Lithgow v Insurance Australia Ltd trading as NRMA Insurance [2017] NSWSC 1104

Lithgow v Insurance Australia Ltd trading as NRMA Insurance [2017] NSWSC 1104

The further amended summons was dismissed because there was no statutory requirement that a treatment expense claim be before SIRA before a disagreement about treatment could be referred as a medical dispute under s 60. There was plainly a dispute about whether the plaintiff's lumbar spine surgery related to the motor accident injury and whether it was reasonable and necessary, so SIRA was obliged to refer it for assessment. Dr Ryan was not bound by Dr Kenna's earlier causation findings and his certificate and reasons showed that he considered the relevant material, examined the plaintiff, took a history and adequately explained his conclusion that the surgery did not relate to the...

Jurisdiction
Australia
Judgment Date
21 August 2017
Procedural Posture
Judicial Review Under S 69 of the Supreme Court Act 1970 (nsw) / Principal Judgment on Further Amended Summons
Outcome
Further amended summons dismissed; plaintiff ordered to pay the defendants' costs.
Legal Topics
['medical Assessment Under the Motor Accidents Compensation Act 1999 (nsw)' 'treatment Dispute' 'permanent Impairment Assessment' 'jurisdictional Error' 'certiorari and Mandamus' 'adequacy of Reasons']
['administrative Law' 'motor Accidents Compensation' 'judicial Review'] ['medical Assessment Under the Motor Accidents Compensation Act 1999 (nsw)' 'treatment Dispute' 'permanent Impairment Assessment' 'jurisdictional Error' 'certiorari and Mandamus' 'adequacy of Reasons']

Case Brief

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Procedural Posture

Judicial Review Under S 69 of the Supreme Court Act 1970 (nsw) / Principal Judgment on Further Amended Summons

Legal Issues

  1. 1 ['Whether SIRA acted outside jurisdiction by referring a treatment dispute for medical assessment when the material before it did not establish that the plaintiff had made a claim for treatment expenses.' 'Whether the making of a claim for treatment expenses was a jurisdictional fact or precondition to referral of a medical dispute under s 60 of the Motor Accidents Compensation Act 1999 (NSW).' 'Whether the earlier medical assessment certificate of Dr Kenna precluded referral of questions about whether the lumbar spine surgery related to the motor accident injury and was reasonable and necessary.' 'Whether Dr Ryan failed to identify the injury, failed to have regard to relevant medical evidence, or failed adequately to deal with causation in his medical assessment certificate.']

Ratio Decidendi

The further amended summons was dismissed because there was no statutory requirement that a treatment expense claim be before SIRA before a disagreement about treatment could be referred as a medical dispute under s 60. There was plainly a dispute about whether the plaintiff's lumbar spine surgery related to the motor accident injury and whether it was reasonable and necessary, so SIRA was obliged to refer it for assessment. Dr Ryan was not bound by Dr Kenna's earlier causation findings and his certificate and reasons showed that he considered the relevant material, examined the plaintiff, took a history and adequately explained his conclusion that the surgery did not relate to the...

Court Disposition

Further amended summons dismissed; plaintiff ordered to pay the defendants' costs.

Orders

  • ['Dismiss the further amended summons filed on 15 August 2017.' "Order the plaintiff to pay the defendants' costs."]