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AAX v NRMA Insurance Ltd [2018] NSWDRS MR 024

NSW DISPUTE RESOLUTION SERVICE (NSWDRS)
JurisdictionMerit Review
CatchwordsStatutory benefits - weekly payments - self employed - review discontinued
Legislation citedMotor Accidents Injury Act (NSW) ss 3.6, 7.13, Schedule 2
Motor Accident Injuries Regulation 2017
Motor Accident Guidelines effective 13 July 2018 cl 7.441
Cases citedN/A
Text citedN/A
Parties AAX - Claimant
NRMA Insurance Ltd - Insurer
DisclaimerThis decision has been edited to remove all Unique Personal Identification including the name of the Claimant.

Merit Review Certificate

View the certificate

Issued under section 7.13(4) of the Motor Accident Injuries Act 2017

The Claim
Claimant AAX
Insurer NRMA 
Claim Number NWRTP180108301
The Reviewable Decision
Reviewable decision‐maker Karen Burgoyne
Date of Reviewable decision 21 June 2018
Nature of Reviewable decision The weekly payments of statutory benefits to injured persons
The Merit Review
Our Reference 10040465
Merit Reviewer Terence O'Riain
Date of Merit Review Certificate 13 September 2018

Merit Reviewer’s Determination

This determination relates to a merit review matter, which is a reviewable decision under Schedule 2(1)(a) of the Motor Accident Injuries Act 2017, about weekly payments of statutory benefits to injured persons.

My determination of the Merit Review is as follows:

  • The Merit Review is discontinued

A brief statement of my reasons for this determination are attached to this certificate.

Terence O’Riain
Merit Reviewer, Dispute Resolution Service
13 September 2018

Merit Reviewer’s Reasons for Determination

Background

1.  There is a dispute between AAX and the Insurer in respect to the payment of weekly payments under section 3.6(2) of the Motor Accidents Injuries Act 2017 (“the Act”) arising from the motor accident on 22 May 2018.

2.  The Insurer initially declined to pay the benefit for the period from date of accident up to and including 29 May 2018 and this decision was affirmed on internal review.

3.  Since this Merit Review was sought the Insurer has conceded that AAX has an entitlement to weekly payments for the period claimed.

4.  At this stage the only outstanding matter is the quantum of weekly payments as AAX is self employed.

5.  AAX or the Insurer may reapply for Merit Review regarding quantum if that matter cannot be resolved.

Documents and Information

6.  I have considered the documents provided in the application and the reply and any further information provided by the parties.

Legislation

7.  In conducting my review I have considered the following legislation and guidelines:

a.    Motor Accident Injuries Act 2017 (NSW) (“the Act”)

b.    Motor Accident Guidelines effective 13 July 2018 (“the Guidelines”)
c.    Motor Accident Injuries Regulation 2017 (NSW) (“the Regulation”)

Legal Costs

8.   Legal Costs are not sought

9.   Disbursements for medical reports to be agreed between AAX and the Insurer.

Determination

My determination of the Merit Review is as follows:

·         The Merit Review is discontinued.

Terence O’Riain
Merit Reviewer, Dispute Resolution Service
13 September 2018