis B and Hepatitis C and for HIV: Exhibit "6", Tab 9, page 54. 584On 26 May 2006 Dr Rahman's notes record that the plaintiff was pregnant and was considering terminating the pregnancy for which she was referred for counselling: Exhibit "6", Tab 9, page 55. As there was no further reference to that pregnancy in Dr Rahman's notes and those notes contained no evidence of a child having been born in 2006, I infer from those records that the pregnancy was not carried to term. 585On 18 October 2006, Dr Rahman's notes refer to the plaintiff having had her last menstrual period a few days earlier, and that the plaintiff was on what I infer from Dr Rahman's notation "OCP' to have been the oral contraceptive pill, and that she was wanting a pregnancy test: Exhibit "6", Tab 9, page 57. 586The next record of a gynaecological nature recorded in Dr Rahman's notes is on 6 February 2007, which was just 14 weeks after the accident, and at which time it was recorded that the plaintiff apparently thought she had her last menstrual period in late December 2006, and that she thought she was pregnant. Dr Rahman then referred the plaintiff for an ultrasound test in order to date the plaintiff's pregnancy: Exhibit "6", Tab 9, page 59. 587The next entry of a gynaecological nature in Dr Rahman's notes is 22 February 2007, which records that the plaintiff had experienced a miscarriage, and that she had a curette procedure for this in the previous weeks: Exhibit "6", Tab 9, page 59. 588After 22 February 2007, on my reading of Dr Rahman's notes, which extend through to 21 May 2010, and which are difficult to read, there seems to be no further references that suggest the plaintiff was sexually active in the interval of time between 22 February 2007 to 21 May 2010. Nor do those records show that she had sought contraceptive advice in that time: Exhibit "6", Tab 9, pages 59 - 75. I have not overlooked the entry in Dr Rahman's notes for 16 April 2008, but that note seems to me to be equivocal as the plaintiff's complaint on that occasion could have been due to a side effect of the antibiotics she was taking for a stated tooth infection that was referred to in the notes: Exhibit "6", Tab 9, page 68. That said, medical evidence would be required to interpret that note in this way: Strinic v Singh [2009] NSWCA 15. 589The general effect of the objective evidence pointed to by the defendant was to the effect that as appears from the plaintiff's medical records of a gynaecological nature, and contrary to her own evidence, the plaintiff had in fact been sexually active at least in parts of the period of time under present consideration. This was evidenced by a miscarriage that was noted by her general practitioner on 22 February 2007, quite apart from the most recent pregnancy which has resulted in a caesarean section on 20 May 2011, and which will be considered separately. 590Whilst the objective evidence as summarised above overwhelmingly points to the plaintiff having given inaccurate evidence in which she downplayed the fact of her sexual relations in the intervals of time after her divorce and after the accident, and that inaccurate evidence should ordinarily reflect poorly on her credit as a witness, I consider that those matters must be seen in a relevant context that to a degree ameliorates the effect of this evidence on her credit. 591That context is what Dr Clark has described as cultural considerations. Notwithstanding Dr Haik's alternative characterisation of the plaintiff as being mendacious on this issue, (a matter I shall consider separately, and which I only mention here to confirm that I have not overlooked Dr Haik's commentary), I consider that the plaintiff's cultural background, and her status as a divorced woman, when viewed together, provide an ample basis for concluding that it was to a degree understandable that she may have been reluctant to have such matters of a highly personal nature canvassed in medical consultations that were, on her reasonable understanding, primarily concerned with an evaluation of her post-accident psychiatric condition. 592In my view the same comment applies to the plaintiff's oral evidence on such personal matters. The course taken by the representatives of the defendant to tender evidence concerning such personal matters, and to explore such matters in oral cross-examination, is a matter that was bound to cause the plaintiff embarrassment. 593I consider this to be particularly so where the relevance of such questions was at best marginal, as appears from the rather compendious list of some 55 particulars of disability filed on behalf of the plaintiff in these proceedings, and which are enumerated in the series (a) to (ccc), none of those particulars of disability could be reasonably thought to suggest that the plaintiff has claimed any physical or psychological impairment in her ability to engage in sexual activity, including with a view to pregnancy, the latter being an unquestionable natural right of any woman, especially when of childbearing age and wanting to become pregnant. 594These matters were explored in evidence because of latitude afforded to the cross-examiner. In my view, having viewed the plaintiff's evidence as a whole and considered the true issues in the proceedings, the defendant has failed to establish any true relevance of such matters in this case. 595The only reason the matter of the plaintiff's sexual activity became an issue was that some of the psychiatrists who assessed her had questioned her about the issue. In my view, the plaintiff's reluctance to discuss that topic with candour when questioned by the psychiatrists is, from the perspective of her social position, entirely understandable. The same comment also applies to her evidence, given that the subject matter of the cross-examination on this topic did not directly relate to a fact in issue in the proceedings concerning her disabilities. 596There was no medical evidence given in this case to suggest that a diagnosis of depression on the part of the plaintiff was inconsistent with her having engaged in sexual activity whilst depressed. 597Had that purported issue been made clear by the defendant at an earlier stage of the trial, before the concurrent expert evidence of the 5 consultant psychiatrists was given, and before the delivery of submissions, those psychiatrists could have usefully been asked to consider the possible significance, if any, of the history recorded by Dr Rahman on 6 May 2005 and to which I have already referred, of the plaintiff's subsequent complaint of anhedonia as recorded by Dr Prior, and any connection between such matters. As no evidence was given to address that point, I will not speculate upon that matter. 598Following my evaluation of the evidence, my conclusions on the credit issue that was raised by the defendant concerning the plaintiff's sexual history and pregnancies, are fourfold. 599First, the plaintiff's reticence to disclose such matters of a personal nature when questioned by medical examiners for the purpose of the proceedings is perhaps understandable from a cultural and social perspective, as explained by Dr Clark, especially given that in these proceedings she made no allegations of impairment of her libido, her sexual function, or of her fertility. 600Secondly, the fact that the plaintiff was less than candid in her evidence as to the extent of her involvement in such activities does to a degree reflect poorly on her credit, subject to the mitigating consideration identified in the immediately preceding paragraph. This is so because the occasion of giving sworn evidence requires total candour and in contrast to that obligation she editorialised in an evasive way. Notwithstanding that the matter of her sexual activity and pregnancies were largely irrelevant to these proceedings, when questioned, frank answers were required of the plaintiff. Instead of responding frankly, she sought to evade the issue where, in the absence of a sustained objection, a proper and factually correct answer to such questions was required of her as a witness sworn to tell the truth. 601Thirdly, notwithstanding the above considerations, which indicate a degree of shortcoming in the honesty of the plaintiff on this issue, given the personally sensitive nature of the subject matter upon which her evidence was shown to be evasive, and given that the issue upon which she showed incomplete candour did not relate to any fact in issue in the proceedings, I consider this matter to be a matter of relatively diminished importance to an assessment of her overall credit. Nevertheless, it is a matter that I will take into account in assessing the overall credibility of the evidence of the plaintiff. 602Fourthly, the matters raised by the recorded history at Exhibit "6", Tab 3 page 12, of the plaintiff having been involved with a partner who had fathered 5 children, without more, is not evidence that I consider to be sufficiently persuasive to compel the conclusion sought by the representatives of the defendant that the plaintiff was at that time, or has since been, in a personal domestic relationship with Mr Taoube, as was submitted by the representatives of the defendant.

Credit attack (21) - Concealed pregnancy and paternity thereof 603The circumstances in which it was bizzarely revealed that the plaintiff had concealed the fact of her pregnancy in the lead up to the hearing: and during the hearing itself, to the point where, but for the late production on subpoena of some hospital notes, her cross-examination had all but concluded have already been reviewed and described in paragraphs [68] to [84] of my reasons and need no further restatement here. 604On behalf of the defendant it was submitted that the plaintiff gave false and deceptive evidence of the circumstances surrounding her admission by ambulance to Liverpool Hospital on 6 May 2011, which was at a time when she was in an advanced stage of her pregnancy, and when it was clear that she thought her child would have to be delivered in that admission. 605Notwithstanding the submissions made on behalf of the plaintiff to the contrary, for the reasons that follow, I accept the submission made on behalf of the defendant that the plaintiff gave misleading evidence to conceal the fact of her most recent pregnancy which led to the caesarean delivery of her child on 20 May 20011, an event that occurred during the currency of the hearing. 606On one view, it was arguable that the plaintiff had not deliberately concealed her pregnancy and was simply answering questions asked of her, and that her answers to the effect that she had pains in the region of her stomach or abdomen were simply factual. However, in the context of the pregnancy, which was known to her, it was odd to say the least, to maintain that she should not disclose that she was due to give birth at any time during the currency of the hearing, particularly as caesarean section was the intended method of delivery, and that would have required some planning. 607The argument in favour of a benign interpretation of the events under present consideration is in my view entirely eclipsed by the content of the plaintiff's instructions to her lawyers as was related to the court by her senior counsel at the time an adjournment of her cross-examination was sought. This was to the effect that she was unwell due to stress issues. That explanation was later augmented by her answers to leading questions which were not objected to, and in which she assented to have been feeling stressed, depressed and being physically ill: T71.42. 608It is unnecessary to reach a conclusion on how the plaintiff's pregnancy had earlier escaped the notice of her legal advisors at the time the hearing commenced, and perhaps in the days beforehand. This may have been due to the fact that she was wearing a loose coat. Similarly, it is unnecessary to explore how earlier, the fact of the plaintiff's pregnancy had also escaped the attention of Dr Pierides, Dr Akkerman, Dr Faithfull, Professor Harris, Ms MacMaster, and perhaps to a lesser extent, Dr Haik, all of whom had examined her in February 2011. 609Dr Haik seems to be in a different position to the other experts because of the specific observations he made in the examination section of his report dated 15 February 2011 concerning his examination on 9 February 2011. There, he noted the plaintiff presented dressed untidily, wearing a warm zipped dark jacket and black denim pants. On that occasion he also noted distinct dark patches of pigmentation scattered on the plaintiff's face, and he observed that she was overweight at 90kg in the context of her height of 1.66m, and I infer from the context of his report, that he had measured her body mass index at 33, when the normal range for that measurement was stated by Dr Haik to be between 20 to 25. When Dr Haik gave oral evidence, no-one asked him whether at the time of his examination on 9 February 2011, when he made these observations of the plaintiff, that he suspected she might be pregnant. 610That said, a question does arise as to how Dr Pierides, Dr Faithfull, Professor Harris and Ms MacMaster did not notice the physical appearance of the plaintiff's pregnancy at the time of their respective physical re-examinations of her on 3, 15, 22 and 23 February 2011. This is particularly the case with Ms MacMaster given that she photographed the plaintiff for the purposes of her report. On those occasions all of these experts examined the plaintiff's lumbar spine, which would have presumably revealed to a medical practitioner or occupational therapist, a body habitus consistent with a gestation of about 6 months pregnancy, working back from the estimated date of delivery [EDD] recorded in the referral letter to Westmead Hospital antenatal clinic: Exhibit "6", Tab 30, page 191. However, since this issue was not addressed through specific questions to the doctors concerned, I will not speculate further upon the nature and extent of the respective physical examinations of the plaintiff by those experts on those occasions: Strinic v Singh [2009] NSWCA 15. 611From the perspective of an evaluation of the credit of the plaintiff, it was obvious that she knew she was pregnant when on 20 May 2011, she requested her legal representatives to obtain an adjournment of the proceedings to enable her to seek medical assistance. If for no other reason, this was because of the fact of, and content of the record of the discussion of her attendance at the Westmead antenatal clinic on 27 April 2011. 612In my view, in the circumstances where the plaintiff was seeking the indulgence of an adjournment, a greater degree of candour was expected of her than that which was forthcoming at the time. 613Notwithstanding the arguments that were put on behalf of the plaintiff to the effect that she was simply giving direct answers to the questions that had been put to her, and that she was answering those questions in terms that were factually correct and specific to the nature of the questions asked of her, I am satisfied that the plaintiff deliberately withheld disclosing the fact of her advanced state of pregnancy at the time of the hearing, both before and after the caesarean section delivery of her child. I am satisfied that she did so with a view to enhancing, or not diminishing, her claim for damages for loss of earning capacity. 614That conclusion must result in an adverse credit finding against the plaintiff on this issue. 615During the course of the hearing, at the time the experts were giving their evidence concurrently, I did consider the possibility that the plaintiff's behaviour as a witness during her post-caesarean section evidence may have been influenced by the possible effects of pain following such major surgery. Counsel for the defendant objected to a question that I had asked of the medical experts on that issue, and I therefore did not enforce an answer to my own question in that regard. The matter was not taken up by counsel for the plaintiff. Accordingly, there is no basis for taking a benign view of the plaintiff's evidence as to whether, and if so, to what extent or effect, the plaintiff was taking post-operative pain killing medications, whether in the form of opiates that may have affected her faculties, or otherwise. Such matters require evidence, and inferences based on speculation are not permissible. 616In a similar vein, no evidence was given as to the possible hormonal effects, if any, that may have affected the plaintiff's mental functioning in the period of her advanced state of pregnancy in the lead-up to the delivery of her child. However, Dr Akkerman did say that sometimes, pregnancy can have profound effects on mental functioning: T546.13. As to whether there was such a factor at play in this case that might have affected the quality and reliability of the plaintiff's evidence requires specific evidence which was absent, and speculation on this issue is not permissible. 617In my consideration of the evidence of the plaintiff where she was criticised for not being completely candid about the history of her sexual activity and her past pregnancies, I considered that those matters were of diminished importance because of cultural considerations and due to possible embarrassment on the part of the plaintiff: paragraphs [577] to [602] above. 618However, in my view, the credit conclusion I have reached on the matter of the plaintiff's concealed pregnancy is of an entirely different character, for which a more benign view cannot be taken because of her obligation of candour when giving evidence. 619I therefore conclude that the plaintiff's concealment of her pregnancy and recent childbirth during the progress of the trial is a matter that must be seen to detract from her credibility. 620This leaves for only brief consideration, the question asked of the plaintiff as to who was the father of her most recently delivered child. That question was rejected as being improper: T338.45. No question arises from the paternity of the plaintiff's child in question insofar as the credibility of the plaintiff is concerned in connection with these proceedings. Nor does the conception and birth of that child necessarily compel a conclusion that the plaintiff was in a personal domestic relationship with Mr Taoube at any time after the accident. For such a conclusion to be drawn, specific evidence or material upon which inferences could be properly based is required. The state of the evidence does not constitute such proof and it does not justify the inference that was sought to be made by the defendant's representatives.

Credit attack (22) - Alleged lies, untruths and false evidence by plaintiff 621In the course of his cross-examination of the plaintiff, on behalf of the defendant, Mr Fitzsimmons confronted the plaintiff with a number of questions in which it was asserted, variously, that the plaintiff had lied, told untruths, and had given false evidence. 622An examination of the transcript reveals some 2 occasions on which it was put to the plaintiff that she had lied: T173.8 and T193.32. 623Similarly, there were some 5 instances in which it was put to the plaintiff that her evidence was untrue: T248.29; T248.39; T308.11; T311.26 and T375.27. 624Similarly, there were some 6 instances in which it was put to the plaintiff that she had given false evidence: T63.39; T74.14; T133.20; T245.30; T248.20 and T248.24. 625It is of some significance that the defendant used these three different formulations by which to attack the evidence of the plaintiff. 626There can be no doubt about the meaning of the term lies. According to plain usage of language, a lie must be taken to involve a deliberate untruth. 627The term untruth, in the context of cross-examination should be taken to also involve deliberate untruthfulness. 628However, the meaning of the term false requires a more careful consideration as it's meaning is open to a number of interpretations. It could variously mean either evidence which is simply incorrect, including innocently incorrect, and therefore false in the sense of it being factually wrong, or alternatively, evidence which is incorrect but deliberately false: Mackenzie v R [1996] HCA 35; (1996) 190 CLR 348, at page 3. Moreover, the meaning of the term false is possibly open to subjective interpretation on matters of perception, which is all the more reason to regard the term with a considerable degree of caution where it is used to imply that evidence has been given dishonestly, especially where no specific counter-proposition was put to the witness, and where the alleged falsity has not been further defined as being of a deliberate nature. 629Against that background, I turn to consider each of these identified categories of attack upon the plaintiff's credit. Alleged lies 630Essentially, the identifiable questions where it was put to the plaintiff that she had lied when giving her evidence, this involved assertions that she had lied about her knowledge of the nature of the relationship between Mr Taoube and his wife (T173.8) and that she had lied in stating that an interpreter had not attended an appointment that she had with Dr Akkerman on 29 September 2009 (T193.32). 631The substance of those assertions were not conceded by the plaintiff, and I am not satisfied that the plaintiff had lied or was being deliberately untruthful in giving that evidence. The suggestions put, and the evidence relied upon by the defendant for putting those assertions, does not necessarily compel a conclusion that the plaintiff had lied on those occasions. In my view, the defendants' questions, which asserted that the plaintiff had lied, had overstated the position. 632The matter of whether an interpreter had attended the consultation the plaintiff had with Dr Akkerman on 29 September 2009 is in reality a matter of little consequence and the plaintiff could be excused for being wrong about the detail of such circumstances that occurred so long ago on that issue. Being wrong is very different to a suggestion that she lied, which I reject. 633Even if I am wrong about the characterisation of the plaintiff's relationship with Mr Taoube, and her knowledge of the state of the relationship between Mr Taoube and his wife, and whether she had lied about such knowledge, I consider the issue to be of diminished importance to an assessment of the plaintiff's credit having regard to the cultural factors and matters of reticence identified by Dr Clark in his oral evidence concerning such personal matters. Alleged untruths 634Essentially, the identifiable questions where it was put to the plaintiff that she had given untrue evidence involving the assertions that it was untrue she could not leave the house without a support person (T248.29, T248.39); that it was untrue that she had witnessed another accident involving Mr Taoube at a later date than the subject accident and in the manner she had described (T308.11); that it was untrue that she had never attended a medical appointment on her own (T311.26); and that it was untrue she had stayed in hospital overnight on 6 May 2011 (T375.27). 635In my view the plaintiff's explanations involving those assertions on these largely peripheral matters were not implausible or patently incorrect, and I do not consider that the evidence necessarily mandates findings of untruthfulness on the part of the plaintiff, as was asserted by the submissions made on behalf of the defendant. 636In that regard, I accept the evidence of the plaintiff that at times she attempted to do things for herself, such as leaving the house at times without a support person, including to attend medical examinations. The question of whether or not the plaintiff had an overnight stay in hospital on 6 May 2011 is of limited importance especially where it appeared she was admitted for observations, and was sent home after a number of hours as she was found not to have been in formal labour, she only had Braxton-Hicks type contractions or "tightenings": Exhibit "6", Tab 30, pages 200; 198. 637On the question of whether or not the plaintiff stayed in hospital overnight on 6 May 2011, I consider that this too was a largely peripheral matter. Her evidence was to the effect that she had not stayed in hospital overnight on 6 May 2011. In contrast, the Liverpool Hospital records show that the plaintiff was brought into the hospital Birthing Unit by ambulance at 17:26 hrs on 6 May 2011 and she was later discharged at 08:57 hrs on 7 May 2011: Exhibit "6", Tab 30, page 190. The hospital notes state the reason for the presentation was LSCS (lower segment caesarean section) Cyesis (pregnancy) EDC (estimated date of confinement) 27 May 2011. 638During that admission it was noted by the hospital staff that the plaintiff appeared to be mildly distressed (page 201) and the first clinical impression was that she was in early labour. She was examined on a total of 14 occasions over the 15 hours of her stay (pages 200 - 204) and she received intravenous fluids (page 214) and continuous electronic fetal cardiotocograph (CTG) monitoring between 17:39 hours and 21:50 hrs on 6 May 2011 (pages 216 - 224) and then again from 07:16 hrs to 08:50 hrs on 7 May 2011 (pages 226 - 228). 639In the light of the above events, although there was no specific evidence on the point, I consider that it would be reasonable to allow for the possibility that the plaintiff's perception of time was to some degree distorted by the emotional accompaniments of those events, and by her thoughts on the possibility that her baby may have been delivered during that stay. 640For those reasons I consider that little weight should be placed on the credit argument based on the plaintiff's denial that she stayed in hospital overnight on 6 May 2011, and that her evidence to the contrary, was untrue where her stay at the hospital was for less than a 24 hour period. 641In my view, the evidence on these matters does not reasonably support the proposition that the plaintiff gave deliberately untruthful evidence on such matters. Alleged false evidence 642Essentially, the questions where it was put to the plaintiff that in some specific instances she had given evidence that was false, involved assertions that it was false that the plaintiff did not know Mr and Mrs Taoube had in fact separated in 2001 and that this remained the case at the time of the accident (T63.39; T74.14); it was false that when the plaintiff lived in Mr Taoube's house in Canley Vale, Mr Taoube lived at her house in Revesby (T133.20); it was false that she never left the house alone (T245.30; T248.20; T248.24); and it was false that she never went out to medical appointments on her own (T310.33). 643I do not consider that the alleged falsity of the evidence cited by the defendant in support of the credit arguments has damaged the plaintiff's credit on the matters asserted. These questions focussed upon matters that were peripheral. 644Whilst Exhibit "3', Tab 2, page 9 shows Mr and Mrs Taoube had separated in 2001, that is not sufficient material to sustain an assertion in 2011, that the plaintiff had given knowingly untrue evidence upon that matter, or that Mr and Mrs Taoube had remained separated in the interim period. The matter of where the plaintiff and Mr Taoube lived, either in Canley Vale or Revesby, did not directly relate to an issue in the proceedings. 645The plaintiff's evidence also explained that she had at times left the house alone, or had at least tried to do so. In my view no significant credit issue arises on that matter. 646In my view, those matters, individually and in combination, do not serve to discharge the onus carried by the defendant to demonstrate that the claimed falsity of the plaintiff's evidence on those matters equated to the plaintiff giving knowingly untrue evidence on those matters. Conclusion on submissions as to alleged lies, untrue and false evidence 647Based upon the foregoing analysis, I do not accept the defendant's submissions to the effect that in her evidence, the plaintiff had told lies and untruths, and had given knowingly false evidence. 648At best the defendant has shown aspects of the plaintiff's evidence to have been wrong, but that is a very different proposition to matters of lies, untruth and falsity: Mackenzie v R, at page 3. Browne v Dunn 649As to the question of whether the plaintiff was exaggerating her evidence on matters of disability, at T390, Mr Fitzsimmons conceded that he had not formally put to the plaintiff that she was exaggerating the extent of her disabilities. 650In response to that acknowledgment, Mr Cranitch SC indicated that he would not be criticising the defendant for formal non-compliance with the requirements of putting specific challenges to the plaintiff for her comment: T390.15. Unfortunately, that approach operates to stand in the way of a full detailed analysis where there were no specific counter-propositions put to the plaintiff as would have been the case with a more traditional approach to the rule in Browne v Dunn (1894) 6 R 67. A traditional approach would have provided the plaintiff with an opportunity to fairly address criticisms made of her evidence and of her case. 651Be that as it may, I consider that if the defendant is to rely upon assertions of that character, it was incumbent on the defendant, where specific allegations of exaggeration were being relied upon, to put such specific matters to the plaintiff in cross-examination in order to provide her with a fair opportunity to comment on the assertions: Browne v Dunn (1894) 6 R 67. 652There are certain cases where counsel come to some understanding of convenience between themselves as to whether there should be challenges made to the testimony of a witness on specific matters, as appears to be the case here. Clearly, some cases are litigated on that basis and the parties have a clear understanding that this is so. However, this is not such a case, where the defendant sought to make a case that the plaintiff had exaggerated her symptoms. 653The pleaded principle has been outlined by Hunt J in Allied Pastoral Holdings Pty Ltd v Commissioner for Taxation [1983] 1 NSWLR 1, at (16): "It has in my experience always been a rule of professional practice that, unless notice has already clearly been given of the cross-examiner's intention to rely upon such matters, it is necessary to put to an opponent's witness in cross-examination the nature of the case upon which it is proposed to rely in contradiction of his evidence, particularly where that case relies upon inferences to be drawn from other evidence in the proceedings. Such a rule of practice is necessary both to give the witness the opportunity to deal with that other evidence, or the inferences to be drawn from it, and to allow the other party the opportunity to call evidence either to corroborate that explanation or to contradict the inference sought to be drawn. That rule of practice follows from what I have always believed to be rules of conduct which are essential to fair play at the trial and which are generally regarded as being established by the decision of the House of Lords in Browne v Dunn (1894) 6 R 67." 654Those obligations are not matters that the parties can, for convenience, ignore where the credit of a witness is sought to be impugned. In my view it was insufficient for the defendant to simply rely on a generalised or perfunctory statement of asserted exaggeration: T390.7 - T390.19. I consider this to be especially so in circumstances where the consensus of the experts was that the plaintiff had a psychological disability. This is a matter to which I shall return in dealing with the reports of Dr Haik and in determining which expert opinion should be accepted.

Credit attack (23) - Allegations of mendacity made by Dr Haik 655Since a significant source of material for the attack upon the credit of the plaintiff came from within the evidence of Dr Haik, for the purpose of analysis, it is relevant to identify those portions of the evidence of Dr Haik, including his reports, which the defendant relies upon in order to seek to sustain the attack on the credit of the plaintiff. 656An examination of the reports of Dr Haik reveals that the basis for the position he has adopted for criticising the credibility of the evidence of the plaintiff is as follows: (1) As a Lebanese Catholic, she could not name the several denominations of Catholicism in Lebanon (Maronite and Melkite): First report, 9 February 2009, Exhibit "3" pages 48, 52; (2) He doubted the plaintiff's statement that she did not eat much and has lost weight. He took that view because her physical size suggested otherwise: First report, 9 February 2009, Exhibit "3" page 51; (3) He considered the plaintiff's statement that "I am not thinking about anything anymore" was an implausible reason for not selling "her garaged and probably registered car": First report, 9 February 2009, Exhibit "3" page 51; (4) He presumed from the plaintiff's "intimate activities with an unknown man" that this suggested a "wider spectrum of activity than she proposes" and he described her statement of the absence of a sexual relationship since 2005 as being "mendacious": First report, 9 February 2009, Exhibit "3" pages 51, 52; (5) He deduced from the fact that in 2007 the plaintiff was treated for a burn from bleaching her hair that this "would suggest she in (sic) not as introverted and indifferent as she suggests": First report, 9 February 2009, Exhibit "3" page 51; (6) He doubted the plaintiff's "collection of allegedly disabling emotional symptoms", describing them as being "extreme and improbable", and also stated it was "difficult to believe" she remained sheltered in her bedroom 24 hours a day: First report, 9 February 2009, Exhibit "3" page 51; (7) He stated that the collision in question "was not of a nature to engender the degree of emotional trauma she described", drawing upon the absence in the description of any explosion, fire, or people being killed or maimed, or being exposed to horrors for extended periods, and she had not been seriously injured and had not required extensive surgery: First report, 9 February 2009, Exhibit "3" pages 51-52; (8) He relied upon his own internet research to rebut the plaintiff's statement to him that she had not been exposed to traumata during the Lebanese civil war between 1975-1990: First report, 9 February 2009, Exhibit "3" page 52; (9) He relied upon his own internet research on whether there were forced marriages amongst Christians in Beirut: First report, 9 February 2009, Exhibit "3" page 52. It was difficult to understand Dr Haik's reference to that matter because in this context he had recorded the plaintiff's history as stating her marriage was arranged at the age of 15, "though not forced", which made his comment irrelevant; (10) He attributed to the plaintiff an "appetite for a significant reparation for the series of adversities to which she had been exposed", describing the plaintiff's quest for primary and secondary gain : First report, 9 February 2009, Exhibit "3" pages 53-54; Third report, 15 February 2011, page 61. (11) He expressed the opinion that "There is little doubt that Mrs Khalil has experienced an unkind if not harsh series of adversities in her relatively short life" and now "seeks recompense for the hand that she has been dealt as well as a determination to overwhelm all those who might oppose her goal": Second report, 1 March 2010, Exhibit "3" page 56. 657Those opinions of Dr Haik were expanded upon in his oral evidence. That evidence was relied upon by the defendant to seek to undermine the credit of the plaintiff. It is therefore relevant that I set out in full (with added emphasis) the basal assumptions that were relied upon by Dr Haik, and which appears from the following extract of his evidence which was given concurrently at T535.37 - T537.31: "HIS HONOUR: Yes, now, Dr Haik, I understand that your view is different to the others? WITNESS HAIK: It is. HIS HONOUR: So, this is your opportunity to speak to your view. WITNESS HAIK: Although it might be understood that the plaintiff has a psychiatric disorder, that disorder, I believe, was more probably than not in existence prior to the accident and that it is a result of many years of hardship. However, I do not believe that the accident has caused a psychiatric diagnosis in itself. HIS HONOUR: Now, you use the expression "more probably than not". Can you assist me by identifying the factors that you've weighed in favour and against the proposition? Can you hear me? WITNESS HAIK: Could you repeat it? HIS HONOUR: Yes. You've used the expression in your answer "more probably than not". What I would like to hear from you, if you can assist me, is the identification of the factors that you've used in weighing for and against the proposition. WITNESS HAIK: The features. HIS HONOUR: In whichever order you like but I'd like a bit of a structured discussion on what you considered, if anything, would be in favour of the diagnosis of a psychiatric condition and what you considered weighed against the diagnosis of a psychiatric condition. FITZSIMMONS: That is arising from the accident, your Honour. HIS HONOUR: That's arising from his opinion. WITNESS HAIK: From the - from the accident? HIS HONOUR: Well, yes, that's the underlying assumption. WITNESS HAIK: From the accident? HIS HONOUR: Well, yes, that's the underlying assumption. WITNESS HAIK: I could not determine that there was a psychiatric diagnosis as a consequence of the accident because I understand that it was a low speed collision. I understand that there were no significant physical abnormalities found at Liverpool Hospital. I understand that there was no subsequent evidence of physical disorder that might objectively explain the plaintiff's subjective complaints. I don't believe that post-traumatic stress disorder exists because of the nature of the accident, the causal stressor in other words. Number 2, the fact that she did not have persistence avoidance of car travel. She was able to drive in a car subsequently. The repetitive intrusive disorder called nightmares does not really meet the problems that exist in posttraumatic stress disorder because they were very stereotyped. They were exactly - it was like a video tape, the same experience in nightmares as she had during the time of the accident and I could not consider based upon those features, that she suffered from post-traumatic stress disorder. However, prior to the accident, Ms Khalil has had a very difficult life as documented in my report, extending back to her arranged marriage when she was 15 to a man twice her age, the fact that she had two children born in Lebanon, that both died soon after birth, the fact that a third child was born with severe cerebral palsy. But they came to Australia and her husband was not a good man in the sense of his gambling, his drinking and his poor supply of money and that she divorced him in 2001 to live by herself and her two children subsequently born, that she developed no further relationships according to her subsequent to that, no romantic relationships and that she has had to live in Department of Housing dwellings and rely heavily upon social security for an income. She then relinquished the care of her child as soon as she divorced her husband in 2001 to permanent residency - a disabled child - and the bus brought the child to her on Sundays for a couple of hours and then after the accident in 2006 she did not have the child come to her house anymore. Obviously it was a very stressful experience for her and from what I gather when I saw her the first time, she was only seeing the disabled child once a year and as I understand it, the accident provided her with an opportunity to relinquish care of that or seeing that child about whom she must have been very ambivalent. So there was a very difficult life for her as I have endeavoured to list and I would suspect that the accident offered her an opportunity to perhaps be relieved of many pressures as a result of claims of disablement both physical and psychological." [Emphasis added] 658There were some additional matters relied upon by the defendant arising from the oral evidence of Dr Haik in seeking to sustain the credit attack on the plaintiff. Those comprised the following 8 matters: (1) Variations in the plaintiff's history concerning her future work intentions 659Dr Haik focussed upon his own summary to comment adversely as to the plaintiff's credit by pointing to variations in the plaintiff's history of proposed employment by stating that at the first interview the plaintiff told him she intended to work in a forestry (sic) shop whereas at the second interview, he said she had told him she had been about to obtain work in a mixed business or convenience store. He characterised that divergence as evidence that the plaintiff was "mendacious", at T540.23 - T540.41: "HIS HONOUR: Thank you. I have one follow up question from your answer and what I propose to do is give your colleagues the opportunity of raising any matters they wish to point to arising from your answers and there will be a debate amongst you and then counsel will of course have the opportunity of asking questions. But my question of you is this, Dr Haik, insofar as you've referred to the events of the accident, as a possible cause or not of a condition of post-traumatic stress disorder, can you relate to me your understanding of what was involved in the accident according to her history? WITNESS HAIK: Gentlemen, I became aware that Ms Khalil was telling untruths. For example, she told me that immediately prior to the accident she was going to go to work in a forestry (sic) shop because she had just obtained a TAFE degree. However, that TAFE degree was obtained in 2001, not in 2005. In my second interview with her I asked her about that same issue and she told me that just before the accident she was about to obtain a job in a mixed - in a convenience store at Fairfield. That was a concern to me that one of many issues where I believe she was mendacious." 660One of the "inconsistencies" Dr Haik drew upon in support of his argument against the plaintiff having PTSD was the discrepancy between the history of the plaintiff's intention to pursue a career in floristry and working in a convenience store: T558.45 - T559.1. A difficulty in relying on those matters as a basis for seeking to discredit the plaintiff is that Dr Haik appeared to make no effort to reconcile these matters with the plaintiff but simply left the discrepancy to remain unexplained. 661There is no evidence of the actual questions that were asked by Dr Haik that elicited those summarised answers. In my view that would be an important baseline consideration for making any reasoned judgment to the significance or otherwise of those matters on the issue of the plaintiff's credit. In my view Dr Haik appears to have made a harsh judgment on an unresolved peripheral matter that is not at the core of the plaintiff's post-accident complaints, as is shown in the following extract of his evidence: "WITNESS HAIK: I was not aware as to whether or not the next day she was going to start work. I was simply drawing attention to the fact that she told me that she was beginning in floristry, as a result of completing a TAFE course in floristry the year before. I am drawing attention to that, that it wasn't the year before. It was in 2001. That's all I'm saying and then it wasn't floristry. Later she told me it was in a convenient store." (2) Inferences as to intimate activity on the part of the plaintiff 662Dr Haik also argued that the plaintiff's statement to him to the effect she "hadn't had sex since about 2005" whereas it had been discovered that "she has had a number of pregnancies according to her GP's notes" and has subsequently given birth to a child, suggested to him she was not a truthful historian. He said of these matters it was "plausible that she may be mendacious for her own cause for financial ... secondary gain". He posed the question to his colleagues that she may be lying to enhance her position in the context of her claim for compensation: T540.41. "The other issue is that she told me that she didn't drive, that she has owned two cars since the accident. The third thing is that she told me that she hadn't had sex since about 2005 but it was discovered that she has had a number of pregnancies, according to her GP's notes and I believe subsequently she was born of a child. These facts suggest to me that she is not a truthful historian and when she gives a history to people such as us, it's plausible that she may be mendacious for her own cause for financial - for a secondary gain. Do you gentlemen consider that from an objective perspective she may be lying to enhance her situation from a compensation perspective based upon those facts?" 663In my view, the plaintiff's reluctance to admit to intimate activity on her part in her interview with Dr Haik is understandable, in the light of Dr Clark's proffered explanation. I also allow for the possibility that she was, to a degree, intimidated by the circumstances of the interview in that the plaintiff said that Dr Haik was "very rough" on her: T38.8. In my view the term "mendacious" was too strong for the circumstances. I do not consider a critical credit issue arises on this point, given Dr Clark's explanation for the withholding of such information. (3) "Exaggerated" memory of accident 664Dr Haik stated that he felt the plaintiff has "exaggerated out of all proportion" her memories of the accident. His belief to that effect appears to have been based on the assumptions that the collision was "a low speed car accident where she received no injuries" according to the hospital file. He argued that as there was "no explosion or fire or maiming or damage to her body that required surgery". He expressed the concern that "she does exaggerate hugely": T543.31 - T543.48: "WITNESS HAIK: Added to what I have said, I am concerned that Ms Khalil has exaggerated out of all proportion and I noted that in page 3 of my first report that she said that every time she sits she has memories of the accident. In fact, all day she has memories of the accident. They never let up and we're talking about an accident that I understand was a low speed car accident where she received no injuries, according to the hospital file, and there was no explosion or fire or maiming or damage to her body that required surgery of an extended period of time, so based upon that, I am concerned that she does exaggerate hugely and I have explained why she does so. The other issue is that in many of the reports that I have read, there's no mention of her children being damaged or suffering as a consequence of the accident until later, much later. All the reports say things like she rips into the children but knows they're not at fault and yet she told me they wet the bed every night. She told me that they suffer in many, many ways and have nightmares and again this isn't in accord with what has been otherwise written and reported. Thank you." 665In my view Dr Haik's criticisms of the plaintiff on these matters has been inappropriately magnified by the adjectival inclusions in his criticisms. Furthermore, Dr Haik's view does not accommodate the scenario explained by the other psychiatric evidence to the effect that it was the impact of the accident on the plaintiff that was the relevant perception for the purposes of diagnosing PTSD. Dr Haik seems to have only focussed upon the low speed collision and lack of apparent frank injury, without considering those other matters. For that reason I do not accept this credit criticism of the plaintiff that was advanced through his evidence. (4) Doubts entertained by Dr Haik over plaintiff's account of events 666Dr Haik referred to reports (not in evidence) to suggest that the plaintiff's children were "damaged or suffering as a consequence of the accident until later, much later," as a basis for doubting the plaintiff's account of events: T543.42. 667It is difficult to evaluate Dr Haik's remarks concerning whether the plaintiff's children were "damaged or suffering" because the matters to which he referred and relied upon were not in evidence in these proceedings. Furthermore, there is evidence that the plaintiff's children required psychological counselling and there is evidence that at the scene, the plaintiff heard her children screaming. For these reasons I would discount Dr Haik's commentary that was critical of the plaintiff's account in this regard. (5) Civil war in Lebanon and inconsistencies that Dr Haik could not believe 668Dr Haik stated that Mrs Khalil had told him that Beirut was "unaffected by the civil war" and he used his own research about Beirut being "a place of warring factions" during the years that she was there, to seek to discredit her: T548.39 - T548.41. 669I propose to discount Dr Haik's comments concerning the "warring factions" on grounds of procedural fairness. It is apparent that he did not give the plaintiff the opportunity to expand upon her statement to provide Dr Haik with information or comments contrary to his views and the products of his own researches outside the confines of the consultation with the plaintiff. 670The only matter within the evidence that touched upon this issue was a comment on the plaintiff's medical history recorded in the Liverpool Hospital antenatal booking-in notes dated 27 April 2011: Exhibit "6", Tab 30, page 210. This was to the effect that in Lebanon, she could not visit her first child much "as war in Lebanon was going". This was not a matter explored with the plaintiff as to what psychological effect if any, this might have had upon her, nor was it referred to in submissions. 671Dr Haik pointed to the history of the plaintiff not having had sex since 2005, and "this business about Beirut and the warring factions" as being "inconsistencies" that he "could not believe": T549.49 - T550.2: "WITNESS HAIK: I didn't - found out I couldn't believe, for example, the fact that she hadn't had sex since 2005. That was another one of the inconsistencies. So this business about Beirut and the warring factions was another inconsistency that I determined." (6) Plaintiff's non-disclosure of alleged ongoing "continual" relationship 672Dr Haik was critical of the plaintiff for not informing him "that she had an ongoing relationship with someone that she had continual sex with" and he characterised that omission as being "probably" because she did not want him "to know that she was sexually active": T55.9 - T555.15: "WITNESS HAIK: If she told me that she had a one night stand in 2005, she could also have told me that she had an ongoing relationship with someone that she had continual sex with which, presumably, may well have been the truth, but, no, I don't believe that her telling me about her sex life was a grievous difficulty for her and she did share that with me and she probably chose not to tell me any more because she didn't want me to know that she was sexually active." 673In my view the fallacy within Dr Haik's critical comment as cited above is self-evident. There is no evidence other than Dr Haik's unsupported assumption, that the plaintiff was in a relationship that involved "continual sex". That type of hyperbolic statement is unhelpful to an analysis of the plaintiff's credit. It was not a matter which Dr Haik put to or explored with the plaintiff, in fairness, for her comment, and I discount the comment on that basis. I also discount the comment on account of Dr Clark's evidence by which he provided a possible reason for the plaintiff's reticence to discuss sexual matters, namely on account of embarrassment and cultural factors. (7) Assumed motive for plaintiff relinquishing care of disabled son 674Dr Haik argued, speculatively and without any factual basis that was acknowledged in the evidence of the plaintiff, that she had relinquished the care of her eldest child who was disabled because the accident had provided her with an excuse for doing so. He described the assumed fact that the plaintiff gave up the care of her son as being "a relief of the difficulties of seeing a severely disabled child, who didn't even recognise her.": T556.23 - T556.27: "WITNESS HAIK: If you read my report, she said she wanted to have the child, but she couldn't because of all these symptoms post accident. So, in effect, the accident provided her with a relief of the difficulties of seeing a severely disabled child, who didn't even recognise her. That must have been inordinately hard for her." 675A difficulty with the above theory propounded by Dr Haik is that its foundation is factually flawed. It was the plaintiff's separation and divorce from her husband that led to her inability to cope with the care of her eldest son, leading her to place him in institutional care. It was not the accident that led to those circumstances The effect of the accident was that the plaintiff was unable to have her son for weekend care, a different scenario to that described by Dr Haik. 676Another difficulty with the above theory propounded by Dr Haik is that this was not in fairness put before the plaintiff for her comment, either in the consultations she had with Dr Haik or in cross-examination. For those reasons, I therefore discount Dr Haik's theory as unsubstantiated speculation. I do not propose to have regard to such unsupported speculation in assessing the credit of the plaintiff. (8) "All the inconsistencies and untruths" 677Dr Haik argued that "all the inconsistencies and untruths" he had documented led him to the conclusion "that there was no evidence of post-traumatic stress disorder" in the plaintiff, and he argued that her claim "can't be supported": T557.26 - T557.34: "WITNESS HAIK: I have documented all the inconsistencies and untruths that I understand Ms Khalil has demonstrated and drew them - and wrote a report based upon those and attempted to support my conclusions, based upon those inconsistencies, and concluded - not for the defence - concluded that there was no evidence of post-traumatic stress disorder, but I could certainly understand her hugely difficult life prior to the accident that she would make the claims that she has that can't be supported, in my opinion, by the fact that has post-traumatic stress disorder." 678The question of whether the plaintiff has PTSD is a matter that stands to be resolved in determining which body of expert medical evidence should be preferred. I set out my reasoning on such matters in connection with Issue 4 at paragraphs [757] to [842].

Conclusions on credit of the plaintiff as a witness 679As explained in the preceding paragraphs, I have concluded that the plaintiff's credit as a witness has to a degree, been damaged on peripheral matters, but in a much more limited sense than that alleged concerning her evidence on relevant facts in issue. Matters of no adverse consequence to the plaintiff's credit 680For the reasons I have outlined in the above section of my judgment, the matters that I have considered to be of no adverse consequence to the plaintiff's credit as a witness are, her capacity to understand English: Credit attack (1); her account of the events of the accident: Credit attack (2); the content of the summarised medical histories: Credit attack (3); her description of her physical injuries and disabilities: Credit attacks (4) and (5); her pre-accident psychological issues: Credit attack (6); her post-accident psychological issues: Credit attack (7); the DVD evidence of surveillance and static surveillance: Credit attacks (8) and (9); the claim for domestic assistance: Credit attack (10); aspects of the claim for economic loss: Credit attack (11); the plaintiff's living arrangements: Credit attack (12); the plaintiff's use of medication: Credit attack (13); the plaintiff's social isolation: Credit attack (15); the plaintiff's activities of daily living: Credit attack (16); the plaintiff's physical presentation: Credit attack (17); the plaintiff's numerous "I can't remember" type answers: Credit attack (18); alleged lies, untruths and allegedly false evidence: Credit attack (22); and the allegations of mendacity on the part of the plaintiff made by Dr Haik: Credit attack (23). Damage to the credit of the plaintiff 681However, for the reasons I have stated, I have also concluded that the plaintiff's credit has been relevantly damaged in the areas of her history of ownership and driving of motor vehicles: Credit attack (14); the plaintiff's personal relationships: Credit attack (19); the plaintiff's past pregnancies: Credit attack (20) and the plaintiff's most recent and concealed pregnancy, and the paternity thereof: Credit attack (21). However, in my view these findings do not indicate that the plaintiff's evidence on critical matters should be rejected outright and in its entirety, as was submitted on behalf of the defendant. Instead, I propose to weigh the plaintiff's evidence with caution in the light of those credit findings. I have favoured that approach in contrast to outright rejection of the plaintiff's evidence because those matters where the plaintiff's credit has been damaged, do not directly relate to the principal matters in issue, and the other evidence, both medical, and lay, provides support for the plaintiff's case. 682With regard to that latter point, particularly as I have rejected Dr Haik's claim of mendacity on the part of the plaintiff, I consider that there are aspects of Dr Akkerman's evidence that preclude the blanket credit finding sought by the defendant. I consider it unlikely, as stated by Dr Akkerman, that the plaintiff could have successfully fooled her treating doctor, Dr Ali, and himself on successive occasions, and feigned her psychiatric symptoms and illness, or alternatively, consistently recited a feigned history of the timing of the origin of those symptoms and illness. 683I now turn to a consideration of the remaining issues calling for decision in the proceedings.

Issue 2 - Circumstances of the collision 684The defendant conceded that there was an accident involving the plaintiff on 1 November 2006. The defendant called no evidence to contradict the evidence of the plaintiff concerning the events of the accident, which I find involved two collisions. I find there is no reasonable basis upon which the unchallenged version of events as described by the evidence of the plaintiff should not be accepted: Whalan v Kogarah Municipal Council [2007] NSWCA 5, at [41]. 685Accordingly, I find that the relevant events of the accident, when dissected into their operative components, comprised at least five relevant elements within a continuum, which I outline as follows. 686The first element in the sequence of events was that the plaintiff was a front seat passenger wearing a lap sash seatbelt when that vehicle was struck on the rear right side by another vehicle as those two vehicles were in the process of being driven in a roundabout. There is no evidence as to the speed of that first collision. 687The damage to the rear right side of the plaintiff's vehicle was described in the COPS report as being of a minor nature. Paradoxically, the COPS report refers to the accident as being a "major traffic crash" involving injury: Exhibit "6", Tab 1, page 3. 688The second element in the sequence of events was that the collision between the two vehicles caused the plaintiff's vehicle to travel off the intended course whilst in the roundabout, and as a result it travelled off the roadway, spinning, and continued on towards a further collision with a power pole. The evidence in the COPS report was that at the time of the collision with the pole, the stated speed of the plaintiff's vehicle was 35kph: Exhibit "6", Tab 1, page 7. The hospital records variously refer to the collision having occurred at "low speed" (Exhibit "6", Tab 7, page 21) or at 35 - 40kph: Exhibit "6", Tab 7, page 36. I accept that in those events, the plaintiff, who then had her two children with her in the vehicle, would have been subjected to a very stressful experience in which she would have been worried, distressed and concerned as to her own wellbeing, and as to the wellbeing of her two children, who were also in the vehicle at the time. 689The plaintiff's Motor Accident Personal Injury Claim Form throws no further light upon the force of these collisions, and only refers to the damage to the plaintiff's vehicle as being slight. There is no evidence as to whether the vehicle was braking before that final collision. The impact of the vehicle with the power pole was described in the COPS report as causing "slight damage" to the front of the vehicle. Be that as it may, the described collisions occurred, and it is the effects of those collisions on the plaintiff, which requires assessment. 690The third element in the sequence is the fact that after the plaintiff's vehicle came to a rest after the collision with the power pole, she and her children were not immediately released from the vehicle. In this regard, the un-contradicted and un-controverted evidence is that the ambulance, the police and the rescue arm of the fire brigade attended the scene. In those circumstances, the plaintiff was placed in a neck brace due to her reported symptoms, whilst concurrent steps were taken for the fire brigade personnel to use rescue cutting equipment to cut the metal B-pillar of the passenger side of the vehicle in order to free the plaintiff and her children from the wreckage of the vehicle. 691The fourth element in these events is that although the first and second collisions occurred very quickly in a relatively short period of time, the plaintiff nevertheless had to wait for some 49 minutes between the time the ambulance arrived at the scene, and the time she was loaded into the ambulance in order to be transported to hospital. 692The fifth element in these events is that in the events of the collision and the immediate aftermath of the collision, the plaintiff was aware of the fact that her children were injured in the accident. Naturally, as their mother, in addition to any concerns she had about herself, she would have been concerned about the wellbeing of her children, who to her knowledge, were screaming in the events that followed the collisions. 693It scarcely needs stating that these circumstances had an adverse effect upon the plaintiff's psychological wellbeing at the time. I infer from the described circumstances that the events of the accident and their immediate aftermath were shocking and distressing for the plaintiff, as the accident had occurred suddenly and unexpectedly, and the plaintiff was conscious throughout the events.

Issue 3 - Injuries suffered by the plaintiff in the accident 694There was controversy as to whether the plaintiff was in fact injured in the accident as she has claimed.

General approach to determining the extent of the plaintiff's injury 695In arriving at my findings on the nature of the injuries suffered by the plaintiff in the accident, given that some reservations of caution arise in relation to any unqualified acceptance of the evidence of the plaintiff consequent upon my credit findings, I have first had regard to the objective sources of information regarding the effects of the collision upon the plaintiff. 696I have then had regard to the matters of opinion within the written and oral evidence of the medical experts, including the opinions of the MAS Assessors, who in effect conceded that the plaintiff had suffered injuries in the accident. I then considered the evidence of the plaintiff and the recorded histories of injuries as summarised by the medical experts who were concerned with identifying the probable injuries suffered by the plaintiff. That process led me to determine whether, and to what extent, the plaintiff's evidence should be accepted as to the nature and extent of the injuries she sustained in the accident.

Preferred medical opinions on the injury issue 697I started my analysis with an acceptance of the proposition that the content of the ambulance and hospital records, including radiology investigations, are likely to be substantially correct as a contemporaneous record of objective observations of any detected abnormalities in relation to injuries suffered by the plaintiff. I took that view because there was no good reason for doubting those records. I have also accepted that in the circumstances that immediately followed the accident, that the plaintiff was shocked and distressed, including in relation to possible injuries suffered by her children. I consider that at that time, it was unlikely that she would have had the guile to fabricate or exaggerate her symptoms of injury when speaking with the ambulance and hospital personnel. 698In taking that approach I have also considered and allowed for the evidence of Dr Faithfull to the effect that the ambulance report may not necessarily have represented a full account of the plaintiff's injuries: T463.30. 699I then looked to the material from the plaintiff's treating general practitioner Dr Rahman concerning the consultations that followed shortly after the accident, and in which he assessed the plaintiff as suffering from a whiplash type injury to the neck, tendinous injuries to the shoulders, and a low back strain. 700I then looked at the material from Dr Maniam, the treating orthopaedic surgeon, where he had considered the plaintiff's history and the investigations that followed the accident. I also considered Dr Maniam's opinion to the effect that he felt that the plaintiff had problems with her cervical, thoracic and lumbar spines, and in relation to both shoulders. 701I have had regard to the fact that the observations and clinical acumen of those doctors has not been challenged. 702I then looked to the array of medical reports, especially those that were in the interest of the defendant, and which were more critical of the plaintiff, to determine whether there were matters that were conceded in those reports, and which were substantially consistent with the complaints made by the plaintiff in her case. 703In that regard, I observed that the first expert to examine the plaintiff on behalf of the defendant, Dr Pierides, did not record any direct history of any injury suffered by the plaintiff in the accident. Instead his initial report dated 22 June 2007 focussed on matters of disability. 704Nevertheless, and significantly in my view, Dr Pierides conceded that the plaintiff "... no doubt had a significant jarring after the subject accident and would have been in some pain in various areas...". It was of significance that this view expressed by Dr Pierides was substantially similar to the opinion of Dr Matalani dated 12 March 2009, in which he accepted that the plaintiff had suffered a musculo-ligamentous strain of the neck and back, and that she had shoulder problems that related to the accident, putting aside for the moment, the question of whether the plaintiff had in fact injured her left knee as was claimed. 705In addition to the above concession made by Dr Pierides, I also noted that on 2 December 2008, Professor Harris also accepted that the plaintiff had sustained multiple soft tissue injuries in the subject accident, except for her left knee, which he excluded on the basis of the recency of the plaintiff's complaint of problems in that area. 706I also had initial regard to the opinion of Dr Marsh, in his MAS assessment dated 29 May 2008, in which he determined that the plaintiff's neck, mid-back and low back problems, and her shoulder problems, were accident related. 707I then gave consideration to the evidence of the plaintiff in the light of those matters, also against the background of the other medical opinions concerning the plaintiff's likely physical and psychological injuries. As the remainder of those opinions were principally concerned with matters of disability, I shall refer to them in more detail in connection with my disability findings which are the subject of Issue 4. 708Following the process of analysis that I have outlined above, I have found that in the accident in question, the plaintiff sustained the injuries that are stated below. 709I find that in addition to the emotional shock and generalised jarring to the body suffered by the plaintiff in the accident, in a descending physical order, the physical injuries she sustained involved her head, her neck, her shoulders her chest and abdomen, her upper and lower back, her pelvis and grazes to her right lower leg. Whilst I accept that the plaintiff may have struck her left knee on the dashboard of the vehicle in the events of the accident as she claimed, I do not accept that the plaintiff had suffered any ligamentous injury or damage to her left knee in the accident as claimed and as identified by medical investigations and opinions commencing in 2008. The basis of those findings is as follows.

Injury to the head 710The plaintiff described having hit her head in the accident. Her perception of this was that she hit her head on the dashboard of her vehicle. She also described an area of "redness" on her face at an unstated time after the accident: T85.37. The plaintiff said that she hit her head in the accident, notwithstanding that at the time of the accident, she was wearing a lap sash seatbelt. That evidence stands to be evaluated. 711In the course of cross-examining Dr Faithfull, counsel for the defendant elicited evidence from him that in the event of the two collisions in question, it was probable that the plaintiff had struck a part of her head on the passenger's side door of her vehicle. On considering the described dynamics of the two respective collisions, which included the plaintiff's vehicle spinning out of control after the first impact, and before the second impact, followed by the vehicle striking the power pole, it seems to me that the explanation in favour of a head injury put forward by Dr Faithfull was credible and convincing, and was not otherwise improbable. In my view, this evidence provides a comfortable basis upon which to accept the evidence of the plaintiff that she had hit her head in the events of the accident. 712Furthermore, the diagram on page 29 of Exhibit "6" comprising a part of the Liverpool Hospital notes, records the fact that at the hospital an examination was undertaken of some part of the plaintiff's head notwithstanding that there was no complaint of loss of consciousness on her part. That examination assists in persuading me that the plaintiff sustained some kind of injury to her head in the accident, probably by means of a blow to the head in the manner she described, but with the proviso that her head was more likely to have made contact with the side of the passenger door or door pillar of the vehicle rather than the dashboard as she had perceived, and as was explained by Dr Faithfull. 713I am therefore satisfied that the plaintiff suffered a blow to her head in the events of the accident. I am also satisfied that the events of the accident and its immediate aftermath were shocking and terrifying for the plaintiff at the time.

Injury to the cervical, thoracic and lumbar spines 714I find that the plaintiff suffered soft tissue injuries to the cervical, thoracic and lumbar spines as claimed. Those injuries were contemporaneously documented in Exhibit "6". The consistency of those injuries was confirmed by the opinions of Dr Maniam, Dr Pierides, Professor Harris, Dr Marsh and Dr Matalani. I also accept the opinion of Dr Mahony that this category of injury additionally involved nerve root irritations to those three areas of the plaintiff's spine. 715At Tab 6, page 19 of Exhibit "6", the ambulance report refers to cervical neck pain with sensory loss to the arms and legs. At Tab 7 page 20 the hospital admission record notes complaints of neck pain and paraesthesia in all limbs. At Tab 6 page 29 of Exhibit "6" it was noted that on examination, the plaintiff was tender over her entire spine following a leg rotation manoeuvre. At Tab 6 page 27 of Exhibit "6", diagrammatic notes were made by hospital staff that the plaintiff was moderately tender in the region of her cervical spine, mildly tender in the region of her thoracic spine and tender in the region of her lumbar spine. At Tab 6 page 28 of Exhibit "6", at 20:30 hours, the hospital notes record that the plaintiff was complaining of neck and back pain. 716In considering the evidence of Dr Faithfull on the question of whether the plaintiff could have been injured in her lumbar spine whilst wearing a seatbelt, I do not read his general evidence in that regard as indicating that it was not possible for the plaintiff to have suffered such an injury whilst wearing a seatbelt. In any event, I infer from the content of the hospital notes that I have cited, that the plaintiff did in fact receive soft tissue injuries in those three areas of her spine as claimed, which supports an acceptance of her evidence on the matter of injury to her spine in those three areas.

Injury to both shoulders 717I find that the plaintiff suffered an injury to both shoulders in the accident. I consider that this is demonstrated objectively by the diagrammatic representations contained in Exhibit "6". 718At Tab 6, page 19 of that exhibit, physical injury to both of the plaintiff's shoulders is confirmed in the contemporaneously prepared pain diagram that was annotated by ambulance personnel at the scene of the accident. In my view, the markings on that diagram clearly indicate that there were pain responses or descriptions from the plaintiff in the region of both of her shoulders when those areas were examined at the accident scene. In my view it was improbable that those pain responses were fabricated at the time they were elicited. 719I do not consider the absence of any further note of shoulder problems in the hospital clinical notes to be a good reason for doubting the accuracy of the ambulance record, especially having regard to the evidence of Dr Faithfull on this issue. 720The plaintiff's complaint of shoulder problems were also consistent with the opinion of Dr Mahony, whose opinion I accept to the effect that the plaintiff had, amongst other things, a nerve root irritation to her cervical spine. That view is picked up and confirmed by Dr Marsh who considered the plaintiff to have shoulder problems referred from the neck injury. 721Consequent upon the shoulder injuries noted in the diagram prepared by the attending ambulance officers, the plaintiff has undergone radiological investigation of both shoulders, albeit that she believed the investigation of the right shoulder was as a result of an error on the part of her referring doctor. Be that as it may, as was initially observed by Dr Maniam, the plaintiff had bilateral traumatic impingement of both shoulders, apparently consistent with the observations of pain sites that were diagrammatically recorded in the ambulance report. The jarring injuries recorded by Dr Pierides could also possibly explain the plaintiff's shoulder injuries. 722Whilst there was some subsequent confusion in the medical evidence as to whether the plaintiff had a left or a right shoulder problem, I consider that confusion, even the plaintiff's own confusion on the matter as to whether her right shoulder was mistakenly investigated, to be of diminished importance given the pain diagram in the ambulance records, by which I consider that it was confirmed the plaintiff had injuries to both of her shoulders in the events of the accident.

Injury to the chest and abdomen 723I find that the plaintiff suffered a seatbelt injury to her chest and abdomen in the accident. This is consistent with the plaintiff's evidence that she was wearing a seatbelt at the time of the collision. This was confirmed by the ambulance report and that history is repeated in the hospital notes. 724In my view, the plaintiff's claim of having sustained a seatbelt injury is confirmed by the ambulance record which notes the plaintiff had chest pain, tenderness over the rib cage and abdominal pain, as well as by the hospital notes which record a history of the plaintiff having worn a seatbelt and tenderness in the sternum, with chest pain. It was undoubtedly because of these matters that radiological investigations were ordered for the plaintiff's chest and abdomen whilst she was in hospital: Exhibit "6", Tab 7, pages 20, 27, 28, 29 and 30. 725Furthermore, the mechanism of a seatbelt injury appears to be consistent with the explanation given by Dr Faithfull in his oral evidence. That explanation does not seem to be inherently unlikely or improbable, especially given the opinion of Dr Pierides to the effect that the plaintiff received jarring injuries to multiple areas of her body.

Injury to the pelvis 726The hospital clinical notes record the plaintiff's pelvis as having been noted to be "OK". Nevertheless, the plaintiff's pelvis was x-rayed whilst she was in hospital, Exhibit "6", page 42. Furthermore, the pain diagram in the ambulance report indicates that the plaintiff made a pain response on examination in the approximate region of the lower pelvis. I infer from these matters that the plaintiff suffered an injury to her pelvis in the accident.

Injury to the left knee 727The plaintiff stated that she hit her left knee on the dashboard in the collision. That evidence was not of itself inherently improbable. A handwritten entry in the hospital notes, which was made at 2.00am on 2 November 2006, records that the plaintiff had a graze rash over her right knee but no bony tenderness was found to have been present: Exhibit "6", Tab 7, page 31. 728The bases upon which the defendant challenged the plaintiff's claim of having sustained an injury to her left knee was first, that the plaintiff simply could not be accepted as to her complaint of having injured that knee in the accident, secondly, there is no contemporaneous evidence providing confirmation of the plaintiff's claim of injury to the left knee, and thirdly, the plaintiff's claim of left knee injury should be rejected as a late complaint without any nexus to the accident in question, having regard to preferred medical opinions. 729As to the first factor, I do not accept that the plaintiff's evidence should be rejected outright as to the circumstances of her injuries. The fact that the plaintiff's credit has been found wanting on some peripheral matters does not in my view mandate a blanket rejection of her evidence, and I decline to accept the defendant's submission to that effect. 730As to the second factor, I do not accept that the plaintiff's credit has been damaged to the extent that her evidence claiming she sustained a left knee injury requires corroboration before it could be accepted. I take this view because the damage to her credit was in relation to peripheral matters and there were other injuries recorded. It is quite feasible, and not improbable, that the plaintiff could have injured her knee in the events of the collisions, and her evidence to that effect is not inherently improbable. 731As to the third factor, the fact that the plaintiff made a late complaint of injury to her left knee does not necessarily, without more, require that her claim of left knee injury be rejected. I consider this to be so for a number of reasons. 732First, as I have already identified, there is a documented note of an injury consisting of a graze to the plaintiff's right knee in the hospital records. That suggests that the accident could possibly have also caused a left knee injury that did not necessarily show any outward signs of injury at the time or in the ensuing hours or days following the accident. Alternatively, it may indicate that any injury to the left knee was not significant, or sufficient to cause damage, or not sufficiently significant to be noted, as was explained by the general observations of Dr Faithfull on the priorities of initial trauma assessment. 733Secondly, whilst the plaintiff was in hospital, it was likely that she was less mobile than might have otherwise been the case, and an injury to her left knee may not necessarily have been detected at that early stage. In this regard, the entry in the hospital nursing notes at 20:25 hours, indicates that the plaintiff complained to hospital staff that she still had pain "everywhere": Exhibit "6", Tab 7, page 36. Later, at 22:00 hours, on the same page, the hospital notes record that the plaintiff "continued to feel generalised discomfort all over". This could well have included left knee problems which were not specifically recorded by hospital staff because the plaintiff's other complaints were more pressing: T163.30. 734Thirdly, the plaintiff said that notwithstanding that Dr Rahman's report and notes do not refer to a left knee injury in the early days of consultation and treatment, she had in fact told Dr Rahman that she had injured her left knee in the accident, but she could not recall precisely when she had told him that she was experiencing a problem with her left knee. 735The plaintiff's explanation for the late complaint of pain in her left knee was that she experienced pain "all over" after the accident, but explained that her left knee pain got worse. She said that when she started to walk, it "slowly, slowly, slowly" started to get worse: T94.6 - T94.11. 736The plaintiff also stated that she did not complain to Dr Rahman about her knee pain until "later on" when it worsened, but she was not specific as to when this had occurred: T94.20. She explained that when she saw Dr Maniam for her accident related problems about a month after the accident she did not mention the knee pain to him at that time, explaining it was not her worst pain at that time: T95.2. She reiterated that after a while, she started to complain of left knee pain when it got worse: T95.19. That evidence was not inherently improbable given that there was no description of outward signs of injury to the left knee following the accident. 737The plaintiff denied that she had not complained of knee pain before early 2008, and said she had complained of it earlier but could not recall the dates. In that regard she agreed that it was not until January 2008 that she was referred for investigations of her left knee problems: T96.10 - T96.25. 738It is relevant to observe that on 22 February 2007, a little over 3 months post-accident, Dr Maniam examined both of the plaintiff's knees and found no abnormality in them, as was indicated by him entering a tick symbol in his notes to that effect on that day: Exhibit "6", Tab 10, page 79. 739In determining whether the plaintiff's left knee problems were accident related I have had regard to the oral evidence of Dr Faithfull, which I found to be persuasive. 740Dr Faithfull agreed that if injured in the manner claimed by the plaintiff, the plaintiff's left knee would have been expected to have been bruised or to have shown some outward sign of injury (T465.5 - T465.16), and would be expected to have been the subject of a reported problem within say 12 months of the injury (T465.48 - T466.37). 741In fairness to the plaintiff, Dr Faithfull acknowledged that immediate reporting of knee symptoms was not an essential prerequisite for connecting the problems to the accident during or shortly after hospitalisation, as such problems are sometimes later recognised after the patient starts walking around: T460.50. 742However, whilst Dr Faithfull considered that it was possible that a complaint of knee pain may not be made immediately after leaving hospital, he expected it would have been made within the ensuing days depending on whether the plaintiff was up and walking around: T464.6; T464.35 - T464.40; T464.45, Dr Faithfull also agreed that bruising would be evident not long after a knee injury, and this would be expected to be reported to a general practitioner within days following its emergence: T465.1 - T465.16. Furthermore, given the range of the plaintiff's other reported complaints, if there was bruising to her left knee following the accident, I consider that it would have been unlikely that she would have refrained from drawing this to the attention of her doctors. 743It is because of the evidence of Dr Faithfull as summarised above that I do not accept the plaintiff's evidence that she has ongoing left knee ligament problems due to the effects of the accident. 744The notes of Dr Rahman make no mention of any complaint by the plaintiff of left knee problems in the period from the first consultation with him on 5 November 2006, to 11 January 2008, which was the date on which Dr Rahman referred the plaintiff for an ultrasound for her left knee due to a complaint of pain behind that knee: Exhibit "6", Tab 9, page 64. 745Although the plaintiff saw Dr Maniam on 1 December 2006, it was not until November 2007 that the plaintiff complained of lower limb problems which Dr Maniam noted as "sore legs": Exhibit "6", Tab 10, page 80. 746It was not until January 2008, some 15 months after the accident, that the first complaint of knee problems was recorded in the notes of Dr Maniam, where he wrote that the plaintiff's left knee problems were worse than the right knee. 747It is also noteworthy that on 22 June 2007, when the plaintiff saw Dr Pierides, he made no notes of any complaints of problems in either knee: Dr Pierides, report dated 22 June 2007. 748In my view, if the plaintiff had evolving problems in her left knee before then as she claimed, she would have complained of such problems much earlier, as she did with all of her other problems. For this reason I consider that based upon the evidence of Dr Faithfull, her late complaint of left knee problems indicates some other non-accident related cause. Whilst the evidence does not reasonably permit another cause for the left knee problems to be identified, the state of the evidence and the time gap between the accident and the record of complaint of left knee problems does not persuade me those problems are related to the accident in question. 749Dr Faithfull explained that the normal protocol for investigating a knee injury would be to order, in sequence, a plain x-ray, followed by an ultrasound, followed by an MRI scan: T467.46 - T468.12. 750In this case the sequence of events for the imaging scans of the left knee was as follows: (a)Ultrasound - 22 January 2008: Exhibit "4"; (b)MRI scan - 7 February 2008: Exhibit "8"; 751Dr Faithfull's interpretation of the MRI scan of the plaintiff's left knee on 1 February 2008 was that it showed old rather than new trauma: T468.19. He explained that in this context, "old" meant more than just several months: T468.26. He explained that a new injury tends to show oedema and inflammation whereas a sprain, or a new injury, means unhealed tearing would be seen: T468.16 - T468.22. 752Dr Faithfull confirmed that his reading of the MRI scans dated 7 February 2008 indicated the left knee injury shown on those scans was consistent with the timing of the accident in that the injury shown on those scans was not new or recent: T468.37. However, in my view, standing in the path of acceptance of the accident being a cause of the pathology shown on the MRI scans is a complete absence of early complaint of injury or signs of injury such as bruising:T465.1 - T465.16. 753Dr Faithfull confirmed that on an MRI scan, a recent injury would be expected to show some inflammation: T469.10. The inflammation referred to in the ultrasound scan report dated 22 January 2008 would seem to suggest a more recent cause of the plaintiff's left knee problems than the accident in question. Dr Faithfull agreed that the 22 January 2008 (Exhibit "4") ultrasound report indicated a more recent injury because of the reference to inflammation: T469.48 - T470.37. 754I therefore conclude that whilst the plaintiff may have injured her left knee on the dashboard in the accident as claimed, the evidence does not reasonably permit a finding that the plaintiff's left knee disabilities are accident related.

Injury to the right knee comprising a graze 755I have already identified the fact that the hospital notes recorded that the plaintiff had sustained a graze to her right knee: Exhibit "6", Tab 7, page 31. In my view this confirms the plaintiff had suffered a grazing injury to her right knee in the accident. The absence of a record of that injury in the ambulance report is in my view indicative of the process identified by Dr Faithfull, in which he stated that the detail of such injuries could get "lost" in the processing of the patient. 756I now turn to a consideration of the disabilities suffered by the plaintiff in the accident.

Issue 4 - Disabilities that continue to affect the plaintiff 757The plaintiff claims disabilities of both a physical and a psychological nature. The defendant has submitted that the plaintiff's claim for accident related disability should be rejected entirely on the ground that her credit has been overwhelmingly impugned. I have already set out my reasons for rejecting the defendant's submission in that regard in connection with my findings as to the plaintiff's credit: Issue 1. 758As my findings on disability follow my consideration of the medical evidence, it is therefore necessary that I identify the bases upon which I have reached my conclusions concerning the medical opinions that I have preferred within the array of medical opinions that were tendered by the parties. 759Since the plaintiff's psychological problems are claimed to have followed from the physical problems caused by the accident, and since these two elements are intertwined, it is convenient to commence the analysis of the medical evidence on the plaintiff's claimed disabilities of a physical nature. In my view, this is an essential preliminary consideration before assessing the psychological component of her disabilities, and before assessing the combined interaction of the two respective components because it is somewhat artificial to simply view the two strands of expert opinion within the physical and psychiatric specialties in isolation from each other.

Physical disabilities 760There is a distinct polarisation of views within the array of the expert medical opinions of the orthopaedic surgeons and the occupational physicians on whether the plaintiff continues to suffer from any ongoing physical disabilities, and if so, the nature and extent of those disabilities. The opinions relied upon by the defendant concerning the plaintiff's physical complaints comprise those by Dr Pierides, Dr Marsh and Professor Harris. In contrast, the opinions relied upon by the plaintiff in connection with physical disabilities comprise, Dr Maniam, Dr Mahony, Dr Davis, Dr Matalani and Dr Faithfull. 761For convenience, my analysis of the reports dealing with the plaintiff's physical disabilities commences with a consideration of those reports that are critical of a causal nexus between the accident and the plaintiff's claim of disabilities, in order to evaluate the reasoned basis for those criticisms. I took this approach because my first consideration of the medical evidence, on matters of a physical nature, tendered by the plaintiff indicated that the opinions expressed as being supportive of the case the plaintiff sought to make were in themselves reasonable, if the plaintiff's historical account of her disabilities is accepted. I shall return to that matter after considering the reports critical of the plaintiff's case. Reports of Dr Pierides 762The first report of Dr Pierides, which was dated 22 June 2007, discounted any "ongoing injury" in the plaintiff, and spoke of the consultation on that occasion being marred by the plaintiff's "pain behaviours". Dr Pierides also considered there was a "significant degree of embellishment" in the plaintiff's presentation. Dr Pierides considered that any post-accident condition suffered by the plaintiff would have resolved by the time 8 months had elapsed from the time of the injury, which was the approximate time of his examination. His report did not contain detailed reasoning for that view. 763In his second report, which was dated 12 December 2008, Dr Pierides stated that he did not believe the plaintiff had any ongoing physical injury. At that time he was of the view that any ongoing effects from the jarring in the accident would have continued for some 8-12 weeks. In my view there was no cogent reasoned explanation forthcoming from Dr Pierides to explain the basis of that view, especially since he did not identify the baseline of what he understood the injuries to have been. 764In his third report, which was dated 26 March 2010, Dr Pierides reiterated his earlier views, and considered that the plaintiff's presentation at the third interview was contrived. In his fourth report, which was dated 4 February 2011, Dr Pierides again referred to the plaintiff's pain behaviours, and he reiterated his earlier view that resolution of the plaintiff's symptoms would have been expected to have occurred within 12 weeks after the accident. 765I found these reports by Dr Pierides unpersuasive for a number of reasons. 766First, Dr Pierides did not record an actual historical account of the plaintiff's injuries. As a result, there was no discernable stated baseline within his report from which to adequately assess the foundations for his opinions by reference to a history of injury. In that regard, I consider that the reports of Dr Pierides do not adequately state the reasons for his views, as is required by Schedule 7, clause 5(c) of the Expert Witness Code. 767Secondly, as indicated at paragraph [154] of my reasons, it appears that there is uncertainty over what materials Dr Pierides was given in order to assist him in arriving at the formulation of his opinions and the basis of his reasoning is not adequately explained according to the requirements of UCPR Sch 7 cl 5(c). In my view, that is a matter that creates an unresolved doubt as to the basis of the reports and opinions of Dr Pierides. 768Thirdly, Dr Pierides referred to his examination of the plaintiff as having been marred by the plaintiff's pain behaviours, and what he described as embellishment, feeble efforts at complying with the examination process, and self-limitation. He expressed those views without any apparent consideration of any psychological factors that may possibly have contributed to those observations or opinions. That approach seemed to me to be an unusually restrictive one for an occupational physician to take, given the psychological factors identified by other experts. Report of Dr Marsh 769The MAS report of Dr Marsh dated 29 May 2008 referred to the plaintiff exhibiting considerable exaggerated pain behaviours and indicating some inconsistencies with some previous assessments. 770I found the report of Dr Marsh generally unpersuasive because, like Dr Pierides, whilst his report contained criticisms of the plaintiff's presentation as outlined above, his reasoning did not include any discussion of psychological factors that may have contributed to that presentation. Furthermore, Dr Marsh clearly had regard to other matters which were not the subject of evidence, and this has made his report partially but significantly opaque to analysis. Since Dr Marsh was only asked to apply his consideration to the physical matters as a MAS Assessor, his omission to include a discussion on any operative psychological factors in his evaluation of the plaintiff was perhaps less significant than in the case of the opinions of Dr Pierides, notwithstanding that these two experts are of like specialty. Reports of Professor Harris 771The first report of Professor Harris, which was dated 11 December 2008, indicated the plaintiff's complaints could not be explained by her injury on 1 November 2006. He further stated that he had assumed the plaintiff's injuries from that accident would have healed within several weeks or months from the accident. The basis for that opinion was not explained in that first report. 772In his second report, which was dated 25 March 2009, Professor Harris expressed the view that there was no temporal connection between the plaintiff's injury and the symptoms of disability of which she complained. In making that observation, he noted the plaintiff was depressed and anxious. In his third report, which was dated 24 February 2011, Professor Harris reiterated his view that there was no link between the plaintiff's current physical complaints and the accident on 1 November 2006. That opinion was expressed in general terms, and did not include any differentiated discussion of any particular complaints made by the plaintiff. 773Professor Harris' comment in his 11 December 2008 report to the effect that the plaintiff's symptoms cannot be explained by the injury of November 2006 is based on the proposition that any soft tissue injuries the plaintiff might have had would have healed within some weeks or months after the accident. Insofar as the plaintiff's neck symptoms are concerned, or more properly, the plaintiff's symptoms of radiation in the little and ring fingers, Professor Harris did not discuss that subject along the lines that are apparent within the opinion of Dr Faithfull, to the effect that the plaintiff's symptoms in that regard have not been fully investigated. In his second report (Exhibit "3" page 38) Professor Harris noted he did not have the benefit of any investigation results since issuing his first report. In his third report, Professor Harris referred without comment to those symptoms of the plaintiff that Dr Faithfull had referred to as indicating further investigation was required: Exhibit "3", page 42. This was not a matter that was followed up by either party. Evaluation of reports of Drs Maniam, Mahony, Davis, Matalani and Faithfull 774Dr Maniam's assessment and treatment records concerning the plaintiff extended over the period 1 December 2006 to January 2008. He made the observation that the plaintiff's neck, lumbar spine and left shoulder symptoms were still evident when he saw the plaintiff in April 2007, which was in a period beyond the time range of what Dr Pierides and Professor Harris had estimated for a resolution of the plaintiff's symptoms. 775Dr Mahony's assessment of the plaintiff in December 2007, which was also beyond the time range that had been suggested by Dr Pierides and Professor Harris for resolution of the plaintiff's symptoms, was that her complaints of neck, shoulder, back and chest symptoms, and the radiated abnormal sensations in the limbs, were consistent with the injuries the plaintiff had reported as having sustained to those areas in the accident. 776Dr Davis' assessment of the plaintiff in March 2008 was that the plaintiff had incurred a chronic soft tissue injury to her cervical and lumbar spines, a tendon injury to the left shoulder and trauma to the left knee. He also identified some psychological problems, which led to him describing an adjustment disorder affecting the plaintiff. The opinion of Dr Davis on the plaintiff's left knee problems must be read in the light of my findings that the plaintiff's claim of problems following injury to her left knee was not accident related. 777Dr Matalani's assessment of the plaintiff, dated 12 March 2009, was that the plaintiff suffered from shoulder impingement problems together with neck, thoracic and lumbar problems due to soft tissue strains from the accident. He associated the plaintiff's complaint of radiated discomfort in the upper and lower limbs to the spinal injuries the plaintiff had sustained in the accident. He identified a chronic pain syndrome with a guarded long-term prognosis. Dr Matalani also identified the prognosis of the plaintiff to be guarded. In my view, that guarded prognosis must also be read as applying to the unrelated left knee problems. 778In his report, Dr Faithfull associated the plaintiff's neck, left shoulder, thoracic and lumbar, and left knee problems with the accident. However, the oral evidence of Dr Faithfull made it clear that the plaintiff's left knee problems were unlikely to have been associated with the accident and I have made a finding to that effect as set out in my reasons regarding Issue 3. 779Having reviewed the array of medical evidence and factual evidence concerning the plaintiff's ongoing disabilities, I now turn to state my reasons for preferring particular portions of the medical evidence over others. Preferred opinions concerning plaintiff's physical disabilities 780In analysing the medical evidence, I have concluded that of the expert opinions that deal with the plaintiff's claims of ongoing physical disabilities, I have generally preferred the opinions of Dr Faithfull, Dr Maniam, Dr Mahony, Dr Davis and Dr Matalani to those of Dr Pierides, Dr Marsh and Professor Harris. 781I have found the oral evidence of Dr Faithfull to be very helpful in clarifying the likelihood of the plaintiff's left knee problems being related to the accident. In all other respects, I also considered that in his reports and in his oral evidence, Dr Faithfull gave clear and cogent evidence on the nature and cause of the plaintiff's other complaints. I considered that I could comfortably rely upon Dr Faithfull's opinions and his explanations as to the likely cause of the plaintiff's ongoing problems as they related to the accident, and in particular, his opinion that the plaintiff's ongoing cervical spine and related radiated complaints in her little and ring fingers had been inadequately investigated. 782I found Dr Faithfull's evidence was also consistent with the opinion of the treating orthopaedic specialist, Dr Maniam, whose opinions I have accepted, noting that there is a broad similarity between his early opinion and the early opinion of Dr Mahony, whose opinion I also accept. 783I have generally accepted the opinions of Dr Matalani (other than where he attributed the plaintiff's left knee complaints to the accident) because his view that the plaintiff suffered a soft tissue injury with chronic musculo-ligamentous strain of the neck and low back is supported by the reasoned opinions of Dr Davis and Dr Faithfull. He has also identified the plaintiff's radicular complaints in her left arm, and also identified the plaintiff's left shoulder tendonitis and bursitis with impingement, consistent with other medical opinion. I consider that Dr Matalani's evidence should be accepted. I have had the advantage of hearing his views when his evidence was tested by cross-examination. He made concessions where appropriate. His explanations were balanced and cogent. He rationally explained his views and I considered his evidence should be accepted as being more probably than not correct. 784I have put to one side any matters arising from the plaintiff's left knee complaints, as I have found those complaints to be unrelated to the accident. I have observed that the bulk of the defendant's cross-examination of Dr Matalani was taken up with discussion of the plaintiff's left knee problems. 785The matters set out in Dr Matalani's report concerning the plaintiff's cervical and lumbar spine complaints, and her left shoulder problems, were not relevantly traduced in the cross-examination of Dr Matalani. In that regard, Dr Matalani stated that his assessment was based not just on the reported symptoms, but by also looking at the presenting picture as a whole, including the results of investigations. He explained that simply because there was no pathology in the plaintiff's spine, it did not necessarily mean the plaintiff has no symptoms in that area: T516.3. I consider Dr Matalani's evidence on these matters was balanced, fair, considered, and appropriately reasoned. I therefore accept that evidence. 786I have also accepted the opinions of Dr Davis (except as to the attributability of the plaintiff's left knee problems to the accident) because rather than just refer to generalities as to the nature of the plaintiff's soft tissue injuries, he has provided a cogent explanation for the plaintiff's symptoms being due to those injuries, whereas such an explanation was absent in the reports relied upon by the defendant. Dr Davis explained that the plaintiff suffered a traumatic injury to the upper and lower facet joints of the cervical and lumbar spine, and that this has gone on to develop chronic soft tissue problems to the joint capsules, as well as injury to the joint capsules, in addition to tendonitis of the left shoulder. He described such injuries as being consistent with the history, and I accept that opinion, which was unchallenged. 787In contrast, I find myself unable to accept the opinions of Dr Pierides, Dr Marsh and Professor Harris. 788I found that the opinions of Dr Pierides were unduly dismissive of the plaintiff's complaints, and the reasoning for his views lacked a firm foundation in the form of a recorded history of the precise nature of the injuries sustained by the plaintiff in the accident. I consider that his subsequent opinions therefore lacked sufficient reasoned foundation for acceptance. 789Furthermore, whilst Dr Pierides referred to the plaintiff's "pain behaviours", and "contrived" presentation as an obvious reference to psychological issues, he did not engage in an analysis of such factors by reference to the accident and the effects of the accident on the plaintiff as a whole, and I therefore considered his report lacked a balanced discussion on the inter-relationship of such factors. This was in contrast to Dr Davis, who referred to psychological issues, and whose opinion I have therefore preferred to that of Dr Pierides for that reason as it presented a more balanced discussion of the matters the plaintiff complained of as having affected her as a whole. 790I found that the opinions of Dr Pierides and Professor Harris to the effect that the plaintiff's post-accident soft tissue symptoms should have settled or resolved within weeks or months of the accident did not take into account the matter raised by Dr Faithfull, where he explained that he considered that the plaintiff's symptoms in her little and ring fingers had been inadequately investigated, which from the context, was an obvious reference to radiated symptoms from the neck. For that reason I considered the opinion of Dr Faithfull should be preferred to those of Professor Harris and Dr Pierides. 791Furthermore, the opinions of Professor Harris were generally undifferentiated as to which particular symptoms he was referring to in his rejection of a nexus between the plaintiff's complaints and the effects of the accident. In contrast, Dr Faithfull was taken to particular aspects of the plaintiff's claimed disabilities, and I therefore considered that his answers were grounded in particularity, which was not present in the reports of Professor Harris. 792Notwithstanding my general view of the opinion of Dr Marsh as outlined at paragraphs [769] - [770] above, I have accepted his opinion that the plaintiff's left knee problem was not caused by the accident in question, as explained at paragraphs [727] - [754] above. 793I have not referred to the opinions of the occupational therapists on matters of diagnosis of physical disability as I have regarded that to be a matter for medical diagnosis. I will refer to those occupational therapy opinions in connection with the claim for domestic assistance. 794The above conclusions that I have stated in connection with the preferred opinions on matters concerning the plaintiff's ongoing physical disabilities have guided me to my conclusions and findings on the nature and extent of the plaintiff's ongoing physical problems. I will identify those findings after I have given a similar consideration to the expert psychiatric evidence, as it is plain that the plaintiff's physical disabilities cannot be viewed in isolation because they are to a degree influenced by her psychological condition.

Psychological disabilities 795Before identifying my findings on the nature of the plaintiff's psychological disabilities, it is necessary that I state my reasons for preferring one body of expert psychiatric opinion to the opposing opinion as to the plaintiff's psychiatric diagnosis and related matters. 796There was a polarisation of views amongst the expert psychiatrists. Whilst all the psychiatrists agreed that the plaintiff had a psychological illness, with the exception of Dr Haik, they all agreed that the plaintiff suffered from accident related PTSD with associated depression. 797Dr Haik considered the plaintiff's psychological illness was not accident-related, but was instead due to her pre-existing circumstances, and "the hardships" of her life. He also considered the plaintiff was mendacious and motivated by secondary gain, or a quest for compensation. 798I have already outlined the basis upon which Dr Haik considered that the plaintiff was mendacious and should not be believed because of what he described as inconsistencies in her history, background and presentation. For the reasons that I have already identified in connection with topic (23) of my credit findings concerning Issue 1 at paragraphs [655] to [678] above, I do not accept Dr Haik's characterisation of the plaintiff as mendacious, or motivated by secondary gain, as was asserted by Dr Haik. I have already identified significant problems with the reasoning that Dr Haik employed in order to seek to support the conclusions he had advanced in that regard. 799It seemed to me that Dr Haik placed great emphasis upon a sterile analysis of history gathered from various sources and less emphasis on matters discussed and explored in psychiatric consultation with the plaintiff. 800A prime example of this process was Dr Haik's recourse to modes of analysis that pointed to what he considered to be historical inconsistencies, yet he appeared to have made little or no effort to seek to reconcile such inconsistencies. 801In that regard, Dr Haik has relied upon his own understanding in 2009, acquired after he saw the plaintiff in consultation and before he wrote his first report, of the prevailing circumstances concerning the remote in time civil war in Lebanon in the 1990's, and the cultural practices amongst the Christian religions in Lebanon concerning teenage marriage, in order to declare the plaintiff to be an unreliable historian in respect of such matters. 802It is plain that Dr Haik took that approach without, in fairness, first providing the plaintiff with the opportunity to comment on his contrary views based on matters he had assumed and researched without reference to her. That process has led Dr Haik unfairly putting forward criticisms of the veracity of the plaintiff. 803When questioned as to why he had not provided the plaintiff with an opportunity on the several subsequent occasions on which he saw her, Dr Haik gave what I considered to be an entirely spurious response, namely, that he had assumed the plaintiff would dissemble on such matters so that there was no point asking her for a comment on these matters of concern to him. In the circumstances, I consider that was a necessarily restrictive approach to the assessment task before him. In my view, that aspect of Dr Haik's approach has rendered his opinions in this case to be of significantly diminished weight, and of no probative value. 804I take that view because of explanations that came from Dr Akkerman and Dr Ali in the concurrent expert evidence session. In contrast to Dr Haik, Dr Akkerman considered, with what appeared to me to be a good deal of commonsense, that the factor of clinical acumen was an important part of the armamentarium of psychiatric assessment. In that regard, although he fairly considered the possibility that he might be wrong in this particular case, he considered that it was unlikely that the plaintiff would have had the level of sophistication to consistently be able to fool four experienced psychiatrists: T588.49. 805I do not accept Dr Haik's characterisation of the plaintiff's history, in which he appears to have rejected the value of the clinical assessment process, describing the plaintiff's presentation as being stereotyped, or video-like. Dr Haik was the only psychiatrist who took that view, and I consider that the preponderance of psychiatric opinion militates against the operation of such a factor. 806Furthermore, I also considered that Dr Ali's role as the plaintiff's treating psychiatrist who had seen the plaintiff in clinical consultation for regular treatment over a period of about 12 months, and the resultant views he has formulated from that process, to be of great weight in providing appropriate insight in determining the nature and cause of the plaintiff's psychological problems. I considered Dr Ali's clinical advantage in reaching his psychiatric diagnosis of the plaintiff's condition over time during the course of his treatment of her, to be of great weight, and a factor that greatly outweighed Dr Haik's more sceptically based views. 807Following my review of the expert psychiatric evidence I have concluded that I am unable to accept Dr Haik's opinions as to the nature or cause of the plaintiff's psychological problems. There are multiple bases upon which I have arrived at that view, both individually, and in combination with one another. Furthermore, for the reasons that follow, I do not consider Dr Haik's analysis to be either reasonable or appropriate to the described circumstances of the plaintiff. 808One such basis is that Dr Haik's opinions are not well supported by rational argument, but rather, significant aspects of them are founded upon hyperbole, sweeping statements involving adjectival extremes of description and unsupported speculation, as the following extract demonstrates, when clarification was sought of an aspect of his opinion that was critical of the plaintiff, at T559.20 - T560.8: "CRANITCH: Nothing further, your Honour. HIS HONOUR: Before you re-examine, Mr Fitzsimmons, I might just direct one question to Dr Haik. Dr Haik, I'm looking at your report of 9 February 2009 at page 10. Do you have it in front of you? About point 4 the way down the page you say this, "Her appetite for a significant reparation for the series of adversities to which she has been exposed prior to the collision would reasonably explain her obdurate and nonsensical symptoms, both physical and emotional." Would you care to elaborate on what you regarded as her obdurate and nonsensical symptoms? WITNESS HAIK: By "obdurate", I endeavoured to communicate the notion that she has - Ms Khalil has continued to make the point that she has unrelenting pain that has not been relieved by any treatments and, secondly, from what I gather, there is no medical investigation that has been able to support evidence for her having a defect that would cause the pains that she has and, secondly, she has said that she has - her life has been ruined as a result of this accident, which I understand was not a severe one. There was no explosion. There was no fire. There was no damage to her that required surgery or anything like that and, despite that, she said her whole life is ruined. She sits in her room. She never goes out, never does anything, never like has any housework, can't do anything like she used to prior to the accident. So I use the word "nonsensical" when it doesn't make sense that, despite the fact that she has got all these physical complaints that can't be supported by medical investigations and that other specialist doctors have said she should be better by now, there is no reason to believe that she has got an ongoing disability. I concluded, therefore, that as a result of those things, she has gilded the lily in an attempt to find reparation for a very hard life and I understand that. She is seeking to find reparation for a very hard life, but it's not a result of the accident because of the physical findings being unable to support her symptoms and because, in my opinion, she didn't have the ESD (sic for PTSD) by virtue of the nature of the causal stressor of the accident and the fact she - those stereotypic memories and the fact she was able to drive in a car and in fact own two cars of her own." 809The cited critical comments advanced by Dr Haik were based upon speculative assumptions. Insofar as his opinion was stated to have been based upon the assumption that the accident was "not a severe one" that view is not borne out by the COPS report. I do not regard a collision at a stated speed of 35kph to be a minor one. The COPS report described the collision as being a major traffic crash: Exhibit "6", Tab 1, page 3. Dr Haik's diminished characterisation of the collision as "not severe" is therefore difficult to either understand or accept. Even if I am wrong in taking that view, I consider that Dr Haik's analysis and opinions fail to consider the psychological effect which the accident and its immediate aftermath had on the plaintiff. 810The above extract of Dr Haik's evidence seems to me to involve a misdirected consideration of the nature of the plaintiff's injuries. Dr Haik seems to have focussed upon medical conclusions based upon investigations to the effect that there was no evidence that the plaintiff had a diagnosed defect that would cause her pain. In my view, he has thereby misdirected his consideration to the question of whether there was a defect, instead of considering the possible ongoing effects of a musculo-ligamentous soft tissue injury in the plaintiff, and for which it would not be expected that there would be evidence of a defect. 811Furthermore, Dr Haik's references to the plaintiff's life being "ruined" seems to me to call for him to engage with the plaintiff's psychological processes, and the context in which the plaintiff made such a statement. He did not undertake that task, and instead, he has simply reiterated a pejorative commentary critical of the plaintiff's veracity and probity. 812In addition, it seems to me that in proffering the view that the plaintiff was "gilding the lily in an attempt to find reparation", Dr Haik has not pursued a pathway of reasoned analysis, but has instead assumed the mantle of an advocate. 813At times, Dr Haik's critical commentary invoked anecdotal matters and hyperbole in addition to critical adjectival emphasis, rather than reasoned argument, for example, as appears at T586.1 - T586.9: "WITNESS HAIK: Your Honour, given what she's told me and from what I gather she's told others she is so disabled there's no way in the world that she could have found the motivation to do it. I've seen patients for 40 years and they don't go out and do stuff like that if they're down in the dumps as long and as deeply as she claims she has been. I understand what you're saying but it's extremely improbable that she would go out under those circumstances. Maybe once, as Dr Akkerman says, but not regularly or more than once, in my opinion." 814In my assessment the above passage extracted from the evidence of Dr Haik, with his use of extreme descriptions in his criticisms, without allowing for the possibility of an interpretation of events less critical of the plaintiff, gave me the impression that Dr Haik had adopted a position of advocacy rather than just proffering a balanced expert opinion. 815A further example of Dr Haik's resort to hyperbole appears at T592.48 - T593.7: "FITZSIMMONS: Dr Haik, in terms of assessing impairment, are you essentially reliant on what you're told? WITNESS HAIK: I'm reliant on what she told me when comparing that to the inconsistencies that I keep going on about. I am concerned that you can't rely upon what she has told me compared to what seems to be a momentum of alternate truths. And therefore, I became very concerned when I heard that - her huge disability could not be supported in many ways because of those inconsistencies. And when you say that she's been driving a lot, I can only assume that she was driving because she had two cars there. But when I'm told that she was driving a lot or being a driven a lot, it supports the notion that I've been going on about. That there are - there is considerable verbosity." 816I did not understand Dr Haik's commentary of "huge disability" as cited above to be anything more than him invoking hyperbole in order to seek to discredit the plaintiff. His comment did not amount to a reasoned rebuttal of an alternative psychiatric diagnosis against which he was arguing. To the extent that his comments are a criticism of the credit of the plaintiff, they do not coincide with my own assessment, as I have outlined in my detailed reasons for decision in connection with Issue 1. 817Dr Haik's arguments drew upon matters that were outside of his field of expertise concerning an evaluation of the plaintiff's physical complaints regarding her left shoulder and her spinal complaints, as the following extract at T560.18 - T 560.23 demonstrates: "WITNESS HAIK: I have written - noted in paragraph 3 reports that there should have been, for example, evidence of damage to her left shoulder, but there wasn't according to the MRI. She was understood to have spinal complaints but Dr Maniam has referred to the fact that MRIs of the cervical, thoracic and lumbar spines reveal no physical abnormality. Dr Robinson(?) (sic) found MRI of the - the cervical spine to show no abnormality." 818Dr Haik was not qualified to speak on matters of MRI diagnosis. In my view, his commentary in the passage I have cited amounted to advocacy rather than expert psychiatric opinion. Furthermore, there seems to be a false premise in Dr Haik's reasoning within the passage I have cited, namely, his statement that the MRI scans of the plaintiff's cervical, thoracic and lumbar spines have revealed no significant physical abnormality. When regard is had to the MRI scans taken of the plaintiff's cervical and lumbo-sacral spines on 13 August 2007, it is plain that Dr Haik's cited comment is not an accurate rendition of the report of those scans because the report refers to the presence of a slight degree of posterior bulging of the discs at the levels T10/11 and T11/12 which has caused indentations upon the anterior aspect of the thecal sac: Exhibit "C" page 144. Furthermore, the imaging of the plaintiff's spine taken on 7 November 2006, probably a plain x-ray, was reported as showing that there were small osteophytes at the end plate margin of L3/4 consistent with mild disc degenerative disease, and end plate irregularity shown on the inferior aspects of T13 and L1: Exhibit "C" page 249. It would appear those degenerative changes pre-dated the accident, which raises the spectre of an aggravation type injury, which Dr Haik did not consider as a possibility. The same comment arises in respect of Dr Mahony's comment that the cervical spine imaging shows slight narrowing of the intervertebral foramina at the levels C2/3 and C3/4, and signs of a disc bulge at C6/7. 819It is surprising that Dr Haik made the observation he did about the MRI scans because the first page of his report dated 9 February 2009 refers to him having a copy of the MRI scan report dated 13 August 2007 which comprises Exhibit "C", page 144, and which I have summarised above. I can only conclude from such circumstances that either Dr Haik has inaccurately represented the MRI scans taken on that date, or has expressed an opinion outwith the confines of his expertise. 820Furthermore, Dr Haik appears to have undertaken a limited analysis which included matters outside of his expertise by dwelling on matters of physical damage without apparently considering the psychological implications of the injuries upon the plaintiff, as is evident from the following extract from his evidence at T560.34 - T560.41: "WITNESS HAIK: The MRI won't show musculoligamentous damage, for example. But time invariably, particularly in young people, heals those wounds, heals those injuries. And that's why I presume Dr Parides (sic) and other doctors have said that they can't find an abnormality because presumably after some months those musculoligamentous injuries may have healed or should have healed. So, yes, the MRI won't show those sorts of soft tissue injuries, but generally they get better particularly in young people, and she's relatively young." 821Dr Haik's general statement to the effect that time invariably heals "those wounds" particularly in young people, appears to wrongly assume the nature of the plaintiff's injuries. There were no relevant "wounds". Even allowing for Dr Haik's loose use of the word "wounds" to refer to musculo-ligamentous soft tissue injuries, he made no attempt to reconcile his views with the opinions to the effect of chronic nature of the plaintiff's complaints in terms of possible long term sequelae of soft tissue injuries. 822Accepting that such an analysis may well have been outside Dr Haik's field of expertise, the analysis he has adopted was necessarily not a balanced one. This appears to me to be particularly so as Dr Faithfull has given unchallenged evidence of his view that some of the plaintiff's symptoms, which he has associated with the effects of the accident had been, for whatever reason, inadequately investigated. 823Dr Haik focussed his criticisms of the plaintiff on a literal interpretation of the plaintiff's evidence, without also considering for balance, a less extreme interpretation of her evidence as to her reclusive habits, as is evident from the following extract of his evidence at T581.46 - T582.1: "WITNESS HAIK: It certainly is consistent - consistent with a concern about her truthfulness because if she says that she hasn't been out - what she said to me, she doesn't go out, she just stays in her bedroom and goes to the toilet and goes nowhere and that she's seen to go out, that's another inconsistency or untruth." 824Dr Haik's evidence to the above effect does not take into account the plaintiff's explanation given in her oral evidence to the effect that she has tried to go out by herself on occasions, and her evidence in which she described her friends as having encouraged her to go out and try to be more active. That evidence was available for Dr Haik's consideration as it was given before the concurrent expert evidence of the psychiatrists. 825Whilst the evidence does not permit a conclusion that Dr Haik was provided with a copy of the plaintiff's evidence to the above effect, it was certainly available for the defendant to provide Dr Haik with a copy of it for his consideration. Whether or not Dr Haik had actual access to the transcript of that evidence, the fact remains that the evidence which Dr Haik criticises, was in fact tempered in the plaintiff's oral evidence with a more complete or balanced explanation from her on that issue, and not just the narrower account that Dr Haik has considered in forming his views. To the extent that Dr Haik has not had access to that evidence, I consider that I am in a better position than Dr Haik to assess the nature and importance of the plaintiff's evidence on that subject when it comes to assessing the weight to be attached to Dr Haik's remarks that were critical of the plaintiff. 826Dr Haik relied on "inconsistencies" or questions that were apparently left unexplored by him in his consultation, such as the plaintiff's retention of her ownership of motor vehicles when there is no evidence that he raised this topic for a more fulsome discussion with the plaintiff beforehand, such as at T583.24 - T583.29: "WITNESS HAIK: Well, she told me that she never leaves the house and - and really doesn't go out with anyone except when she is driven by Mr Taoube to the psychiatrist and that's it. She told me that she doesn't use either of her cars except that one time when she hit a tree, even though she bought a second car she said she never drove it. When asked why she didn't sell the first car she said ..(not transcribable).. about that if she in fact is not driving it." 827Dr Haik did not seek to examine whether there was any rational explanation for the plaintiff's continued retention of ownership of motor vehicles. He did not appear to consider the plaintiff's evidence that she kept the vehicles for them to be driven by Mr Taoube or his sons when they were assisting her. Neither did Dr Haik relate an explanation as to how the retention of ownership of motor vehicles by the plaintiff, or even her use of motor vehicles to a degree greater than that admitted to by the plaintiff, would negate, either in part or whole, a diagnosis of PTSD. 828In my assessment of his evidence, Dr Haik seems to have adopted a negative stance on all matters of contention. He did not seem to consider more benign possibilities or explanations for the plaintiff's behaviour, and consistently maintained an extreme position of scepticism towards her history and presentation, for example, at T585.35 - T585.45: "WITNESS HAIK: I find that very difficult to believe that she would - if she's depressed and doesn't leave her bedroom and doesn't shower and remains at home all the time I find it extremely difficult that she would go to a club or go out with friends. She would say, "I'm too sick," as she told us, all of us, that's she's too sick, she's too disabled, she just has these thoughts of the accident all the time, she sits on the bed, she doesn't sleep, she - her life is ruined, and for her in that circumstance to sort of go out to a club or go out with friends, even once or twice, putting aside the fact that she's got to pick the kids up, she's got to do it, putting aside that, to go out and see those friends and go to clubs is highly improbably based upon the fact - things she's told us, that she's disabled." 829In my view, Dr Haik's comment that it was "highly improbable" that the plaintiff was disabled, is not explained by the examples of activity he has cited. Furthermore, it appears that he has not given any weight or consideration to the evidence of the plaintiff to the effect that her friends have from time to time encouraged her to go out for her own good. In my view, the sceptical slant on the events cited by Dr Haik diminishes somewhat when the evidence of the plaintiff and the other lay evidence is taken into account on the issue of the efforts that have been directed at trying to reduce the extent of the plaintiff's social isolation. 830Dr Haik used what I consider to be very light evidence as a basis for labelling the plaintiff's evidence as being exaggerated, as appears at T601.9 - T601.14: "WITNESS HAIK: I can't accept that it would be significant based upon the fact that the plaintiff is somebody who does exaggerate. For example, I read in Dr Parmegiani's report that she said she'd lost 100 kilograms, which can't possibly be right. So from the other perspective when she says she's only driven a few times, that could be many more times in the same way she has lost far less than 100 kilograms. It's a matter of exaggeration from both perspectives, if I may say so." 831In my view, Dr Haik's accusation that the plaintiff was exaggerating has taken an overly simplistic view, and was proffered without any apparent consideration of a possible alternative, and less sceptical viewpoint. I considered that Dr Haik's commentary in this regard, as cited above, was more in the vein of advocacy than balanced expert evidence. 832For the reasons I have outlined in the preceding paragraphs, in arriving at my findings on matters of disability, I do not accept the opinions or characterisations proffered by Dr Haik. Instead, I prefer the opinion of the plaintiff's treating psychiatrist Dr Ali, as supported and reinforced (as they are) by the respective individual and collective opinions of Dr Akkerman, Dr Clark and Dr Prior. 833In stating that view I also record my view that it seemed to me unusual that Dr Haik refused to accept that the plaintiff might have suffered a traumatic experience in the collisions, and as a result of having to be cut free from the wreckage, when such events could readily be understood to be upsetting to her, and could be understood to serve to magnify her sense of injury and apprehension flowing from that accident. 834Dr Haik's methodology for his opinion unfortunately did not allow for the plaintiff to deal with the adverse views he formed of her based on his own notions and assumptions. It was also unfortunate that Dr Haik's views seemed to have influenced Dr Parmegiani's second opinion, albeit on the false premises outlined above. For those reasons, I place little weight on Dr Parmegiani's second report. 835In contrast, Dr McClure seemed to have no difficulty certifying that the plaintiff had a chronic PTSD with a chronic major depression and a pain disorder involving psychological factors: Exhibit "3", pages 257 - 275. Significantly, Dr McClure considered the issue of exaggeration of symptoms. He identified a range of explanations for this ranging from abnormal illness behaviour, factitious disorder or outright malingering: Exhibit "3", page 266. Although Dr McClure considered the plaintiff was malingering (Exhibit "3", page 271), I placed little weight on his opinion to that effect, and the opinion of Dr Parmegiani for that matter, because such views could not be tested due to the fact these were MAS assessment and were not expert reports to which the expert witness code applies. In my view a heavy onus rests on the clinician who alleges malingering. That onus requires the provision of persuasive reasons, which in my view, are absent in this instance. 836Based upon the above review of the evidence, including my findings on the credit of the plaintiff, I now turn to record my findings concerning the disabilities that continue to affect the plaintiff as a result of the accident.

Disabilities findings 837In arriving at my findings of disability I have drawn upon the evidence of the plaintiff, and the summaries of the histories of the complaints the plaintiff has made to the various medical practitioners who have examined her. I propose to treat the evidence comprising those summarised medical histories obtained by the various doctors who have examined her as evidence of the plaintiff's post-injury disabilities: Daw v Toyworld (NSW) Pty Ltd [2001] NSWCA 25, per Heydon JA at [70]; s 60 of the Evidence Act 1995. 838I find the plaintiff's post accident physical disabilities to be as follows: (a)Headaches; (b)Pain, discomfort and restriction of movement in the neck, with radiation of pain into the shoulders, upper limbs, with sensory changes in the little and ring fingers of the left hand; (c)Pain, discomfort and restriction of movement of the thoracic spine; (d)Pain and discomfort in the chest in the region of the seatbelt injury; (e)Pain, discomfort and restriction of movement in the left shoulder aggravated by elevated left arm movements; (f)Pain, discomfort and restriction of movement of the lumbar and lumbo-sacral spine; (g)Difficulty carrying out an unrestricted range of physical activities involving full strength and dexterity of the neck, back, left shoulder and upper limbs; (h)Chronic pain syndrome, noting that it is likely that the plaintiff has a low pain threshold, as was adverted to in the evidence and submissions. 839I find that these problems have resulted in the plaintiff suffering from the following psychological symptoms and disabilities: (a)Chronic post-traumatic stress disorder with feelings of anxiety; (b)Major depression and adjustment disorder; (c)Dysphoric affect; (d)Broken sleep patterns, nightmares, flashbacks associated with reduced concentration, memory problems, irritability, tearfulness, feelings of anger, hypervigilance and avoidance; (e)Memory impairment; (f)Social isolation, reclusive habits and lethargy; (g)Lack of enthusiasm and loss of confidence for day to day activities requiring prompting for such activities; (h)Nervousness when driving and travelling in motor vehicles, comprising a specific phobia regarding those activities; (i)Chronic pain disorder. 840I find that in combination, the plaintiff's physical and psychological problems which she has described, and which have been noted by the practitioners who have interviewed her, have caused her to suffer difficulty in coping with the everyday activities of daily life and family responsibility. 841A complicating feature of these findings is that the plaintiff has also suffered and continues to suffer from significant problems of pain and discomfort in her left knee. These problems cause her to experience reduced standing and walking tolerance and impair her physical dexterity. This is a major problem for the plaintiff and it adversely influences her ability to lead a normal day-to-day life. These problems also have an adverse impact upon the plaintiff's future capacity to earn and her ability to carry out normal household activities. These are matters which must be assessed in relation to her claim for specific heads of damage. 842I now turn to the assessment of the heads of damage claimed by the plaintiff.

Issue 5 - Assessment of damages 843In the paragraphs that follow, after identifying the plaintiff's probable life span, I set out my damages assessment in relation to each of the claimed heads of damage.

Life span of plaintiff 844An assessment of the component of the plaintiff's entitlement to damages for future domestic assistance first requires identification of the years that probably remain for the plaintiff. Having regard to the current prospective life tables, at age 38 years, this being the plaintiff's age at trial and, in the absence of any medical or other evidence suggesting the plaintiff may have a decreased life span, I assess the plaintiff's probable remaining life span to be in the rounded down statistics based figure of 50 years. The multiplier for 50 years on the 5 per cent actuarial tables is 976.2.

Mitigation 845The plaintiff is under a duty to mitigate her damages: s 136 of the MAC Act. In my view the plaintiff has discharged that duty by undergoing medical treatment, including psychiatric treatment: s 136(3)(a) of the MAC Act. The defendant has not introduced any evidence that suggests the plaintiff has not mitigated her damages: s 136(4) of the MAC Act.

Future loss of earning capacity 846On behalf of the plaintiff a claim is made for future loss of earning capacity in the submitted buffer amount of $150,000. In contrast, on behalf of the defendant, it was submitted that there should be no award of any damages for future loss of earning capacity. This claim must be evaluated against the requirements of s 126 of the MAC Act. 847The starting point of the analysis is the observation that at the time of the accident, the plaintiff had not worked in any employment in Australia in the 13 years between the time of her arrival in 1993, and the time of the accident in 2006. She had no training or any other work skills or experience that was acquired in any employment. Furthermore, until the accident she had been fully engaged in parenting responsibilities as a single parent since 2001. In my view, in those circumstances it was highly probable that before the accident those responsibilities would have continued to keep the plaintiff out of the workforce, or at least out of the full time work force, for some years, as her youngest child was aged 8 when the accident occurred, bearing in mind that at the time of the accident the plaintiff was pregnant and, as it transpires, was intending to have at least one more child. 848In my view, even though before the accident the plaintiff had arranged to obtain some work experience with Mr Youseff in his small supermarket, and even though she had undertaken some TAFE courses aimed at improving her facility with English and learning the basics about floristry, in view of her single status and her apparent lack of other avenues for support and childcare, on the balance of the probabilities, the plaintiff's most likely circumstances at the time of the accident were that she would not have been in a position to obtain, secure and maintain employment before the time of the accident, and for some time thereafter, on account of her parental responsibilities. 849The probability is that the above circumstances represent the reason why no claim has been made on behalf of the plaintiff for past loss of earnings. The plaintiff is represented by lawyers with extensive experience in litigating this type of claim, and I am comfortably satisfied that if there was a claim of that kind available to the plaintiff for past loss of earning capacity, it would have been particularised and advanced on her behalf through evidence and argument. 850In light of the foregoing conclusion, an appropriate time frame must be identified for the commencement of the plaintiff's claim for future loss of earning capacity to take into account a delayed entry into the labour market, subject also to the usual vicissitudes. In view of the plaintiff's domestic circumstances as they prevailed at the time of the trial, it would be unreasonable to assume that she would have, by May 2011, commenced to exercise an earning capacity. 851This is because on 20 May 2011 she was delivered of her fourth surviving child. As with her domestic position that had prevailed before the birth of that child, it is most unlikely that she would have the time and the opportunity to pursue work in addition to her parenting responsibilities by reason of the needs of the two older children who live with her, and the added responsibilities of looking after a newborn infant, and seeing to the needs of that child until school age, and to a lesser extent continuing to look after that child once it started school. This is not a case where the plaintiff had existing maternity leave entitlements or family support available to her that would enable a conclusion that she would have returned to work at some stage after the birth of her latest child. 852In the plaintiff's pre-accident circumstances, in my view, the balance of probabilities indicate that in an uninjured state, any future work she would have found would most probably have been of a part-time nature, and necessarily structured around her parenting responsibilities, and even then, only in a slowly incremental nature for some years. 853The plaintiff's youngest child would not be due to start high school for a further 12 years, by which time the plaintiff would be aged 50 years, with little or no work experience or qualifications behind her to commend her to any prospective employer except for menial and unskilled work. 854In those circumstances, I consider that any claim by the plaintiff for future loss of earning capacity must be seen as being necessarily limited, and subject to a consideration of whether, and to what extent, any demonstrated impairment in her earning capacity is likely to be productive of a financial loss: Graham v Baker [1961] HCA 48; (1961) 106 CLR 340, at [10], p 348. 855In the plaintiff's circumstances I consider that it would have been very unlikely that she would have had the time, experience or capacity to start up a florist's business and devote the required time to it in order to make it a going concern. At best, I consider that the plaintiff's earning capacity would have been as an employee, probably for part-time work only. 856Against that background, I now turn to the first requirement the plaintiff must satisfy, namely whether she has an accident related impairment to her earning capacity. 857At paragraphs [837] to [841] of my reasons I have recorded my findings as to the plaintiff's ongoing accident related disabilities. It therefore becomes necessary to make findings on an evaluation of the medical evidence on whether a preponderance of that evidence supports a claim for damages for future loss of earning capacity. 858That evaluation must also take into account my findings concerning the plaintiff's left knee problems and complaints which are not accident related. 859In the paragraphs that follow, I trace the chronological evolution of the medical opinions tendered by the parties in support of the proposition that the plaintiff has suffered an assessable impairment to her future earning capacity: (a)The first post-accident medical commentary, namely that of Dr Maniam, who provided a short letter to Dr Rahman dated 19 October 2007, referred to the first consultation with the plaintiff a month after the accident. The letter made no relevant mention of work capacity. This was obviously because from Dr Maniam's perspective, the plaintiff's treatment for symptoms that were then current, was ongoing; (b)The second medical commentary in time was the short note by the plaintiff's treating general practitioner, written on 5 December 2007, which was a little over a year after the accident. Dr Rahman noted that the plaintiff's capacity for employment had been affected in the year that had passed since the accident, but he expected the plaintiff should not have difficulty with employment in the 2008 year; (c)On 2 January 2008 and on 12 February 2008, which was just a few months after Dr Rahman's employment prediction, from an orthopaedic perspective, Dr Mahony considered that the plaintiff's capacity for employment would be limited. He said he doubted that the plaintiff would be able to find a suitable position. His view was that she should be considered to be unfit for work as a florist; (d)On 5 March 2008, Dr Clark expressed the opinion that the plaintiff was severely impaired in her capacity for work, and any work should be limited to no more than 1 or 2 days at a time, or for less than 20 hours per fortnight; (e)On 10 March 2008, Dr Davis was of the opinion that the plaintiff should be restricted in activities which include heavy lifting and carrying, forceful work, any work above mid-chest level, climbing stairs, squatting or crouching or prolonged periods of travel or other activity requiring static loading of the upper or lower spine, and work involving continuous standing or the need for frequent bending; (f)On 12 March 2009, Dr Ali expressed the view that although the plaintiff was not working at the time of the accident, if she had been working, she would not be able to work full-time, and he doubted she would be able to cope with working part-time; (g)On 12 March 2009, Dr Matalani expressed the opinion that the plaintiff's occupational functioning will be adversely affected. He also expressed the view she would have difficulties working as a sales assistant because of problems with prolonged standing and manual handling activities. He listed what he described as a multitude of physical restrictions and chronic pain as the basis for his view the plaintiff would never be able to "return to work as a florist" on physical grounds, as well as the barrier issue of her experience of chronic pain. He thought the plaintiff's symptoms would affect her work capacity; (h)On 23 September 2009, Dr Prior expressed the opinion that the plaintiff would only be able to enter the workforce if her psychiatric diagnosis remits significantly, and his view was that she was not at that time fit for entry into the workforce; (i)On 12 November 2009, Dr Ali expressed the opinion that he felt the plaintiff would not ever return to her normal duties. He expressed that view on the incorrect assumption that the plaintiff had previously worked. He also expressed the view that the plaintiff would have to cease work earlier than age 65, but the basis for that view was not fully explained; (j)On 17 September 2010, whilst Ms MacMaster made no specific recommendations concerning work restrictions, the nature of her recommendations concerning the plaintiff's need for domestic assistance with manual tasks, which I shall refer to in connection with that component of the claim, indicates similar restrictions would apply to any proposed work tasks of a similar nature; (k)On 9 February 2011, Dr Akkerman expressed the opinion that at that time the plaintiff could not work at all, and would possibly never work again, reiterating his 29 September 2009 opinion to the same effect; (l)On 24 February 2011, Dr Faithfull expressed the opinion that the plaintiff would have difficulty working as a florist or working on her feet in a shop because of her knee and lumbar spine problems. 860In contrast to those opinions harnessed by the plaintiff to support a claim for loss of earning capacity, the evidence relied upon by the defendant to resist the plaintiff's claim for loss of earning capacity was as follows: (a)On 22 June 2007, Dr Pierides expressed the opinion that the plaintiff could return to work without restrictions. (b)On 6 December 2007, Dr Rahman thought the plaintiff should have no difficulty with employment in the 2008 year. (c)On 19 June 2008, Dr Parmegiani expressed the opinion the plaintiff would not be able to work at that time as she was not able to concentrate. (d)On 9 February 2009, Dr Haik expressed the opinion that when litigation was finalised, "it would seem that she will be capable of part-time work until her 2 younger sons leave school". (e)On 26 March 2010, Dr Pierides reiterated his earlier expressed view that it was in the plaintiff's best interests that she get back to doing all normal activity, which implies work as well as other tasks. (f)On 4 February 2011, Dr Pierides expressed the view the plaintiff would have been fit for work without restriction from about 12 weeks post-accident. (g)Professor Harris did not direct any specific comments to work capacity. 861On balancing those polarised bodies of opinion, for the reasons that follow, I have concluded that the preponderance of the opinions served cogently support a claim for a measure of compensation for impairment in earning capacity. 862Dr Rahman's opinion that the plaintiff would be unsuited to the work of a florist must be viewed in the context that she has not undertaken that kind of work before. 863In addition I accept the unchallenged opinion of Dr Davis as to the range of work restrictions that I have already identified in paragraph [859(e)] above. 864I also accept the opinion of Dr Matalani to the effect that the plaintiff's occupational functioning will be adversely affected by the effects of the accident, particularly problems due to prolonged standing, the other physical restrictions he had identified, and the plaintiff's difficulties with chronic pain. 865I also accept the preponderance of the opinions of the psychiatrists who gave evidence to the effect that the plaintiff has a psychological impairment to her earning capacity on account of the ongoing effects of her PTSD and her depression. It is uncertain as to for how long that condition will continue. 866It must be recognised that within that array of opinions, a significant part of the plaintiff's claim for future loss of earning capacity must be seen to relate to problems with her left knee. I have found that the left knee problems are unrelated to the effects of the accident and probably represent a supervening disability. In my view it would be an exercise in artificiality to undertake an assessment of damages for future loss of earning capacity of the plaintiff without considering the effect of the plaintiff's left knee problems on that loss of capacity. 867Unfortunately, the state of the medical evidence does not permit a reasoned differentiation of the effects of the plaintiff's left knee problems from the other physical problems that have led the medical experts to identify a basis for a loss of earning capacity in the plaintiff. 868This presents a problem for assessment because the plaintiff carries the onus of proving on the balance of probabilities that her loss of earning capacity has been caused by the defendant's negligence, including any fact relevant to that issue: s 5D and s 5E of the Civil Liability Act 2002. 869In the circumstances, where it has been established that the plaintiff's neck, back, left shoulder and upper limb disabilities affect her earning capacity, and where this calls for some form of monetary assessment, where the medical evidence is silent on the issue, some form of apportionment on account of the left knee problem, albeit somewhat arbitrary, is required in these circumstances. 870In my view, the plaintiff's left knee problems represent a significant component of her claim for loss of earning capacity. This is apparent from the opinions of Dr Matalani, Dr Davis and Dr Faithfull. It follows that any claim for loss of future earning capacity must be substantially discounted on account of the contribution of the left knee problems to the plaintiff's work impairment of earning capacity. This seems to me to be so because a substantial part of the plaintiff's claim for impaired earning capacity is related to her complaints of standing and mobility. 871Turning to the assessment of the loss, I consider that the plaintiff's claim for a buffer amount of $150,000, which does not take into account a discount on behalf of the left knee problem, is nevertheless excessive having regard to the need to defer the timing of the commencement of that loss. In that regard, I consider that a more appropriate lump sum would be $100,000 assuming there was no need to apply a discount to remove from the consideration the influence of the left knee problems on the plaintiff's earning capacity. 872However, it must also be recognised that the major component of the work of a florist or shopkeeper would involve unimpaired standing and mobility requirements. When this physical factor is taken into account, I consider that only 25 per cent of the claim for future impairment of earning capacity relates to accident caused factors that are unrelated to the plaintiff's left knee problems and to the plaintiff's PTSD. 873In my view, taking into account the many uncertainties and imponderables associated with the claim for loss of earning capacity in a person who has, at the age of 38 never worked, and who will for some considerable time in the future, continue to have childcare responsibilities, after removing from the consideration the non-accident related left knee problems, the amount of an appropriate buffer for impairment of the plaintiff's earning capacity should be assessed at $25,000. 874I therefore assess the plaintiff's damages for future loss of earning capacity in the buffer amount of $25,000.

Past domestic assistance 875On behalf of the plaintiff, a claim was made for the value of past domestic assistance, which was submitted in the amount of $159,712. That claim was based upon the premise that the plaintiff had been provided with gratuitous care over a period of 248 weeks from the time of the accident until 27 July 2011, for 28 hours per week at the rate of $23 per hour. The calculation was for 28 hours of care per week over 248 weeks at $23 per hour, which yielded the amount of $159,712. 876In contrast, the defendant submitted that no allowance should be made for this head of damage, both because the claim of a need for such services has not been made out, and because the extent of the care that had actually been provided to the plaintiff would not have met the statutory threshold of a minimum of 6 hours per week for 6 months: s 128(3) of the MAC Act. 877The difficulty with the defendant's submission in that regard is that notwithstanding the defendant's submissions concerning the credit of the plaintiff as to whether she should be believed concerning her limited domestic activities and her need for domestic assistance, the unchallenged evidence of Mrs Ishak, Mrs Yasier and Mr Mohamed Taoube generally supports a claim that the claimed services were provided to the plaintiff in accordance with the claim made on the plaintiff's behalf, thus requiring that an assessment be undertaken for damages for the value of those services. 878The difficulty with the claim by the plaintiff is that a significant part of the claim for the value of past gratuitous domestic assistance is related to the plaintiff's left knee disabilities and the physical activities of a domestic nature that are affected by those disabilities, for which, in accordance with my findings, no damages are assessable. Furthermore, the state of the medical evidence does not permit a reasoned analysis that enables the degree of past assistance required by the plaintiff on account of her left knee problems to be isolated and excluded from the consideration for assessment purposes. 879The plaintiff's evidence was that since the accident she has been unable to attend to her domestic duties and requires the assistance of friends: T26.40; T30.50 - T31.05. Those friends included the defendant Mr Hammed Taoube, his sons Mohamed and Hussein, Mrs Jamal Barakat, her former neighbours Mrs Yasier and Mrs Habib, and Mrs Ishak. 880The plaintiff's evidence was that this assistance was provided regularly and it included tasks such as washing, hanging wet clothing, folding clothing, cleaning bathrooms and toilets, mopping, vacuuming, general cleaning, cooking, making snacks, washing dishes, assisting her with her children's needs, and assistance with travel, including for shopping and in order to attend appointments. 881Mr Mohamed Taoube, Mrs Ishak and Mrs Yasier were not relevantly challenged on their evidence to the above effect. That evidence is corroborative of the plaintiff's evidence on these matters. 882Unfortunately, the evidence of the plaintiff and the evidence of the other lay witnesses does not permit a reasoned apportionment of the level or extent of domestic assistance provided to the plaintiff on account of her left knee problems. 883It is therefore necessary to survey the medical and allied evidence on the subject of the plaintiff's need for domestic assistance. That review reveals the following chronological opinions in support of the claim made by the plaintiff: (a)On 2 January 2008, and again on 12 February 2008, Dr Mahony considered that the plaintiff needed some 12 hours of assistance per week, increasing to 15 hours per week, for home help, separate from the needs of caring for her 3 children; (b)On 12 March 2008, Dr Davis expressed the opinion that the plaintiff would require domestic assistance for general cleaning, shopping, bed making, cooking and the like, which he estimated at the level of 10 hours per week, which did not include attending to the occasional needs of her disabled son on the occasions when he visited; (c)On 12 March 2009, Dr Ali expressed the view that the plaintiff was mildly impaired in her ability to cope with self care and personal grooming, and she needed prompting to go out; (d)On 12 March 2009, Dr Matalani expressed the opinion that the plaintiff's injuries and resultant symptoms have given rise to a requirement for her need for domestic assistance in the vicinity of 6-8 hours per week. In this regard, he cited activities that included cleaning, the more difficult general household duties such as vacuuming, mopping, scrubbing laundry work, hanging clothes, washing windows, cleaning toilets and bathrooms; (e)On 23 September 2009, Dr Prior commented upon the plaintiff's social functioning, and needing friends to assist her with cooking and cleaning, shopping and the like, due to lack of motivation or energy on her part, including for personal grooming. He expressed the opinion that if the plaintiff's condition remained unchanged, and she did not respond to treatment, she may continue to require the informal support of friends in her domestic functioning, including with self-care, and with the care of her children; (f)On 12 November 2009, Dr Ali again expressed the view that the plaintiff would need assistance with care, although his opinion was not specific as to the details; (g)On 12 August 2010 Mrs Cogger carried out an occupational therapy assessment of the plaintiff's domestic assistance needs. She noted an array of reported difficulties in the table located between pages 7 and 10 of her report: Exhibit "C", pages 34 - 37. She estimated the plaintiff's care dependence on others to be of the order of 15 hours per week: Exhibit "C", page 40. It must be recognised that a good deal of that assistance is on account of the plaintiff's non-compensable left knee injury; (h)On 24 February 2011, Dr Faithfull was of the view that the plaintiff's housework was affected in the areas of vacuuming, sweeping, cleaning the bathroom and the toilet, and she would have difficulty with heavy housework. 884The medical and allied evidence against the view that the plaintiff needs domestic assistance is as follows: (a)On 22 June 2007, Dr Pierides expressed the opinion that the plaintiff could return to all activities without restrictions; (b)On 11 December 2008, Professor Harris was of the opinion that the plaintiff required significant support with household tasks, such as with cooking and cleaning, and with transport; (c)On 12 December 2009, Dr Pierides expressed the view that there was nothing to suggest the plaintiff needed to be inactive at home, and she should return to normal activities; (d)On 26 March 2010, Professor Harris stated that he could not attribute the plaintiff's need for domestic assistance to the accident on 1 November 2006. His earlier opinion dated 24 February 2011 was not significantly different; (e)On 4 February 2011, Dr Pierides expressed the view that he could see no reason for the plaintiff to need domestic assistance; (f)On 15 February 2011, Dr Haik expressed the view that the plaintiff did not need any assistance with any daily or self care tasks; (g)On 26 March 2011, Dr Pierides suggested the plaintiff should return to normal everyday activities; (h)Dr Marsh and Dr McClure made no relevant comments on the plaintiff's need for domestic assistance. 885The plaintiff was assessed on three occasions by Ms MacMaster, the occupational therapist appointed by the defendant for the purpose of evaluating the claim for domestic assistance. The dates of those assessments were 4 March 2009, 15 April 2010 and 23 February 2011. The first two assessments took place at the plaintiff's Revesby address, and the third assessment took place at the plaintiff's Mt Pritchard address. Ms MacMaster's assessment was necessarily limited to matters of physical function as she was not qualified to comment on psychiatric issues. 886Ms MacMaster's initial review of the medical reports provided to her led her to state that there were inconsistencies reported in the plaintiff's history Exhibit "3", page 65. Initially, those inconsistencies were not specifically identified by her, and the remainder of the introduction section to her first report made reference to comments made by Dr Pierides and Dr Marsh concerning embellishment in the plaintiff's presentation, and considerable exaggerated pain behaviour: Exhibit "3", page 65. Ms MacMaster appeared to have adopted those comments. 887Ms MacMaster went on to say that she had nevertheless relied upon her own observations in forming her views as to the plaintiff's domestic assistance needs: Exhibit "3", page 67. That comment was reiterated in relation to her second and third reports: Exhibit "3", pages 116 and 160. 888Ms MacMaster's first report confirmed the presence of abnormal pain behaviours or emotional overlay in the plaintiff on formal testing for such matters: Exhibit "3", page 68. 889In her first report, Ms MacMaster recorded the plaintiff's complaints as comprising constant pains in the low back, neck, left shoulder, and left knee, as well as headaches and depression: Exhibit "3", page 73-74. Ms MacMaster prepared a tabulation of commonplace tasks of everyday living in which she identified the plaintiff's perception of her own limitations for those tasks in comparison to her own observation of the plaintiff carrying out those tasks during the consultation. That tabulation identified differences in the plaintiff's reported and observed tolerances for sitting, standing, partial squatting, and self-limited attempts at bending, lifting, carrying and retrieving items from the floor: Exhibit "3", pages 75-76. That tabulation was also developed in Ms MacMaster's second and third reports. 890In her first report, Ms MacMaster concluded that there was a difference between the plaintiff's reported ability to undertake self-care tasks as set out in the medical reports she had reviewed, and the plaintiff's claims of need for assistance in the consultation under present review, concerning the activities of daily living: Exhibit "3", page 82. Ms MacMaster identified what she characterised as inconsistencies in the speed of the plaintiff's gait, and facial grimacing (Exhibit "3", pages 86-87). 891Ms MacMaster's initial report concluded that "it would appear [the plaintiff] has exaggerated her situation" regarding her plans for work (Exhibit "3", page 99), and she made a generally sceptical commentary on the plaintiff's situation, referring to being unconvinced that the plaintiff stays in her room all day crying and without interest in anything as claimed. She also pointed to significant abnormal pain behaviours, and what she described as embellishment of symptoms and inconsistencies in the reported history. She stated the plaintiff appeared to be seeking secondary gain in the invalid role in circumstances where there was no physical pathology. Ms MacMaster indicated that she doubted the plaintiff maintained her abnormal pain behaviour behind closed doors: Exhibit "3", pages 96 - 99. 892My reading of Ms MacMaster's first report does not indicate that Ms MacMaster provided the plaintiff with any opportunity to comment upon those adverse views and assumptions, and it would appear that the sceptical stance that she has adopted has emanated from the reports of Dr Haik, Dr Marsh and Dr Pierides that had been provided to her by way of background materials: Exhibit "3", pages 103-104. 893Ms MacMaster's second report, which was as a result of the assessment carried out on 15 April 2010, was in essentially the same terms. She stated that she had observed the plaintiff to have a slightly flat affect with some incongruity of expression: Exhibit "3", page 117. Ms MacMaster re-iterated that the plaintiff was independent in all her personal care needs: Exhibit "3", page 134. Ms MacMaster stated that on the basis of discrepancies and reports of abnormal pain/illness behaviour and self-limited behaviour and her own findings, she "cannot substantiate the need for any domestic assistance": Exhibit "3", page 145. Notwithstanding her reiteration of her earlier remarks concerning embellishment and secondary gain issues, at Exhibit "3", page 146, Ms MacMaster made the following alternative qualifying remarks as a proviso to her opinions: "If however she is given the benefit of doubt and in view of a reported protracted post traumatic disorder, I have to rely on the expertise of her psychiatrist and/or psychologist to determine the appropriate intervention. It would be preferable if this could be coupled with a proactive program to facilitate a return to exercise and normal daily activity but she must be motivated to participate in such a program." 894Ms MacMaster's third report, which was as a result of the assessment she had carried out on 23 February 2011, was also essentially in the same terms as her two previous reports. At page 7 of her report (Exhibit "3", pages 161-162) Ms MacMaster recorded the following observations concerning the plaintiff's general presentation at this interview: "Mrs Khalil presented as a thirty seven year old woman of average height and above average build. On my arrival she answered the door and returned to sitting on a lounge with a blanket over her. She stated she had the flu although she did not exhibit obvious flu symptoms. She however drank water from a bottle beside her on several occasions. She walked with a left antalgic gait pattern. She continues to take her weight predominantly through her right leg in standing but her posture appeared symmetrical. Her affect appeared flat although there was some incongruity of affect with occasional smiling. There were no behaviours present consistent with physical discomfort exhibited such as regular change of posture. She again demonstrated excellent sitting tolerance of in excess of one hour prior to being asked to move by me to undergo some formal testing of movement. She continues to exhibit abnormal pain behaviour through grimacing, holding onto her back with her right hand, self-limited movement and through her high ratings of the emotive aspects of the Short McGill Pain questionnaire. She exhibited some inconsistent movement e.g. she said she could not move her neck to the right well but later demonstrated informally her ability to rotate her neck to the right to a greater extent when dressing and also when negotiating stairs. On formal examination of her left shoulder movement she exhibited restricted movement but her left shoulder movement was observed to be greater when performing a functional task at her kitchen cupboard (see photographs within report). At this stage she suddenly exhibited a restriction in her right shoulder where on formal testing her right shoulder was within normal limits." 895On her third assessment Ms MacMaster confirmed the plaintiff's earlier history of chronic low back, neck, left shoulder and knee pains as still currently affecting the plaintiff at that time, with continuation of the earlier identified state of depression. Ms MacMaster obtained a history from the plaintiff to the effect that she obtained the assistance of friends with domestic tasks and continued avoidance of such tasks by the plaintiff: Exhibit "3", pages 189-193. 896On the third assessment Ms MacMaster again drew attention to an apparent inconsistent speed of the plaintiff's "slightly antalgic left sided gait pattern". This was a reiteration of comments made in her earlier reports. Ms MacMaster also drew attention to the plaintiff's reiterated claim for some 28 hours of domestic assistance per week: Exhibit "3", pages 197-198. 897After reviewing what she described as continuing inconsistencies in the plaintiff's history, apparently arising from the medical reports briefed to her, Ms MacMaster reiterated her previously expressed view that the plaintiff did not have any requirement for personal care assistance, and had only needed a limited amount of post-accident domestic assistance in the past (for which no claim is made) in respect of heavier housework tasks to an extent that did not meet the assessment threshold under s 128(3) of the MAC Act 1999: Exhibit "3", page 203. 898In assessing Ms MacMaster's reports I considered she had taken an adverse view of the plaintiff, stating that she felt the plaintiff was "highly likely" to be choosing to remain an invalid for monetary gain: Exhibit "3", page 193. I considered Ms MacMaster's reports should be given reduced weight because it was plain she took a negative view of the plaintiff's presentation and her analysis proceeded on that basis without any counter-balancing discussion to exclude such factors in favour of the view she has stated. 899In reviewing the conflicting evidence of the plaintiff's need for past domestic assistance I do not accept the evidence tendered by the defendant to the effect that the plaintiff did not require any domestic assistance. In my view that evidence takes a view of the issue that is too simplistic because the psychiatric evidence that I have accepted indicates that the plaintiff has been significantly affected in her ability to carry out her day to day domestic activities as a result of her PTSD, depression and her reduced motivation, which is a function of her depression. 900I have reached this conclusion on an acceptance of the evidence of the plaintiff as supported and confirmed by the unchallenged evidence of Mrs Ishak, Mrs Yasier and Mr Mohamed Taoube. 901In addition, I have placed significant weight upon the opinion of Dr Ali, the plaintiff's treating psychiatrist, who was of the view, in March 2009, that on psychiatric considerations, the plaintiff was mildly impaired in her ability to cope with self care, personal grooming and needed prompting for tasks and activity. He confirmed that view in November 2009. I consider that Dr Ali was in an advantageous position to make that observation as the treating psychiatrist who had been seeing the plaintiff regularly in clinical consultations for treatment of her PTSD and her depression over a significant period of time. I also accept that such problems have continued to affect the plaintiff until the present time. 902For the reasons that follow, I prefer the views of Dr Ali to the views of Dr Pierides, Professor Harris and Dr Haik on this issue. 903Dr Pierides' views were not the subject of detailed reasons and they did not take into account the plaintiff's psychological illness, and as such, in my view, did not represent a complete or balanced assessment of the issue. 904Whilst Professor Harris conceded that the plaintiff required significant support for household tasks, he was of the view that this was not as a result of accident related disabilities. That view took no account of the plaintiff's psychological disabilities, which I have found have continued to adversely affect her since the accident, as an incident of her PTSD and depression. 905I do not consider that the views of Dr Haik can be accepted on the issue of the plaintiff's need for domestic assistance because clearly, those views have been influenced by the adverse view Dr Haik has taken of the plaintiff's credit, a view that I have not accepted for the reasons I have given. 906I have considered Ms MacMaster's opinions on the issue of domestic assistance. In my view it is plain that Ms MacMaster formed an adverse view of the plaintiff and attributed base motives to her concerning the pursuit of the invalid role to seek monetary gain. I have given little weight to Ms MacMaster's opinions in that regard because her views to that effect seemed to me to be adversarial rather than providing a balanced discussion on that issue, which in any event, is a credit issue for the court to determine. 907Having concluded that the plaintiff is entitled to damages for past domestic assistance, it remains to assess those damages, including assessment of the plaintiff's submission that such damages should be quantified at 28 hours per week from the time of the accident until the date of the trial. 908There are two key difficulties that face the plaintiff's claim in this regard. The first is the finding of the plaintiff's left knee complaints, which are significantly influential on her capacity for physical activity, and therefore, I infer, on her ability to perform housework. The second such difficulty is the imprecise nature and state of the evidence as to the actual domestic assistance that has been provided to the plaintiff to date in terms of the time actually expended on the provision of actual assistance. 909The combined effect of the evidence of the plaintiff, Mrs Ishak, Mrs Yasier and Mr Mohamed Taoube is that they have been attending the plaintiff's premises for an average of in excess of 28 hours per week. That said, the evidence does not go so far as to say that during those times, actual assistance was actually being provided to the plaintiff during all of those hours without a social component being included in that estimation. Even allowing for the fact that some of the assistance provided to the plaintiff was in the form of encouragement, for example to prompt the plaintiff on matters of personal hygiene, grooming and an increased level of activity, I gained the impression from the imprecise content of the evidence, that a significant proportion of the presence of these persons at the plaintiff's home also involved some socialisation. 910The defendant's liability for domestic assistance should be based upon the premise that any domestic assistance to be quantified in an award of damages would be performed efficiently, without a significant social component. 911When the above considerations are taken into account, I am unable to accept that the plaintiff has actually needed, and has actually received, the equivalent of 28 hours per week of domestic assistance from the accident until the present time. Instead, I gained the impression that the presence of Mrs Ishak, Mrs Yasier, Mrs Barakat, Mrs Habib and Mr Mohamed Taoube, when providing assistance, had a social component, for which the plaintiff's submission must be discounted. Furthermore, an additional discount must be made on account of the plaintiff's need for domestic assistance on account of her left knee complaints that do not form part of this assessment. 912As the evidence on these matters is in an imprecise state, the options appear to be either reject the plaintiff's claim for domestic assistance in its entirety as the underlying detail of it has not been proven, or to make a conservative estimate of what appears to be a reasonable number of hours per week for such services in recognition of the fact that the plaintiff has needed and has received such services, albeit that a precise calculation of the hours provided is not possible. 913Given the medical evidence that the plaintiff has the condition PTSD and depression, and a chronic pain syndrome, and is not fully able to carry out her domestic tasks on account of those conditions, and because of problems associated with her neck and her back and her left shoulder, I consider that to award the plaintiff no damages for past domestic assistance would result in an injustice to her. I am fortified in that view by the evidence I have summarised and accepted at paragraph [883] of my reasons. 914This then leads me to consider the second option, namely that of making an estimate, albeit an arbitrary one for the purposes of assessment. In my view this is the preferred approach because when the evidence on this issue is read as a whole, it leaves me with the firm impression that even after discounting for all of the above considerations, the threshold required by s 128(3) of the MAC Act has nevertheless been met, even though it is not possible to identify the precise calculation that reveals the extent of the hours that would have been required, or the extent to which the threshold has been exceeded. 915In these circumstances, where the evidence is in an imprecise state, having determined in fairness to the plaintiff that it would be unjust to deny the plaintiff any such damages, I also consider that in fairness to the defendant, such damages should be confined to the minimum threshold of 6 hours per week identified by s 128(3) of the MAC Act. I take that approach recognising that compensation should be reasonable, and precision is not always achievable because of the state of the evidence. 916On the foregoing approach I have calculated the value of 6 hours per week at the rate provided by s 128(3) of the MAC Act in the Appendix to these reasons. The amount revealed by that calculation is $33,352.14. 917I therefore assess the plaintiff's damages for past domestic assistance in the amount of $33,352.14.

Future domestic assistance 918The plaintiff's claim for future domestic assistance was put as a continuum of the claim for past domestic assistance, namely for 28 hours per week. The plaintiff further submitted that there was no reason to suggest that the level of care provided to the plaintiff in the past will not be required into the future. 919I have already analysed the lay and expert evidence in support and against an award in respect of past domestic assistance. In my view, that analysis holds good for the claim for the assessment of future domestic assistance, with the exception of a number of discounting factors to which I shall shortly refer. 920The rate claimed for future domestic assistance, namely $23 per hour, was less than the rate currently prescribed by s 128(3) of the MAC Act, namely $25.64, and by definition, was therefore reasonable, especially when compared to the customary rate of around $35 per hour as is frequently seen in such cases. 921Although this component of the claim was particularised as being claimed at commercial rates for such assistance, no arguments or calculations identifying any commercial rates were included in the submissions on behalf of the plaintiff for this head of damage. 922Although there was no submitted calculation for this head of damage, the implication of the submissions made by the plaintiff was that the future domestic assistance claim should be projected over the plaintiff's remaining life span of 50 years. 923The projection of the value of 28 hours of care per week at $23 per hour, namely $644 per week, on the 5 per cent tables over 50 years (x 976.2), yields the undiscounted sum of $628,672. 924In contrast to the plaintiff's submission, on behalf of the defendant it was submitted that there should be no allowance made for future domestic assistance because the threshold provided by s 128(3) of the MAC Act is unlikely to be met. That submission was based upon the opinions of Ms MacMaster. 925In my view, the plaintiff's submitted calculation seeking a projection over her remaining life span of 50 years seems to me to be excessive, and requires discounting on several bases. 926The first basis of discount is that the submitted projection assumes that the chronicity of her physical and psychological problems will never remit but will remain disabling for the remainder of her life. In my view, such an assumption is not supported by the expert evidence. In this context, the term "chronic", without explanatory medical evidence, does not necessarily equate to a lifetime of disabling symptoms. For such a conclusion to arise, specific medical opinion is required, which is absent here. There is no firm evidence upon which such a long projection could be justified. 927On the contrary, Ms Cogger's considered recommendation for future domestic assistance is for the provision of 15 hours per week of such assistance for a period of 6 years. 928That recommendation was put forward on the basis of there being a further 6 years until the plaintiff's youngest child reached the age of 18 years, by which time it was anticipated that the plaintiff would have undergone a programme of rehabilitation, the combination of these events indicating a decrease in need for such assistance. 929The second discounting factor is the non-compensability of the plaintiff's left knee complaints. In my view, there should be a substantial discount of the hours for projection on that account. As with the claim for past domestic assistance, the apportionment on account of the left knee problems is not readily achieved on a precise basis, however, a broad approach is indicated, even if this appears arbitrary. That is a function of the evidence. 930I therefore propose to adjust the period of need suggested by Ms Cogger to a longer period of 7 years to reflect the fact that her opinion was given in 2010 and in the interim, the plaintiff has had another child, which may to a degree, prolong her need for assistance. Given that Dr Akkerman has suggested the plaintiff would need such assistance for "at least two years", I consider that an allowance of 7 years is fair and reasonable: Exhibit "C", page 16. 931In apportioning the suggested projection of 15 hours per week I propose to reduce this to a projection of 6 hours per week in conformity with my findings in respect of past care, thus removing the large component of the need for domestic assistance I consider to be referrable to the plaintiff's left knee complaints. 932Also included in that discount is an allowance for the fact that the figures being considered are necessarily averages, which could vary within a range over those years, including on account of a possible remission or reduction in the level of symptoms over time, or even a predominant worsening of left knee symptoms over time, thus eclipsing the other matters for which damages are being awarded in this case. 933The resultant actuarial projection of $23 per hour for 6 hours per week on the 5 per cent discount tables for 7 years (x 309.4) yields an amount of $42,697. I consider that this sum should be further reduced and rounded down to $37,500 on account of the usual possible adverse vicissitudes. 934I therefore assess the plaintiff's damages for future domestic assistance in the amount of $37,500.

Past out-of-pocket expenses 935The parties agreed that the plaintiff had incurred out-of-pocket expenses in the amount of $6852.05: T517.40; T521. 936The defendant conceded that of the amount claimed by the plaintiff as out-of-pocket expenses, the CTP insurer had paid an amount of $4220.85, which it was submitted, should be credited to the defendant in any judgment in favour of the plaintiff in these proceedings: s 83 of the MAC Act. 937The defendant submitted that as a consequence, the balance of the claim by the plaintiff was in the residual amount of $2631.20. 938The defendant consequently submitted that in the event that it was found that the plaintiff was not entitled to any monetary compensation in respect of the other claimed heads of damage, by reason of the operation of s 38 of the Health and Other Services (Compensation) Act 1995 (Cwth), there should be a verdict and judgment entered for the defendant in these proceedings. 939I have concluded that the defendant's argument which I have summarised in the preceding paragraph is a spurious one and should be rejected for the reasons that follow. 940Section 38 of that act provides: "Waiver-small amounts of compensation 38. (1) Despite Divisions 1 and 2, those Divisions do not apply in relation to a claim for compensation in respect of an injury if: (a) a judgment or settlement has been made in respect of the claim before a notice under section 11 or 12 would, but for this section, have been required to be given to the Commission; and (b) the amount of compensation fixed by the judgment or settlement is a small amount; and (c) the amount of compensation so fixed is the entire amount of compensation in respect of the injury. (2) An amount of compensation is a small amount if it is less than the amount prescribed for the purposes of this subsection by the regulations." 941In my view, it is plain from the terms of s 38, and from the manner of operation of Divisions 1 and 2 of that Act, that judgments of amounts of less than $5000 in cases such as this, the Health Insurance Commission ["HIC"] will not require reimbursement of such a "small amount" of out-of-pocket expenses. It is also plain that the decision not to seek reimbursement of such an amount is one that must be made by the HIC, and not by a court assessing and awarding damages. 942In any event, for the reasons I have stated, I do not accept the submission on behalf of the defendant that only $2631.20 should be assessed as being the amount due to the plaintiff on account of her claim for out-of-pocket expenses. That said, in identifying the ultimate judgment amount due to the plaintiff, my orders will reflect the operation of s 83 of the MAC Act concerning the credit due to the defendant in the amount of $4220.85. 943I therefore assess the plaintiff's damages for past out-of-pocket expenses in the amount of $6852.05.

Summary of damages assessment 944My assessment of the plaintiff's damages is summarised as follows: (a) Future loss of earning capacity $25,000.00 (b) Past domestic assistance $33,352.14 (c) Future domestic assistance $37,500.00 (d) Past out-of-pocket expenses $6,852.05 Total $102,704.19

945The medical evidence supported a claim for future treatment expenses, for example, the report of Dr Davis recommended physical therapies at an estimated cost of $1200 per annum together with additional recurring costs of $1240 per annum for consultations and medications (Exhibit "C", pages 110 and 111). Dr Matalani recommended referral to a multi-disciplinary pain management team at a one-off cost of between $7000 and $8000 and other recurring expenses for consultations with specialists and medication (Exhibit "C" pages 101 - 102). Dr Clark, Dr Prior and Dr Akkerman made recommendations for future psychiatric treatment: Exhibit "C", pages 14, 101 and 118. No submissions were advanced on behalf of the plaintiff in respect of those matters and I have assumed those matters were not pressed in view of the fact that no submissions or supporting schedules were put forward by the plaintiff seeking to quantify a head of damage for those amounts. 946I do not propose to include any damages for those amounts as this evidence was not the subject of submissions by either party. In that regard, the plaintiff's submissions were restricted to future loss of earning capacity and past and future care: Plaintiff's written submissions, paragraph 73. 947Similarly, no submissions were made seeking superannuation losses on any amount assessed for future loss of earning capacity. Presumably, this was because any such allowance would be subsumed in the global lump sum assessment for loss of earning capacity.

Disposition 948The plaintiff has established her entitlement to an assessment of damages in the amount of $102,704.19. After giving effect to the terms of s 83 of the MAC Act, by which the defendant is entitled to a credit of $4220.20, this identifies the amount of the plaintiff's entitlement to a judgment in her favour in the proceedings in the amount of $98,483.99.

Costs 949As the plaintiff has succeeded on every substantive issue that was contested by the defendant in these proceedings, she is entitled to an order that the defendant pay her costs of the proceedings on the ordinary basis, unless a party can show an entitlement to a different order, for which there should be liberty to apply.

Orders 950I make the following orders: (a)The plaintiff's motion filed on the 12th day of the hearing, 8 August 2011, seeking a MAS re-assessment, is dismissed; (b)The plaintiff is to pay the defendant's costs of the dismissed motion; (c)Verdict for the plaintiff in the assessed amount of $102,704.19; (d)After applying a credit due to the defendant in the amount of $4220.20 pursuant to s 83 of the Motor Accidents Compensation Act 1999, judgment for the plaintiff for the remaining balance, in the sum of $98,483.99; (e)The defendant is to pay the plaintiff's costs of the proceedings on the ordinary basis unless otherwise ordered; (f)The exhibits may be returned; (g)Liberty to apply on 7 days notice if further orders are required. APPENDIX CALCULATION OF VALUE OF PAST GRATUITOUS DOMESTIC ASSISTANCE / CARE ACCORDING TO MOTOR ACCIDENTS ACT 1999, s 128 [6 hours per week] WEEKLY HOURLY PERIOD WEEKS s.128 s.128 AMOUNT FOR 6 HOURS PER WEEK RATE RATE

1. 02.11.2006 to 17.11.2006 02.14 $884.00 $22.10 $283.76
2. 18.11.2006 to 17.02.2007 13.00 $892.30 $22.30 $1739.40
3. 18.02.2007 to 18.05.2007 12.71 $916.10 $22.90 $1746.35
4. 19.05.2007 to 18.08.2007 13.00 $918.90 $22.97 $1791.66
5. 19.08.2007 to 16.11.2007 12.85 $929.70 $23.24 $1791.04
6. 17.11.2007 to 15.02.2008 12.85 $929.30 $23.23 $1791.03
7. 16.02.2008 to 16.05.2008 12.71 $937.80 $23.44 $1787.53
8. 17.05.2008 to 15.08.2008 12.85 $921.60 $23.04 $1776.38
9. 16.08.2008 to 21.11.2008 13.85 $933.50 $23.34 $1939.55
10. 22.11.2008 to 20.02.2009 12.85 $938.50 $23.46 $1808.77
11. 21.02.2009 to 15.05.2009 12.00 $946.40 $23.66 $1703.52
12. 16.05.2009 to 21.08.2009 13.85 $939.00 $23.48 $1951.19
13. 22.08.2009 to 20.11.2009 12.85 $959.90 $23.99 $1849.63
14. 21.11.2009 to 19.02.2010 12.85 $969.40 $24.23 $1868.13
15. 20.02.2010 to 21.05.2010 12.85 $989.90 $24.74 $1907.45
16. 22.05.2010 to 20.08.2010 12.85 $986.90 $24.67 $1902.06
17. 21.08.2010 to 19.11.2010 12.85 $985.50 $24.63 $1898.97
18. 20.11.2010 to 18.02.2011 12.85 $996.40 $24.91 $1920.56
19. 19.02.2011 to 16.05.2011 12.28 $1025.90 $25.64 $1889.16 TOTAL $33,352.14

DISCLAIMER - Every effort has been made to comply with suppression orders or statutory provisions prohibiting publication that may apply to this judgment or decision. The onus remains on any person using material in the judgment or decision to ensure that the intended use of that material does not breach any such order or provision. Further enquiries may be directed to the Registry of the Court or Tribunal in which it was generated. Decision last updated: 08 May 2012