Peter’s story: $400,000 win after insurance denied his injury claim

What followed the accident was a series of challenges that highlighted systemic issues in emergency response. Peter describes the frustrating aftermath.

“The emergency services were called, but the only thing the policeman wanted to do while I was convalescing on the nature strip was test me for alcohol. When the ambulance arrived, he wouldn’t take me to the hospital as he was unaccompanied. So I walked and called my wife, who was at work, to please pick me up.”

The immediate impact on Peter’s life was devastating. As someone who had been actively involved in recreational flying and training, home renovations, gardening, and bush walking, Peter suddenly found himself unable to perform basic daily activities.

“I couldn’t work, I couldn’t continue renovations, which proved problematic as my wife and I were renovating the kitchen. We had to use the BBQ and camping equipment to live.”

Peter’s recovery journey was marked by multiple surgeries and complications. The first surgery was unsuccessful due to a critical error.

“My surgery was unsuccessful as the nurse’s aide dropped my arm out of surgery, and the tendon was torn from the bone an hour after getting operated on. They said it would be painful, but after 4 weeks of agony, I had another MRI which showed that I needed to have ‘repairs’ done.”

The physical pain was accompanied by emotional distress.

“[I] couldn’t sleep, drank more than I should’ve, as pain relief wasn’t working. I went for four weeks of agony, thinking it was how it normally is. Very painful.”

Even today, Peter continues to experience the long-term consequences.

“I still suffer from aching of the shoulder joint after usage. Pins and needles down the arm to the hand. Numbness in the hand.”

The case presented significant challenges from the outset. Rita Furfaro, Partner at GMP Law, faced an insurer who refused to concede that Peter’s injuries exceeded the 10% whole person impairment threshold required for pain and suffering compensation.

“The insurer refused to accept that the claimant’s injuries exceeded the 10% threshold required to pursue a claim for pain and suffering. In response, we lodged an application to have his whole person impairment assessed by a medical specialist appointed by the Personal Injury Commission. This strategic step proved critical: the PIC doctor assessed his physical injuries at 15% impairment, enabling Peter to proceed with a claim for pain and suffering, in addition to compensation for past and future income loss.”

The complexity of Peter’s case required meticulous documentation and expert testimony.

Rita retained an occupational physician to assess the comprehensive impact of his injuries on his employability and long-term capacity to return to work. The evidence showed Peter was unable to work for three months immediately after the accident, required further time off following multiple surgeries, and was not expected to resume normal duties until late 2024.

Despite the severity of Peter’s injuries and their documented impact on his ability to work, the insurer remained unwilling to acknowledge that his impairment met the threshold for additional compensation. This ongoing resistance is what made escalation to the Personal Injury Commission necessary.

“When a claimant’s injuries are significant enough to require surgery and such a considerable amount of time off work, insurers ought to concede that their impairment exceeds the threshold,” Rita notes.

“This would enable settlement of claims in a much quicker manner and reduce the amount of legal costs incurred.”

The most persuasive evidence included comprehensive income documentation (payslips and tax returns), treating doctors’ reports, clinical notes, and detailed medicolegal assessments. All of which painted a full picture of Peter’s condition and long-term prognosis.

The accident’s impact extended far beyond Peter’s physical injuries.

Unable to pursue his passion of operating a recreational aviation school business, Peter faced not only physical limitations but also the loss of his professional identity and future plans.

“The most challenging aspects were the continuation of pain relief, convincing the medical system that I wasn’t addicted, sleeping, and depression from thinking that it would in no way adequately compensate me for the suffering me and my wife have endured,” Peter reflects.

Peter’s experience offers valuable insights for others facing similar circumstances. His advice is straightforward.

“Go to see an established reputable firm of litigation lawyers, such as GMP Law.”

He also emphasises the importance of documentation.

“Keep better records. On everything. Payslips. Out of pocket. referrals. operations, accident dates. Anything and everything. Try to do it when sleep deprived and in pain.”

Looking back, Peter acknowledges the complexity of the system.

“I now realise that it is a very expensive and all-consuming system, and it’s no wonder we pay so much for insurance.

This case demonstrates GMP Law’s commitment to fighting for clients’ rights even when faced with unreasonable insurance company resistance.

If you believe you have a motor vehicle accident claim, reach out to GMP Law. Our team of lawyers will help you maximise your claim in the minimal time possible.