Mitchelmore, Stern and Ball JJA
Summary
The NSW Court of Appeal dismissed an appeal by NRMA against orders of the Supreme Court. The Court held that the primary judge did not err in findings that a decision of the Personal Injury Commission review panel, relating to Mr Le’s claim for personal injury benefits, did not suffer from jurisdictional error or error of law. The decision provides useful commentary on inferences in expert medical opinion as to causation.
Background Facts
Issues
Mr Le, the First Respondent, was a passenger injured in a motor vehicle accident. Mr Le sustained a number of injuries and lodged a claim for personal injury benefits under the Motor Accident Injuries Act 2017 (NSW). Following the accident, Mr Le was diagnosed as suffering from a closed head injury, with traumatic brain injury (TBI) and amnesia. NRMA, the CTP insurer of the vehicle at fault in the accident, argued that the injury was caused by Le’s conduct in the immediate aftermath of the accident, rather than the accident itself. However, medical assessors and a review panel of the Personal Injury Commission found that the injury was caused by the accident. NRMA sought judicial review of the panel’s decision, which the primary judge rejected. NRMA then appealed.
The principal issues on appeal were whether the primary judge erred in finding:
- That the review panel determined the question of causation according to law; and
- That the review panel exposed its actual path of reasoning by which it arrived at the opinion it formed on the medical question referred to it.
Decision
On the first issue, the Court held that the review panel did not shift the burden of proof on causation. The review panel’s findings as to causation well supported its conclusion that the accident caused Mr Le’s traumatic brain injury.
The Court also clarified that a causal link between an accident and an injury need not rely solely on definitive expert opinion that such connection is established. When expert evidence suggests only a possible causal connection, the question arises as to whether “the expert opinion can be eked out by common knowledge so that the inference as to causation may be drawn.” It is common for expert medical opinions on causation to be based on inferences, drawn from the expert’s training, experience, and consideration of all the relevant circumstances.
Regarding the second issue, the Court held that the primary judge did not err in finding that the review panel’s reasons were sufficiently detailed and met the requisite standard. The appeal was dismissed.
Implications
- The drawing of inferences as to causation is a legitimate part of expert reasoning and legal analysis;
- A causal finding does not require definitive expert opinion but can be based on expert evidence combined with common knowledge and context;
- The review panel meets its legal obligation if it adequately exposes its path of reasoning, even where causation is established inferentially.