Introduction
Ghobrial v QBE Insurance (Australia) Limited [2023] NSWPICMP 168 is a pivotal case in the realm of personal injury in Australia. The case revolves around Ms Sandy Ghobrial who was involved in a high-speed rear-end collision on a motorway while about 23 weeks pregnant. This accident, which occurred on 23 May 2019, resulted in a back injury and the development of a psychiatric condition for Ghobrial.
The matter at hand was a medical dispute regarding whether Ghobrial’s injuries were “minor” as per the statutory definition. The initial assessment by Medical Assessor Samuell classified Ghobrial’s psychiatric injury as a “minor injury”. However, Ghobrial applied for a review of this determination, leading to the convening of a Review Panel on 22 November 2022.
Legislative Framework
The case falls under the jurisdiction of the Motor Accident Injuries Act 2017 (the MAI Act). This act governs compulsory third-party insurance of all motor vehicles registered in New South Wales, providing a scheme for statutory benefits and lump sum damages for persons injured in motor accidents.
A crucial aspect of the MAI Act is the concept of a “threshold injury”. Originally referred to as a “minor injury”, a threshold injury is defined as a “psychological or psychiatric injury that is not a recognised psychiatric illness”. If the only injuries sustained by a person are “threshold” injuries, the injured person cannot receive statutory benefits beyond 26 weeks after the accident and cannot recover damages.
The assessment of whether a psychiatric illness is present must be made using the Diagnostic & Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) published by the American Psychiatric Association. If the symptoms associated with the injured person’s psychological or psychiatric injury do not meet the assessment criteria for a recognised psychiatric illness, with the exception of acute stress disorder and adjustment disorder, the injury is considered a threshold injury.
The Review Panel’s Determination
The Review Panel revoked the certificate of Medical Assessor Samuell dated 21 December 2021 and certified that Ghobrial’s psychological or psychiatric injury was not a threshold injury for the purposes of the Motor Accident Injuries Act 2017.
After re-examining Ghobrial, the Panel determined that she satisfied the criteria for a post-traumatic stress disorder (PTSD), which is a recognised psychiatric injury as per the DSM-5 and is not a threshold injury.
Importance of the Case
The Ghobrial v QBE Insurance case is an important development for future personal injury cases for several reasons:
- Clarification on Threshold Injuries: This case offers significant insights into the understanding and application of “threshold injuries” within the Australian legal context. It clarifies the interpretation and application of the DSM-5 in assessing psychiatric injuries following a motor accident.
- Precedent for PTSD Recognition: The recognition of PTSD as a non-threshold injury sets a precedent for future cases involving mental health conditions arising from accidents. This could potentially impact the way statutory benefits and damages are allocated in such cases.
- Implications for the Medical Assessment Process: The decision to revoke the initial medical assessment certificate underscores the criticality of comprehensive and accurate medical assessments in personal injury claims. It draws attention to the importance of considering all relevant records and evidence during medical assessments.
The exact impact of this case on future personal injury cases will undoubtedly unfold with time. However, the clear message is that careful consideration and accurate assessment of psychiatric injuries are paramount in determining the extent of statutory benefits and damages.
Conclusion
Ghobrial v QBE Insurance (Australia) Limited [2023] NSWPICMP 168 is a landmark case with potential far-reaching implications for personal injury cases in Australia. By acknowledging PTSD as a non-threshold injury, the case highlights the importance of mental health in the context of personal injury and puts a spotlight on the need for careful and thorough medical assessments in such cases.
As the legal landscape continues to evolve, this case serves as a reminder of the importance of continual review and refinement of legislative definitions and medical assessment processes in personal injury claims