Women Involved in Rear End Car Accident Rejects Insurer’s offer and Employs GMP to receive a Significant Compensation Payout

Published 22 Sep 2015

Our client was involved in a rear end collision in the Forster/Tuncurry area and tried to deal with the claim herself directly with the insurance company without any success.

Our client realised after trying to deal with the insurance company that they were not providing her with proper advice as to what her entitlements were. They tried to offer her a token amount to settle the claim without fully appreciating the extent of her injuries.

Our client sustained significant whiplash injury in the motor vehicle accident and had sought treatment from her local GP and physiotherapist. Our client took a few days off work but was able to maintain her duties which were administrative in nature whilst putting up with her pain.

Due to financial pressures she was not able to take significant time off from work.

She was fortunate that her employer understood that she was involved in an accident and allowed her to take regular breaks during the workplace so as to stretch out and keep mobile.

Our client’s work predominantly required her to sit at a computer desk and deal with administrative duties. The level of pain and discomfort increased throughout the course of the day requiring her to stretch out and take regular breaks and at times leave work early.

As such, our client did not lose significant amounts of time off from work but that was solely because she had a sympathetic employer.

During the very early stages of the claim the insurance company essentially tried to “buy out” our client by offering her a token amount of $10,000.00 to settle the claim.

Our client was looking for ongoing treatment to assist her to manage her pain and discomfort but this was not forthcoming by the insurer and ultimately resulted in her seeking the expertise and advice from Reg Kolokossian of Gerard Malouf & Partners.

As our client lived in the mid coast we were able to organise an immediate conference to see her in Forster and obtained detailed instructions from her as to what had taken place. The client had been dealing with the insurance company for over 12 months without any satisfaction.

It was clear she needed specialised advice from a firm that was aggressive in dealing with insurance companies. After having seen our client we provided her with advice as to how the claim should be managed, what her entitlements were with regards to treatment and ensuring that her treatment was overseen by her GP and physiotherapist in a structured way. Insurance companies cannot refuse treatment provided that treatment is reasonable and necessary. It is often the case that Doctors and physiotherapists and other rehab providers need to understand how the insurance companies work.

Gerard Malouf & Partners prides itself on its staff being able to communicate with all treatment providers to explain to them the process so as to ensure that a rehabilitation plan is in place. Such a plan was organised to the benefit of our client and the insurance company was not able to refuse her ongoing need for treatment.

Our client’s role in the administrative area as a secretary placed significant responsibility on her which also resulted in her having an increased degree of anxiety and stress. This is not unusual in victims of motor vehicle accidents where they try to push through the pain barrier and keep working. They end up suffering and stressing about their injuries. This causes a strain on relationships, increased levels of frustration and anxiety. We often advise our clients to be aware of these symptoms and recommend that they see their GP with a view to being referred to a Psychologist for counselling. Again such a treatment plan has to be co-ordinated through the Doctor where the Doctor makes the referral. Our client subsequently saw a Psychologist who was required to prepare an initial plan as to what the purpose of the treatment was going to be and what the goals were. Again, as accredited specialists, we are able to speak with the treatment providers and the Psychologists to ensure that the processes are in place so as to maximise our client’s benefits and entitlements.

Once our client’s treatment is under control it was then a matter of organising for her to be seen by our own independent expert Doctors to determine the level of impairment and whether our client would be entitled for compensation for her pain and suffering under the category of non economic loss.

In motor accident claims injured victims are entitled to seek compensation for the following heads of damages:-

  1. Non economic loss – this is often referred to as pain and suffering for general damages. An individual is entitled to such compensation where their injuries are assessed as being greater than 10% whole person impairment incorporating the American Medical Association Guidelines to the evaluation of impairment. These are strict clinical tests that are carried out by Doctors who are especially trained to determine the level of impairment often commonly referred to as disability.
  2. The other relevant heads of damages that we seek to claim on behalf of our clients are:-
a)    Past and future medical treatment expenses;
b)    Past and future wage loss;

c)    Past and future gratuitous care where they receive and require ongoing assistance from family members with regards to domestic and household activities.

It is often necessary to sit down with our clients to ensure that such aspects of their claims are properly understood and how they are in fact measured.

Reg Kolokossian an accredited specialist was able to sit down with our client, discuss all the various issues and explain to her the preparation required in properly presenting the case to the insurance company.

We ask of all our clients to work with us as it is a team effort to ensure that detailed submissions are prepared and that these submissions are reasonable and not fanciful or exaggerated.

In preparation of our detailed submissions we take statements from our client, her husband, letters of support from her employer and previous employers as well as details in terms of her earnings. We also have our specialist Doctor specifically deal with her physical restrictions and comment as to how they would impact with regards to her domestic day to day activities both at home and at work. This was important in terms of ensuring that a reasonable and fair claim was also submitted to the insurer in terms of the level of care she would require if the assistance was not readily made available by her husband. This is often the case when clients push themselves to go to work but find by the time they get home that they are exhausted as a result of their injuries and do not have the energy to attend to a lot of the day to day domestic and household duties. Family members and friends usually assist however, when this level of gratuitous assistance is no longer available, it is necessary to ensure that a reasonable claim is made for professionally provided domestic assistant care and this was the case in our client’s claim here.

As Specialist Solicitors having over 25 years of experience dealing with insurance companies, our clients get the benefit of having experienced Solicitors deal with insurance companies with regards to their claims. Insurance companies know that we at Gerard Malouf & Partners do not take a backward step and will fight vigorously to ensure maximum and fair compensation for our clients.

Ultimately, if we are not able to settle a claim with the insurance company the matter is referred to the Motor Accidents Authority where an independent Assessor is required to look at all the material and our submissions and formulate his own opinion.

Our lady from Forster was faced with an insurance company that did not wish to fully appreciate the significance of her injury and the efforts that she was making to keep in the workforce and minimise her loss. After failing to make any reasonable offers, the matter was prepared and submitted to the Motor Accidents Authority through the Claims & Resolution Service (CARS).

Finally, the insurance company after detailed and lengthy written and oral submissions in support of our client’s claim, instructed their own Solicitors and common sense prevailed.

Reg Kolokossian was able to sit down at a settlement conference with the Solicitors instructed by the insurance company and explain the submissions in relation to our client’s claim for compensation.

The matter was finally settled for an amount in excess of $145,000.00. This was a long way away from the initial token offer made by the insurance company of $10,000.00 to our client.

Whiplash injuries are notorious in terms of becoming chronic with regards to pain, discomfort and restriction in the neck and shoulder regions. These injuries do not normally get over the 10% impairment threshold and as such our clients are not entitled to receive compensation for their pain and suffering – impairment or disability. However, these injuries do impact on our client’s ability to work and restrict their capacity with regards to work generally. It is this important head of damage that is significant and requires proper understanding.

It is for that reason that injured victims need specialist advice from Accredited Specialist lawyers. We have found at Gerard Malouf & Partners we are able to provide our regional clients with the specialised advice to ensure that maximum compensation is sought and obtained.

Our lady from the Forster region was extremely happy with the final result.