What to expect from insurance companies

Hi Joshua  I am still in disbelief [regarding my award of compensation]. Wow!  Thank you so much for your assistance, hard work and unders...

 Hi Joshua
 I am still in disbelief [regarding my award of compensation]. Wow!
 Thank you so much for your assistance, hard work and understanding.
 Warmest regards,
 LC

We have a client who sustained an injury in the course of his employment and was paid compensation pursuant to the Workers Compensation Act ...

We have a client who sustained an injury in the course of his employment and was paid compensation pursuant to the Workers Compensation Act 1987 (NSW) ("the Act"). The client required surgery to treat the injury and as a consequence of the negligence of the treating doctor, suffered an additional injury.

In the course of the proceedings for damages against the doctor, the client sought a declaration from the workers compensation insurer that payments made to him pursuant to the Act were not repayable pursuant to Section 151Z.

The workers compensation insurer advised us that they considered they had a right of recovery for all weekly compensation benefits and medical expenses paid pursuant to Section 151Z (1) (d) of the Act and would be pursuing recovery of these.

In reply we wrote to the insurer and advised there have been a series of Court of Appeal decisions which have found that in this situation Section 151Z (1) (d) does not operate to allow the workers compensation insurer to recover the payments it has made.

In Hood Constructions Pty Limited v Nicholas [1987] NSWLR 60 the court stated that the injury caused by the medical treatment was not "an injury for which compensation is payable" within the meaning of Section 151Z, notwithstanding the fact that the surgery was undertaken to remedy an injury sustained in the court of employment. The court went on to find that the worker's damages against the doctor were to be reduced to take into account the compensation payments already received.

This was confirmed in the matter of Rooty Hill Medical Centre Pty Limited v Gunther [2002] NSWCA 60. The court of appeal confirmed that Section 151Z of the Workers Compensation Act did not apply and the plaintiff’s damages had to be reduced to give effect to the overriding intention of parliament that a worker should not be entitled to both compensation and damages.

The workers compensation insurer then conceded that Section 151Z did not apply in this case and they would not be pursuing any recovery from our client. This was important as we were then able to advise our client on his likely damages if he was successful in the claim.