Aldridge v Allianz Australia Insurance Ltd [2009] QSC 257
SUPREME COURT OF QUEENSLAND
CITATION: Aldridge v Allianz Australia Insurance Ltd [2009] QSC 257
PARTIES: LOUISE RUTH ALDRIDGE
(applicant)
v
ALLIANZ AUSTRALIA INSURANCE LTD
(ABN 15 000 122 850)
(respondent)
FILE NO: 4937 of 2009
DIVISION: Trial Division
PROCEEDING: Application
ORIGINATING
COURT: Supreme Court of Queensland
DELIVERED ON: 31 August 2009
DELIVERED AT: Brisbane
HEARING DATE: 7 August 2009; further written submissions on 20 August
2009 and 24 August 2009
JUDGE: Applegarth J
ORDER: The applicant prepare and submit proposed minutes of
order.
CATCHWORDS: INSURANCE – THIRD-PARTY LIABILITY INSURANCE
– MOTOR VEHICLES – COMPULSORY INSURANCE
LEGISLATION – GENERALLY – QUEENSLAND – where
applicant is a paraplegic due to a motor vehicle accident –
where respondent insurer has admitted liability – where the
applicant has applied to Court to determine what kind of
accommodation constitutes reasonable and appropriate
rehabilitation services in the circumstances – which of the
accommodation options canvassed by the parties is
reasonable and appropriate in the circumstances
Acts Interpretation Act 1954 (Qld), s 14A, s 14B
Motor Accident Insurance Act 1994 (Qld), s 3, s 4, s 51, s 65
Lynch v Lynch & Anor (1991) Aust Torts Reports 81-117,
cited
Massingham v AAMI Insurance Ltd (2007) 48 MVR 235;
[2007] QSC 174, cited
McMullen v Suhr [1998] 2 Qd R 406, applied
Moriarty v McCarthy [1978] 2 All ER 213, cited
Munzer v Johnston & Anor [2009] QCA 190, applied
Re Walker (1995) 22 MVR 245, applied
Weideck v Williams [1999] NSWCA 346, cited
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COUNSEL: M Grant-Taylor SC and C C Heyworth-Smith for the
applicant
S C Williams QC and S J Williams for the respondent
SOLICITORS: Shultz Toomey O’Brien for the applicant
Moray and Agnew for the respondent
[1] The applicant is a paraplegic as a result of a motor vehicle collision that occurred on
22 June 2008. On 7 January 2009 the respondent, a compulsory third party insurer,
admitted liability for the collision. Before she was injured the applicant lived with
and supported her three teenage daughters in her own home at Pacific Paradise on
the Sunshine Coast. Even with modifications that have been made to enable the
applicant to access its lower level and to live downstairs, the applicant’s two-level
home is unsuitable for her accommodation and rehabilitation. On this application
under s 51(5)(b) of the Motor Accident Insurance Act 1994 (Qld) (“the Act”) I am
required to decide “what rehabilitation services are, in the circumstances of the case,
reasonable and appropriate”. In particular, I am required to decide which of the
following accommodation options is reasonable and appropriate in the
circumstances:
1. The extensive, further modification of the applicant’s home.
2. The construction of a new “project home” that is designed and built to meet
her needs.
3. The identification and rental of an existing residence that is modified to meet
her needs.
4. The identification and purchase of an existing residence that is modified to
meet her needs.
It is envisaged that the costs of acquisition in the second and fourth options would
be partly funded by the net proceeds of sale of the applicant’s home.
The statutory scheme
[2] One of the objects of the Act is “to promote and encourage, as far as practicable, the
rehabilitation of claimants who sustain personal injury because of motor vehicle
accidents”. 1 Once liability has been admitted on a claim under the Act, the insurer
must, at the claimant’s request, ensure that “reasonable and appropriate
rehabilitation services” are made available to the claimant. 2
[3] The term “rehabilitation” means “the use of medical, psychological, physical,
social, educational and vocational measures (individually or in combination) –
“(a) to restore, as far as reasonably possible, physical or
mental functions lost or impaired through personal
injury; and
(b) to optimise, as far as reasonably possible, the quality of
life of a person who suffers the loss or impairment of
physical or mental functions through personal injury.”3
1 The Act, s 3(d).
2 The Act, s51(3).
3 The Act, s 4.
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[4] Section 51 of the Act relevantly provides:
“51 Obligation to provide rehabilitation services
(1) An insurer may make rehabilitation services
available to a claimant on the insurer’s own
initiative or at the claimant’s request.
(2) An insurer that makes rehabilitation services
available to a claimant before admitting or denying
liability on the claim must not be taken, for that
reason, to have admitted liability.
(3) Once liability has been admitted on a claim, or the
insurer has agreed to fund rehabilitation services
without making an admission of liability, the
insurer must, at the claimant’s request, ensure that
reasonable and appropriate rehabilitation services
are made available to the claimant.
(4) If the insurer intends to ask the court to take the
cost of rehabilitation services into account in the
assessment of damages, the insurer must, before
providing the rehabilitation services, give the
claimant a written estimate of the cost of the
rehabilitation services and a statement explaining
how, and to what extent, the assessment of
damages is likely to be affected by the provision of
the rehabilitation services.
(5) The claimant may, if not satisfied that the
rehabilitation services made available under this
section are reasonable and appropriate –
(a) apply to the commission to appoint a
mediator to help resolve the questions
between the claimant and the insurer; or
(b) apply to the court to decide what
rehabilitation services are, in the
circumstances of the case, reasonable and
appropriate.
(5A) ... [these subsections relate to the appointment of a
mediator]
(5B) ...
(5C) An application may be made to the court under
subsection (5)(b) whether or not there has been an
earlier attempt to resolve the questions between the
claimant and the insurer by mediation.
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(5D) On an application under subsection (5)(b), the court
may decide what rehabilitation services are, in the
circumstances of the case, reasonable and
appropriate and make consequential orders and
directions.
(6) The insurer must bear (or reimburse) the cost of
providing rehabilitation services under this section
unless the insurer’s liability is reduced -
(a) by agreement with the claimant; or
(b) by order of the court under subsection (8).
(7) The insurer may, if of the opinion that the cost of
rehabilitation services is unreasonable –
(a) apply to the commission to appoint a
mediator to help resolve the questions
between the claimant and the insurer; or
(b) apply to the court to decide what
rehabilitation services are, in the
circumstances of the case, reasonable and
appropriate or to decide to what extent the
insurer should contribute to the cost of
rehabilitation services.
(7A) ... [these subsections relate to the appointment of a
mediator]
(7B) ...
(7C) An application may be made to the court under
subsection (7)(b) whether or not there has been an
earlier attempt to resolve the questions between the
insurer and the claimant by mediation.
(8) On an application under subsection (7)(b), the court
may decide the questions raised on the application
and make consequential orders and directions.
(9) The cost to the insurer of providing rehabilitation
services under this section is to be taken into
account in the assessment of damages on the claim
if (and only if) the insurer gave a statement to the
claimant, as required under subsection (4),
explaining how and to what extent the assessment
of damages was likely to be affected by the
provision of the rehabilitation services.
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(9A) If the cost of rehabilitation services is to be taken
into account in the assessment of damages, the cost
is taken into account as follows –
(a) the claimant’s damages are first assessed
(without reduction for contributory
negligence) on the assumption that the
claimant has incurred the cost of the
rehabilitation services as a result of the injury
suffered in the accident;
(b) any reduction to be made on account of
contributory negligence is then made;
(c) the total cost of rehabilitation services is then
set-off against the amount assessed. 4
(10) An insurer who is induced by a claimant’s fraud to
provide rehabilitation services for the claimant may
recover the cost to the insurer of providing the
services, as a debt, from the claimant.”
[5] Section 51 is to be construed beneficially from the perspective of claimants.5 The
provision of accommodation in a house that has features that enable a paraplegic to
“optimise the quality” of her life may involve an expense, such as rent, that is
incidental to ordinary living. Yet, having regard to the remedial intent of
s 51, and subject to there being provision for recovery of the expenditure on
rehabilitation services in accordance with s 51(9), “no narrow view should be taken
of the obligation imposed on an insurer under s 51(3)”.6
[6] In Re Walker7 Moynihan J stated:
“… the plaintiff’s remedy remains damages designed to restore
him, so far as money is able, to his pre-accident condition and to
satisfy, again in so far as money can, needs caused by his injury;
see for example Van Gurven v Fenton (1992) 175 CLR 327; 17
MVR 29. The present case is concerned with interim measures
with the overall consequences of the applicant’s injuries to be
assessed later.
Section 51(5) provides a test in broad terms. The elements
would seem to be ‘the circumstances of the case’, ‘reasonable’
4 The following example appears in the Act:
Suppose that responsibility for a motor vehicle accident is apportioned equally between the claimant
and the insurer. Damages (exclusive of the cost of rehabilitation) before apportionment are fixed at
$20000. The insurer has spent $5000 on rehabilitation services. In this case, the claimant’s damages
will be assessed under paragraph (a) at $25000 (that is, as if the claimant had incurred the $5000
rehabilitation expense) and reduced to $12500 under paragraph (b), and the $5000 spent by the
insurer on rehabilitation will be set off against this amount, resulting in a final award of $7500.
5 Re Walker (1995) 22 MVR 245 at 247; McMullen v Suhr [1998] 2 Qd R 406 at 408; Massingham v
AAMI Insurance Ltd (2007) 48 MVR 235 at 237 [8]; also cited as Delaney v AAMI Insurance Ltd
[2007] QSC 174.
6 McMullen v Suhr [1998] 2 Qd R 406 at 408.
7 Re Walker (1995) 22 MVR 245 at 247-8.
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and ‘appropriate’. ‘Reasonable’ would appear to connote no
more than its usual meaning as founded on reason as distinct
from arbitrary or capricious. ‘Appropriate’ would appear to
connote ‘suitable or fitting for a particular purpose’ in this case
‘rehabilitation’ as defined.
Subsection (5) appears to require the court to form its own
opinion. Although there may be a role for expert opinion in
some aspects of applications under subs (5), that should be
limited by the nature of the jurisdiction and to evidence of expert
opinion properly defined. The court must make up its own mind
at the interim stage in a broad rather than refined way.”
The Options
[7] The following discussion of the four options includes reference to specific
properties, such as a rental property at Lows Drive, Pacific Paradise and an existing
residence that might be acquired at Sassifras Street, Mudjimba. The parties do not
propose that an order refer to a specific property. Instead, the evidence in relation to
these and other properties assists in identifying issues requiring consideration in
respect of each option.
The extensive, further modification of the applicant’s home
[8] Before the accident the applicant, a single mother then aged 42, supported herself
and her three teenage girls by operating a driving school business. They lived in a
two-storey home. After the accident some modifications were made to it to enable
the applicant to be released from hospital and return to her family. Even with these
modifications which enable the plaintiff to live downstairs, the home is quite
unsuitable. 8 Extensive further modifications, including the installation of a lift,
have been considered and costed. The modifications would be very expensive.
They would cost approximately $279,000.9 Even after the modifications the
applicant’s home still would not be suitable for her accommodation and the care of
her daughters. Ms Ainsworth, an occupational therapist familiar with the
applicant’s circumstances, gave evidence that the applicant’s function would be
compromised and she would continue to experience difficulty accessing the upstairs
level. 10 The applicant explained that in a two-storey home it was impossible to
properly be involved in supervising and monitoring her three teenage daughters.
One daughter has significant health problems, including regularly suffering asthma
attacks, and the applicant is required to monitor her health. It could take ten to
fifteen minutes to access the second storey by a lift. 11
[9] The applicant and her daughters would be disturbed, and quite possibly would have
to vacate the premises, whilst modifications were performed to it. The applicant
accurately described the required modifications as a “massive undertaking”. Such a
modified two-storey dwelling would be unsuitable for both the applicant’s short-
term and long-term needs, and her rehabilitation.
8 The problems with the property are detailed in the applicant’s affidavit filed 29 May 2009 Court File
Index (CFI) 3. See also Ms Ainsworth’s evidence at Transcript 1-9 line 1-15; 1-13 lines 1-8 and Ms
Cox’s evidence at Transcript 1-23 line 15–1-24 line 45.
9 Affidavits of Mr Lok filed 8 July 2009; CFI 16 and filed 16 July 2009 CFI 18.
10 Transcript 1-9 line 5.
11 Transcript 1-13 line 8.
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[10] It would be wasteful to undertake such modifications, even if the applicant wanted
them performed, which she does not. Substantial expert evidence was assembled
for the hearing, and some experts were required for cross examination. However,
the applicant’s evidence under cross examination and which was given by telephone
distilled the matter nicely:
“I thought a single-storey home, one, it wouldn’t cost as much to
change it and it’s something I can live in for the rest of my life. Like,
eventually this house, even if they change it, eventually I will have to
move out of it because it will just be too big for me to look after,
where if I go into a single-storey home it will be something I can
eventually look after myself and I would like to.”12
[11] It is surprising in the light of the evidence that the respondent submitted that with
modifications the applicant’s existing home would provide a “reasonable and
appropriate level of rehabilitation insofar as accommodation is concerned”. The
respondent acknowledged that it was not “the best solution” but it was said to
provide a “functional short-term solution”.13
[12] This option is neither reasonable nor appropriate in the circumstances for the
plaintiff’s rehabilitation. It is costly, inconvenient and not suited to the plaintiff’s
rehabilitation compared to the applicant living in a single-storey home.
The construction of a new “project home” that is designed and built to meet
the applicant’s needs
[13] The applicant proposed that the respondent fund the acquisition of a block of land in
her locality, construct a reasonable home upon it and that the respondent receive the
net sale proceeds of her existing home. The applicant did not suggest that she
needed a home that was designed by an architect and would be content with a
modified project home. Vacant blocks in the area range from the mid to high
$300,000 to $600,000, and a comparable block to the applicant’s would be in the
order of $400,000 to $500,000. The cost to build a single story home with
modifications for the applicant’s condition is likely to be between $300,000 and
$400,000.14
[14] The applicant’s rehabilitation co-ordinator, Ms Cox, expressed the opinion that it
would be “sensible (and cost effective) to consider purpose building a residence
which allows [the applicant] to maximise her function and corresponding
independence”. 15 Ms Ainsworth, an occupational therapist, expressed the following
opinion:16
“I recommend the construction of a new home that has been built to
the Adaptable Housing Standard (AS 4299) with some alterations in
measurements to suit the client’s specific requirements. The new
construction option will probably be more cost effective compared
to modifying her current home at considerable expense. The
provision of a new home may achieve better outcomes for Ms
12 Transcript 1-37 lines 50-57.
13 Transcript 1-51 lines 13-20.
14 Applicant’s affidavit filed 7 August 2009, CFI 27; and see the affidavit of Ms Hookham filed 5
August 2009, CFI 26 that the cost of a modified project home would range from $250,000 to
$400,000 depending on the extent of the modifications and inclusions.
15 Exhibit SC1 to Ms Cox’s affidavit filed 3 June 2009, CFI 6 at 6.
16 Exhibit TS14 to the affidavit of Mr Schultz filed 29 May 2009, CFI 2 at 138.
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Aldridge in terms of home and community participation in the long
term.”
[15] These and other opinions do not precisely address the question that I am required to
address, and the respondent submits that “each opinion blurs the necessary
distinction between the applicant’s ideal housing requirements (i.e. damages) as
opposed to her reasonable and appropriate rehabilitation requirements”. More
generally, the respondent submits that the application is limited to consideration of
the applicant’s “rehabilitation”, not her long-term, optimum accommodation
requirements, and how she might choose to spend her own funds on accommodation
for herself and her family.
[16] It will be necessary to return to the interplay between the insurer’s statutory
obligation to ensure that “reasonable and appropriate rehabilitation services” are
made available to the claimant 17 and the resolution of a claimant’s damages claim.
In short, the obligation under the Act is not concerned with only short-term
solutions, whereas an award of damages, and only an award of damages, provides a
long-term solution to accommodation needs that were caused by the accident. A
reasonable and appropriate rehabilitation service that an insurer is required to ensure
under the Act may satisfy both short-term and long-term accommodation needs.
[17] The principal difficulty with the modified project home option is that it does not
address the applicant’s immediate need and her need over at least the next twelve
months for suitable accommodation in order “to optimise, as far as reasonably
possible, the quality of [her] life”. 18 This is because it was estimated to take
between 12 and 16 months “starting from scratch” for a modified project home to be
completed. 19 This involves identifying and purchasing a block of land, preparing a
plan, having it approved by council, engaging a builder and then completing
construction of the modified project home.
[18] The claimant was prepared to tolerate this period of delay, even to the extent of
remaining in her home without further modification and the problems that it
presents to her personally and in attending to her children’s care. 20 The option of
the applicant remaining in her present circumstances with the difficulties that it
presents for her rehabilitation, and to then move in over a year’s time and close to
any trial to a modified project home built at the respondent’s cost is an unattractive
option. It may provide a long-term solution to the applicant’s accommodation
needs, but it does not assist her rehabilitation in the meantime.
[19] In response to this fact, the applicant’s counsel raised the prospect that I also order
in the meantime that the respondent fund a rented, modified single-storey home.
That option requires consideration, including the costs of modifying and reinstating
a rental property, and whether a more reasonable and appropriate option would be:
1. for the respondent to fund the rental of a modified single-storey home up
until the date of trial, leaving the applicant to fund the acquisition of a
modified project home with the proceeds of the sale of her home and
damages, including damages awarded in respect of her need for modified
housing (the third option); or
17 The Act, s 51(3).
18 The Act, s 4.
19 Evidence of Mr Lok, Transcript 1-15 lines 50-60.
20 Applicant’s oral submissions, Transcript 1-66 lines 10-16; evidence Transcript 1-35 line 20.
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2. the identification and purchase of an existing residence that is modified to
meet her needs (the fourth option).
The identification and rental of an existing residence that is modified to meet
the applicant’s needs
[20] This option emerged for consideration when the application was originally
returnable on 12 June 2009. Various possible rental properties have been reviewed
since then. Of those only one was the subject of submissions, namely a single level
four bedroom home at 60 Lows Drive, Pacific Paradise (“Lows Drive”), although
there is evidence that similar houses come on to the rental market fairly regularly.21
[21] Concerns were expressed by the applicant that about the lack of security of tenure,
and the respondent sought to address these by obtaining an “agreement in principle”
from the owner of Lows Drive to rent the premises for a period of up to 24 months
in the first instance. The respondent is prepared to fund the rental of the premises
during that period, or if the applicant’s claim for damages is resolved by
compromise or judgment within that period, then until compromise or judgment
monies have been paid. If the applicant’s claim for damages is not resolved at the
expiry of the 24 month rental period, the respondent will use its best endeavors to
extend the lease for a period until such time as the applicant’s claim for damages
has been resolved and compromise or judgment monies have been paid.
[22] The cost of modifying Lows Drive to suit the applicant’s needs is estimated
by Mr Lok, a licensed builder specialising in the design and construction of home
modifications for the disabled and the elderly, to be between $43,470 and $58,710.22
In a letter dated 20 July 2009, Mr Lok said that the cost of reinstatement depended
on what the landlord required to be reinstated, and at worst the cost would be the
same as the total costs of modification, keeping in mind future increases in labour
and material costs. His oral evidence was that if the premises were reinstated
“completely back to normal”, it would be at least the same cost as the cost of
performing the modifications. 23
[23] The respondent:
• has sought, and received, the owner’s consent to carry out those modifications;
• will fund the applicant’s reasonable removal and ancillary costs from her
existing home to those rental premises;
• will fund the “make good” costs on the rental premises and also cleaning costs
in accordance with the recommendations in a rehabilitation report;
• expects the applicant to make all reasonable effort to rent her existing home at a
commercial rate of rental and that the gross rental received by the applicant net
of agent’s fees be applied to off-set the rental paid by the respondent on the
premises in which she would be housed;
• is prepared to treat all costs incurred in the proposal as rehabilitation expenses
under the Act.
21 Affidavit of Ms McNabb filed 16 July 2009, CFI 17, para 12.
22 Affidavit of Mr Lok filed 3 August 2009, CFI 23, para 5.
23 Transcript 1-16 line 25.
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The applicant has inspected the property, and her evidence24 is that the area where
the Lows Drive property is located is not safe. The home also is located on a busy
road and is affected by constant and considerable traffic noise. She says that the
driveway to the premises, even after it is concreted, is too steep, such that she would
not be able to get up or down the driveway in her wheelchair. However, Ms Cox 25
and Ms Zeeman 26 who inspected the property did not identify a problem with the
level of the driveway, and I find that it is likely that the driveway could be modified
to address the applicant’s concerns. The applicant believes that the property in its
present state could not be made sufficiently secure to prevent her dog escaping.
There is no swimming pool, whereas her existing residence has a pool.
[24] The applicant says that there is insufficient space for her hoist and medical
equipment, that there is insufficient storage space and that if modifications are made
there would be even less space. She describes the long corridor with an L-turn at
the end as “problematic”. Her uncontested evidence is that when she attempted to
manoeuvre in her wheelchair down the corridor and make this turn, it was extremely
tight and she had great difficulty in doing so. It was so awkward that she took skin
off her knuckles. Ms Zeman’s evidence in the context of another rental property
with a hallway width of 1060 mm is that a corridor with that width would be
“generally deemed appropriate for wheelchair access”.27 The hallway width at
Lows Drive was described in her report as follows:
“Narrow hallway to bedrooms, bathroom, and laundry. Hall width
840mm. Access to hallway is NOT direct, and accommodates a turn
around a 90 degree junction point. The narrowest width required to
be transversed (sic) at this junction point is 800mm.”
[25] An unresolved issue remains about the size of the powered wheelchair that the
applicant expects to soon acquire, and whether it could be manoeuvred in the Lows
Drive home, even with the modifications that Ms Zeman recommends in her report.
Other deficiencies were raised by the applicant concerning the state of the back
deck, and the risk that rotten boards would not support the applicant and her
wheelchair.
[26] The applicant’s evidence is that the home is simply unsuitable and she would not
want to live there given the constant noise and its close proximity to a busy road. I
accept her evidence about the lack of space, the difficulties she has with her
wheelchair in negotiating its hallway, the noise from the busy road and that she has
genuine concerns about her safety at that location.
[27] The applicant submits that implementation of the respondent’s proposal would
inevitably mean that she would have to move house at least twice, as opposed to the
single move that would be entailed were she to move into her own residence
(whether new or existing).
[28] Ms Cox, the rehabilitation provider appointed to address the applicant’s needs, gave
evidence that the applicant’s recent selection of a power wheelchair would need to
be taken into consideration in determining the suitability of Lows Drive, along with
24 Affidavit filed 3 July 2009, CFI 25.
25 Affidavit filed 7 July 2009, CFI 11, report 30 June 2009 at 3-4.
26 Affidavit filed 21 July 2009, CFI 19, report 16 July 2009 at 5.
27 Transcript 1-41 line 32.
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the applicant’s other concerns.28 Ms Cox’s earlier expressed concerns about
security of tenure might be addressed by an appropriately long lease, and a notice
period that gave adequate notice to enable the applicant to relocate to suitable
premises. 29
[29] Even with these protections, Ms Cox had concerns with “shorter-term solutions”
from a rehabilitation perspective. They were not the most suitable and made it
difficult for the applicant to move on to other rehabilitation goals, such as a return to
recreational activities and a return to work, which the applicant was keen to pursue.
The applicant wanted to return as fully as possible to her role as a mother and as a
member of the community. Ms Cox’s opinion was that “whilst her physical
environment is either unstable or unsure, as it may be in a rental property as
opposed to the security of her own home” it may be difficult for her to move on to
these goals in the manner and the timeframe that they should be progressed. 30 I
accept Ms Cox’s opinion.
[30] Although single-level, four bedroom homes like that at 60 Lows Drive, Pacific
Paradise may come onto the rental market fairly regularly, the respondent and the
experts found only two out of the eight that they inspected that were said to come
close to meeting the applicant’s needs, and then only after modifications. There
were no available rental properties that required little or no modifications. Of the
two, only Lows Road was advanced by the respondent as offering security of tenure
under an agreement in principle with the landlord.
[31] The cost of modifying Lows Drive is substantial, and those costs may double if the
landlord requires the condition of his home to be reinstated. Issues exist concerning
the physical suitability of Lows Drive. If the corridor in Lows Drive proves
unsuitable for the applicant’s power wheelchair, or if the applicant encounters the
problems that she experienced in her existing wheelchair despite modifications to
the corridor, then it will be unsuitable. It may not be simple to find another rental
property that suits the applicant’s requirements.31 In recent months the only rental
property that the respondent claims to be suitable and that the respondent was able
to find was one on a busy main road in an area which the applicant thought was
unsafe for her and her daughters. This provides little assurance that a suitable rental
property that provides security of tenure to the applicant can be found in the near
future.
[32] Although the parties are agreed that it is not my task to decide upon a specific
property, such as Lows Drive, it exemplifies problems with the “modify and rent”
option. A suitable property must be found that the landlord is willing to rent for a
substantial period in order to provide the applicant with security of tenure up until
the trial or settlement of her action, and beyond it until such time as she is able to
move into a home of her own. At least two moves, with disturbance to the applicant
and her daughters, would be involved. The rental property must be suitable in terms
of the applicant’s physical needs, and if Lows Drive is any indication the cost of
modification and any reinstatement is likely to be substantial. The cost of
28 Transcript 1-19 lines 10-20.
29 Transcript 1-19 – 1-20.
30 Transcript 1-22 line 48 – 1-23 line 10.
31 cf Transcript 1-41 line 10 (Ms Zeman).
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modification may be as high as the cost of modifying the design of a project home, 32
or modifying an existing home that is purchased, and these options do not involve
the additional costs of reinstating modifications at the end of a lease.
[33] Even if the rental property can be modified to make it physically suitable for the
plaintiff’s needs, it’s location may not be suitable to the applicant’s rehabilitation.
Lows Drive illustrates the problem. Assuming that can be made suitable for the
applicant’s wheelchairs, and provide her with suitable access, mobility and storage,
it is on a busy and noisy road. The applicant’s evidence about the area not being
safe and her concerns about the security of her family living there were not
contested. Such a state of affairs does not provide the stability required for the
applicant’s rehabilitation.
[34] In the absence of evidence that there are suitable rental properties that are likely to
become available on a long-term lease in the near future in the vicinity in which the
applicant lives and her daughters attend school, I am reluctant to conclude that the
“rent and modify” option is a reasonable and appropriate option.
[35] Even if it was assumed that such properties would become available in the near
future, and could be modified to meet the applicant’s rehabilitation requirements,
the cost of modification is uncertain, as is the cost of reinstatement. If Lows Drive
is any indication, the “rent and modify” option is likely to involve considerable
expense to the insurer in funding modifications and any requested reinstatement, the
disruption and cost of at least two moves by the applicant and her family, and a
location that is ill-suited “to optimise, as far as reasonably possible, the quality of
life” of the applicant.
The identification and purchase of an existing residence that is modified to
meet the applicant’s needs
[36] This option has the advantage over the modified “project home” option that the
applicant will not have to wait between 12 and 16 months to occupy it. Subject to
identifying such a residence, and completing its purchase, it can be occupied once
modifications are performed. If they are modifications of a similar extent to those
required to Lows Road, this may be a matter of several weeks. If the premises are
already of an open plan kind, the cost of modifications will be less and the delay
will be shorter.
[37] In recent weeks the applicant identified a property situated at Sassifras Street,
Mudjimba which has a number of features that the applicant says make it suitable
for her needs. It has four bedrooms and is on a single level. It has an open plan
design and as such, there are no hallways. The kitchen is easily accessible; however,
minor modifications would need to be made to the benches and the like. The
bathroom and en-suite are big enough for the applicant to access in her wheelchair,
however, minor modifications would need to be made to allow her to utilise them.
The property has a double lock up garage with an electric garage door, and the
property can be accessed from the garage. The main bedroom is large enough to
32 The cost of modification of Lows Road is between $43,470 and $58,710 (not including the cost of
reinstatement). No estimate was given of the additional cost of modifying a project home to
accommodate the needs of the applicant, but the cost of constructing a single story home with all
necessary modifications was said to be between $300,000 and $400,000 depending upon finishes:
affidavit of the applicant filed 7 August 2009 CPI 27; see also affidavit of Ms Hookham filed 5
August 2009 CFI 26.
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13
store the applicant’s hoist and bed, with enough room to manoeuvre around in her
wheelchair.
[38] The applicant’s evidence is that she can access every room of the house and the
doorways would not need to be widened. The home has large sliding doors to assist
access to rooms, including the main bedroom, laundry and living area, and the
applicant also can access the back patio. 33
[39] The property is situated about half a kilometre from the applicant’s current home
and is only one street away from local shops. The applicant would be able to wheel
down to the shops which would obviate the need for her to take her car. The
property is situated at the end of a cul-de-sac and in an area in which the applicant
would feel safe living.
[40] Because it was only recently identified by the applicant, it has not been inspected by
rehabilitation consultants who prepared reports and gave evidence. The applicant
says that it is suited to her needs with only relatively minor modifications.
Although its owner, a clinical nurse, did not profess to be an expert on the design of
homes for someone who is wheelchair dependent, his evidence was that the open
plan design lends itself to such a person. 34 On that topic Ms Zeman states:
“Newer residential estates accommodate newer houses, which have
necessarily been built in line with more recent building codes of
practise (sic). In line with such, these residences tend to be open
plan, with only minor bathroom and kitchen modifications required
to improve wheelchair accessibility.”
The applicant’s evidence is that she can move around the whole house without
changing it much. She was of the view that the only significant modifications that
would be required are to the bathroom and to the kitchen, and ramps would need to
be installed. Far less modification was required than to her existing home or to the
rental property at Lows Drive.35 This accords with Ms Zeman’s report that:
“...newer style residence’s (sic) which are open plan are likely to
have fewer modification requirements, and thus are able to be
modified at a lower cost.”
[41] The applicant described the Sassifras Street as “just basic” and what she needed.
The property is for sale at a “negotiable” price of $725,000.
[42] The applicant is prepared to move within a fairly large area to find a suitable home,
but wanted to stay close to her present location to enable her daughters to go to their
high school by bus, and to stay close to their father, who lives nearby and with
whom the applicant and her children have a good relationship.
[43] The evidence suggests that there are similar open plan homes to the Sassifras Street
property that were built in the last few years on the same estate but there was no
evidence that any are available to rent, and the owner of the Sassifras Street
property was not interested in renting it. 36 The applicant is willing to attempt to
acquire the Sassifras Street property or one like it with funding from the respondent,
33 Transcript 1-38 lines 27-30, applicant’s affidavit filed 3 July 2009, CFI 25, para 10.
34 Transcript 1-31 lines 45-51.
35 Affidavit of applicant filed 3 August 2009, CFI 25 para 12.
36 Transcript 1-31 lines 53-56; 1-38 line 40
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14
have relatively minor modifications made to it, and then have the net proceeds of
the sale of her existing home paid to the respondent.
[44] The Sassifras Street property or one like it presents a number of advantages over
other options:
1. as mentioned, it does not involve the 12-16 months delay associated with the
“project home” option;
2. The cost of modifications is likely to be substantially less than the cost of
modifying a rental property such as Lows Drive.
3. If the cost of modification is moderate, and less than the cost of modifying
Lows Drive, then the cost of acquisition and modification is likely to be less
than the cost of acquiring a project home that is modified to the applicant’s
needs. 37
4. It is unnecessary to negotiate a long-term lease and a lengthy notice period
to provide the applicant with security of tenure.
5. The applicant would only be required to move once, not at least twice.
6. Unlike a modified rental property, no costs will be incurred in reversing
modifications at the end of a lease.
7. Its open plan design, other internal features and location make it more
suitable than Lows Drive for the applicant’s rehabilitation.
[45] An issue for consideration is whether, notwithstanding these advantages, the cost of
this option to the respondent and other matters relied upon by the respondent mean
that it is not a “reasonable and appropriate” rehabilitation service in the
circumstances. Another issue for consideration is whether the shorter-term option,
namely the “rent and modify option”, constitutes a reasonable and appropriate
rehabilitation service in the circumstances, despite the problems associated with this
option that I have discussed.
Consideration
[46] The application is concerned with the applicant’s “rehabilitation” and the
“reasonable and appropriate rehabilitation services” to be provided by the
respondent insurer, not her long-term, optimum accommodation needs, and how she
might choose to satisfy them out of the proceeds of the sale of her home and an
award of damages. The respondent’s obligation under s 51 of the Act is to provide
“reasonable and appropriate” rehabilitation services, not the applicant’s long-term
housing needs, a substantial part of which would have existed had she not been
injured in June 2008.
[47] The insurer’s obligation under s 51(3) of the Act to ensure that “reasonable and
appropriate rehabilitation services are made available to the claimant” is to be
construed in accordance with the remedial intent of the legislation, and not
constrained so that services will only be found to be reasonable and appropriate if
they and their cost match a head of damages in a personal injuries action. The
requirement that the services be “reasonable and appropriate” and directed towards
37 See para [13] above.
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15
rehabilitation governs the insurer’s obligation under s 51(3). The expected outcome
of the personal injuries action is a relevant consideration in deciding what is
“reasonable and appropriate” in the circumstances of the case. However, a
distinction exists under the Act between “rehabilitation” which is concerned with
measures to optimise, as far reasonably possible, the quality of life of a claimant,
and the assessment of damages in a legal proceeding. 38
[48] Decisions under s 51(5)(b) are made in the shadow of the future trial or settlement
of a damages claim. In deciding what rehabilitation services are “reasonable and
appropriate” I should have regard to the applicant’s personal injuries claim and the
likely date of trial39 at which she will receive an award of damages, the purpose of
which is to restore her to her pre-accident condition and satisfy her accident-caused
needs, so far as money can. However, it would be an error to treat rehabilitation as
necessarily a short-term process, and the rehabilitation services to which a claimant
is entitled under the Act as necessarily limited to short-term measures that are
designed to see the claimant through until the trial of the action or its settlement, at
which point the claimant’s future needs are funded from a damages payment. To
take a simple example, a specially-modified car or a powered wheelchair may be
reasonably necessary for a claimant’s rehabilitation, so as to optimise, as far as
reasonably possible, the quality of the claimant’s life, and also last for years after
the trial.
[49] Although the insurer’s obligation under s 51(3) is, in a sense, separate from and
additional to, its obligation to indemnify under the policy of insurance that is a
schedule to the Act, the determination of what is “reasonable and appropriate”
occurs in the shadow cast by the common law claim for damages to which the
insurer has admitted liability. The expectation is that at a trial or earlier resolution
of that claim, the applicant will receive a damages award that will seek to restore
her, so far as money is able, to her pre-accident condition, and satisfy, so far as
money can, needs caused by the accident. Short-term measures may be reasonable
and appropriate if they enable the applicant to restore, as far as reasonably possible,
physical or mental functions, and to optimise, as far as reasonably possible, the
quality of her life. The further restoration of those functions and the optimisation of
38 A licensed insurer such as the respondent is bound by the provisions of the “industry deed” which
may provide direction and guidance for licensed insurers about initiating, managing, monitoring, and
measuring the effectiveness of, the provision of rehabilitation services for injured claimants: The
Act, s 65; Massingham v AAMI Insurance Ltd (supra) at 237–242 [9]-[11]. The Motor Accident
Insurance Act 1994 Industry Deed is in Schedule 5 to the Motor Accident Insurance Regulation 2004.
Clause 4 of the relevant deed provides that the commission may issue rehabilitation standards and
guidelines to insurers. Chapter 2 (“Principles of rehabilitation in the CTP insurance scheme”) of the
Commission’s Rehabilitation Standards for CTP Insurers includes the following statement:
“A distinction needs to be made between (i) the rehabilitation process, which
is about optimising the injured person’s recovery, and (ii) the medico-legal
process, which comes later in the life of a claim when the overall
consequences of the person’s injuries are assessed by medico-legal experts
and used in formulating the damages likely to be recovered.”
39 Estimates of the likely trial date varied. The respondent’s solicitor anticipated that a compulsory
conference would occur before the end of this calendar year and in the event that the claim was not
settled at conference the applicant would file proceedings and the claim could be resolved by trial
before 30 June 2010: affidavit of Mr Lang filed 31 July 2009 CFI 20, para 9. The applicant’s
solicitor did not expect that a compulsory conference would be convened until May 2010, that
proceedings could be issued in July 2010 if the matter was not resolved and that it would be not
possible for such a claim to be set down for trial until some time in 2011: affidavit of Mr Schultz.
filed 5 August 2009, CFI 30 paras 10-12.
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16
the quality of her life can also be addressed by choices the claimant makes about
how to use her own funds, including a damages award.
[50] Understandably, the evidence of witnesses and submissions sometimes are cast in
terms of “short-term solutions” and “long-term solutions”. However, the Act does
not use these or similar terms. In some circumstances, short-term solutions will be
reasonable and appropriate. In other circumstances, they will not “optimise, as far
as reasonably possible, the quality of life of a person who suffers the loss or
impairment of physical or mental functions through personal injury”.40 In some
cases, the provision of a particular service will address both a short-term and a long-
term need that must be satisfied for a claimant’s rehabilitation.
[51] The provision of what is found to be “reasonable and appropriate rehabilitation
services” might result in the insurer being required to fund services at a cost greater
than the quantum of an associated head of damages in a personal injuries award. For
instance, an order to pay the rent on suitably modified premises may require the
insurer to pay that part of the rent that the claimant would have incurred in any
event on rental accommodation had the accident not occurred.41 Such a possibility
raises for consideration the operation of s 51(9), which, prior to amendments to the
Act in 2000, was found in McMullen v Suhr42 to provide for recovery of the
insurer’s expenditure through a reduction in damages. The applicant points to
s 51(9) of the Act in this regard, and the provision in s 51(4) for an insurer in such a
case to give a statement explaining how the assessment of damages is likely to be
affected by the provision of the rehabilitation services. The respondent disputes that
s 51(9) operates in this way to effectively permit recovery by the insurer of the cost
of rehabilitation services, and submits that s 51(9A) requires the cost of
rehabilitation services to be taken into account in the assessment of damages only in
the way s 51(9A) provides. In a case in which there is no reduction on account of
contributory negligence, the respondent submits that s 51(9A) applies so that the
costs of the services funded by the insurer are simply added to the award, then set-
off. According to the respondent, the insurer is not refunded any part of them, and
the damages award is not reduced on account of them. I will later address this issue
of interpretation. My conclusion is that the applicant’s submission concerning the
operation of s 51(9), namely that it permits the recovery of the insurer’s expenditure
through a reduction in damages in an appropriate case, notwithstanding the
provisions of s 51(9A), is to be preferred.
[52] The respondent submits that the applicant’s preferred options, namely options 2 and
4, would require it to pay for rehabilitation costs that cannot be taken into account in
its favour by a reduction in damages. Whilst I do not accept the respondent’s
interpretation of the Act in that regard, it is appropriate to consider the extent to
which those options may result in overcompensation to an extent that renders them
neither reasonable nor appropriate in the circumstances, despite provision for
recovery pursuant to s 51(9).
[53] The assessment of the applicant’s damages is, of course, a matter for the judge
hearing the trial of the proceedings if they are not earlier settled, based upon the
40 The Act, s 4.
41 In McMullen v Suhr (supra) at 408 Byrne J concluded that the extent of the obligation imposed under
s 51(3) may extend to the payment of rent that is an expense incidental to ordinary living, and I
respectfully follow that approach.
42 Ibid at 408 lines 20 and 48.
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17
evidence at trial. However, the parties’ submissions on this aspect, and their
relevance to determining whether the applicant’s preferred options requiring the
respondent to assist with the cost of acquiring a modified project home (option 2) or
a modified existing home (option 4) is “reasonable and appropriate” in the
circumstances require me to address the issue of whether, and the extent to which,
those costs are likely to be reflected in an assessment of damages.
[54] The general principles governing assessment of damages, as encapsulated in the
quotation from Re Walker, are not in dispute. The function of an award of damages
is not to provide the applicant with the cost of her and her dependent children’s
long-term accommodation needs, since these needs would have existed had the
accident not occurred.
[55] For the reasons given by me, the further modification of the applicant’s existing
home is neither an acceptable short-term nor long-term solution to the
accommodation needs that have arisen as a result of the accident, and those
modifications will not restore the applicant to a situation in which she is able to care
for her family. The costs of modifying her existing home would be high, and not
result in a satisfactory outcome for her personally or enable her to fulfil her
responsibilities for the care of her children. In circumstances in which her two-level
home, even with modifications, would be unsuitable to her needs, she is entitled to
damages to compensate her for the cost of relocating to accommodation that is
suited to her accident-related needs.
[56] It is erroneous to frame either the issue of common law damages, or the issue of the
obligation under the Act to ensure that reasonable and appropriate rehabilitation
services are available, as if the respondent was being asked to buy the applicant a
new home. The issue is not whether the respondent is obliged to pay for the cost of
a new home in circumstances in which the applicant does not presently own a home.
Instead, the issue for my decision is whether the respondent should be obliged under
s 51(3) to assist financially with the costs of the applicant purchasing a new or
existing home that is suitable to her needs, following which the respondent will
receive the net proceeds of the sale of the applicant’s existing home.
[57] The parties are in dispute over whether an injured plaintiff may be entitled by way
of damages to the cost of erection of a new house. The respondent submits that it is
well established that, exceptional circumstances aside, on an assessment of common
law damages an injured plaintiff is not entitled to damages for the capital cost of the
acquisition of land, or the cost of erection of a new house. 43 The applicant replies
that the respondent’s submission is repudiated by the recent decision of the Court of
Appeal in Munzer v Johnston.44 The resolution of that issue only assumes
importance if I reach the conclusion that reasonable and appropriate rehabilitation
services should be provided by the construction of a new house, and the
respondent’s financial contribution to such a construction could not be taken into
account in the assessment of damages or secured by a suitable arrangement entered
into between the parties. However, a similar issue arises in respect of other options,
43 It cites Lynch v Lynch & Anor (1991) Aust Torts Report 81-117 at 69,099; Moriarty v McCarthy
[1978] 2 All ER 213 at 219-220; Luntz, The Assessment of Damages for Personal Injury and Death,
4th ed, Butterworths, 2002, para 4.1.7.
44 Munzer v Johnston & Anor [2009] QCA 190, especially at [20].
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18
and therefore it is necessary to address the issue. Professor Luntz in Assessment of
Damages for Personal Injury and Death45 states:
“Assuming that it is reasonable for the plaintiff to live at home and
that this requires the home to be modified or a special house to be
purchased, in principle the plaintiff should be entitled only to the
additional costs incurred as a result of the disability and not ordinary
expenditure on housing that would have been incurred anyway.
...
The next issue is whether the plaintiff must give credit for the
increased capital value of the house, if any. It is only an increase that
will be realised at some time in the future, when the plaintiff dies or
leaves the accommodation, say, to enter an institution, that is
relevant. Some modifications – such as wider doorways, ramps or
lower doorhandles – may not increase the value at all, in which case
the costs should be allowed in full. But an extra bedroom for a live-
in carer probably would increase the capital value of the house; a
swimming pool to be used for hydrotherapy may do so. An
evidential onus lies on the defendant to show such increase in value.”
(citations omitted)
[58] Munzer applied these principles. Ms Munzer’s entitlement to damages for home
modifications was limited to “the additional costs reasonably necessarily incurred as
a result of her accident-related disability”.46 It was reasonable for her to take “the
utilitarian cost-effective approach of building a one level barn” with further
modifications for her disabilities that were found to be reasonably necessary. The
authorities relied upon by the parties turn on their facts but Munzer shows that the
statement that “the capital cost of a new house cannot be awarded by way of
damages” 47 admits of exceptions. The compensatory principle is that the
assessment should, as far as money can do, place the plaintiff in the same position
as if he or she had not sustained the injuries. There is no “fixed principle that the
cost of a notional basic home is necessarily excluded from an award of damages”. 48
[59] A conventional approach is to “identify and compensate the additional cost imposed
upon the plaintiff derived from her disabilities in providing and maintaining
comfortable habitation for herself”. 49 In some cases damages will be the cost of
modifying an existing home. In other cases, it will be the “extra cost” of building a
new house, the design of which is altered in order to make it fit for the plaintiff’s
purposes.50
[60] In a case in which an injured plaintiff must move from an existing home to another
home, which is either purpose-built to meet her disabilities or modified to do so, the
defendant may be given credit in damages awarded for the increased capital value of
the purpose-built or modified house. 51 The defendant carries the evidentiary onus
45 Luntz, The Assessment of Damages for Personal Injury and Death, 4th ed, Butterworths, 2002, para
4.1.7.
46 [2009] QCA 190 at [20].
47 Moriarty v McCarthy (supra) at 219j.
48 Munzer v Johnston (supra) at [19] citing Weideck v Williams [1999] NSWCA 346 at [10].
49 Lynch v Lynch (supra) at 69,099.
50 Moriarty v McCarthy (supra) at 219-220.
51 Munzer v Johnston (supra) at [21].
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19
to prove that the damages should be modified because of an increase in capital
value. 52
[61] These principles will arise for consideration and application in the assessment of the
applicant’s damages claim if the matter is not settled. They serve to highlight that
there is no fixed rule that the cost of a new home will not be taken into account in
the assessment of damages when the plaintiff must move from an existing home to
another home that is more suited to the plaintiff’s accident-related disability. How
the cost is taken into account, and how the value or net proceeds of sale of the house
that the plaintiff vacates is taken account, are matters for the court’s assessment in
arriving at a proper measure of compensation. Whether or not the modification of
the plaintiff’s existing home or the acquisition of another home into which the
plaintiff moves results in the plaintiff making a capital gain for which the defendant
should be given credit in a damages award depends upon the assessment of the
facts. For instance, if a paraplegic is required to move to an existing, single-level,
open plan home, then the capital cost of “upgrading” from a comparable home with
corridors that cannot be negotiated in a wheelchair, may appear to involve a capital
gain if the open plan home has a higher market value than the plaintiff’s existing
home. However, the plaintiff may reasonably argue that the extent to which the
market value of the open plan home is enhanced by that feature is not a capital gain
for which the defendant should be given credit, but is a cost that is incurred in order
to acquire a home that has features that meet the plaintiff’s accident-related needs
and that the capital cost forms part of the plaintiff’s compensation.
[62] Neither the policy of the Act nor its terms suggest that what is required by way of
compensation in respect of a particular head of damages should equate with the cost
of reasonable and appropriate rehabilitation services required under s 51(3). In
some circumstances, the cost of rehabilitation services will be to fulfil a short-term
need. For instance, it may be possible for the insurer’s obligation under s 51(3) to
be fulfilled by paying the rent of a suitably modified home, leaving the plaintiff to
fund the acquisition and modification of a new home out of the sale proceeds of her
home and a damages award, which includes a component on account of the
accident-related accommodation costs. An assessment of damages generally would
not include the total cost of renting the modified premises, since the claimant may
have incurred certain rental costs in any event. 53 In other circumstances, the
insurer’s statutory obligation to “ensure that reasonable and appropriate
rehabilitation services are made available to the claimant” may oblige it to assist the
claimant financially to move to suitable premises to be owned by the plaintiff, for
example, if available rental properties are not suited to optimise, as far as reasonably
possible, the quality of life of the claimant, or the costs to modify and reinstate them
is inordinate and wasteful compared to the costs of modifying the home which the
claimant proposes to own and occupy in the long term. In short, the Act does not
establish that a “rent and modify” accommodation option is necessarily the most
reasonable and appropriate rehabilitation service. Whether or not it is depends on
the circumstances of the particular case.
[63] In this case, the second and fourth options do not involve an unqualified obligation
to purchase the applicant another home. They require the respondent to assist
52 Ibid citing Campbell v Nagle (1985) 40 SASR 161 at 187.
53 It was because the insurer’s expenditure under s 51(3) might extend to an expense such as rent
“incidental to ordinary living” that Byrne J in McMullen v Suhr contemplated the insurer recovering
part of its expenditure through a reduction in damages.
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20
financially in the applicant’s transition to a form of accommodation that is
necessary for her rehabilitation and to meet needs caused by the accident. That
financial assistance is to be reduced by the payment of the net proceeds of sale of
the applicant’s home, being a home which no longer can suitably accommodate her
and her family as a result of the accident for which the respondent has admitted
liability. As I have previously found, it is not necessary for the financial
consequences to the insurer of fulfilling its statutory obligation under s 51(3) to
match the quantum of a head of damages. In any event, it should not be assumed
that the damages assessed in respect of the accident-related accommodation needs in
a case such as this will be small, and that the second and fourth options would result
in overcompensation to such an extent that they would be neither reasonable nor
appropriate.
[64] The tortfeasor’s conduct having created the need for the applicant to move to a
single-level dwelling, and an open plan design being the most suited to her needs,
the applicant has a strong claim to damages based on the financial cost of relocating
to such a home in the vicinity of her present home. Such an award of compensation
is subject to credit being given to the defendant, if required, for a capital gain.
However, it should not be assumed that any capital gain would be as large as
appears from a simple comparison between the market values of the applicant’s
existing home 54 and the home to be acquired. To purchase an open plan home in a
nearby area, such as the Sassifras Street property, may involve the applicant moving
to a newer home, the features of which are necessary to meet her accident-related
needs. These features, such as the design of the house, the size of her bedroom and
en suite bathroom and its car accommodation, may also be features which give the
home a higher market value than a home without those features. It does not
necessarily mean that the plaintiff’s acquisition of such a property results in her
making a capital gain to which the respondent is entitled to credit in an award of
damages. If, however, there is some element of upgrading 55 beyond that required to
meet the applicant’s accident-related accommodation needs, then the assessment of
damages, unaffected by the possible application of s 51(9A), may bring this into
account.
[65] In summary, common law damages in such a case as this may be assessed by a
variety of approaches, including the additional cost of modifying a project home to
meet the claimant’s accident-related needs. The assessment is a matter for the judge
who tries the action based on the evidence at trial. The case is not an exceptional
one in which common law damages would be assessed simply on the basis of the
cost of building a new project home or the cost to acquire a suitably-modified home,
since the object of an award of damages is not to award the plaintiff the cost of her
long-term accommodation requirements, including requirements that would exist if
the accident had not occurred. However, the applicant is entitled to damages on
account of the reasonable accommodation costs incurred or to be incurred as a result
of her accident-related disabilities, and these would appear to include the cost of
relocating to a suitable, single-level home which is either designed or modified to
suit her accident-related needs.
54 Estimated to be between $500,000 and $550,000: applicant’s affidavit filed 7 August 2009, CFI 27,
para 3.
55 In a case in which an injured plaintiff must move from an existing home to another home more
suitable to the plaintiff in his or her injured state, the standard of the accommodation in which the
plaintiff was accustomed to live is a relevant factor in the assessment of damages: Weideck v
Williams [1999] NSWCA 346 at [10] cited with approval in Munzer v Johnston (supra) at [19].
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21
[66] The tortfeasor’s conduct having created the need for the applicant to move to such a
home to meet both her short-term and long-term accommodation needs, it is neither
reasonable nor appropriate that the applicant be accommodated in rented
accommodation, especially if, as appears, the available rental accommodation is
unsatisfactory to her rehabilitation, will prove expensive to modify and offers only a
short term and somewhat unstable solution.
[67] The acquisition of an existing home such as the Sassifras Street property which
requires relatively few modifications provides both a short-term and a long-term
solution to the plaintiff’s rehabilitation. The applicant has a reasonable claim to
damages for the costs associated with relocating to such a home, including certain
capital costs which are incurred to acquire a home with features that are required to
meet her accident-related needs.
[68] This fourth option has advantages over the other options that I have canvassed that
make it a reasonable and appropriate option in the circumstances. The option of
modifying the existing home at very substantial cost is not reasonable or
appropriate. Even in a modified state, it is not suitable to either the applicant’s
needs and would not optimise, as far as reasonably possible, the quality of her life.
The fourth option avoids the wait of 12-16 months associated with the modified
project home option, and it is not apparent that the cost of modifications to an
existing home (of which Sassifras Street is an example) would be any greater than
the costs to modify the design of a project home to be built (option 2) or the costs to
modify a rental property such as Lows Drive and to reinstate it, if required, at the
end of a lease (option 3).
[69] The disadvantages of the “modify and rent” option have been addressed earlier, and
make it an option which is not as well suited to the applicant’s rehabilitation as the
fourth option. A combination of the “modify and rent” option as a short-term
measure and the “modified project home” option for the applicant’s long-term
rehabilitation is too expensive to be reasonable and appropriate in the circumstances
compared to the fourth option. 56
[70] The respondent pointed to the risk that it might incur the costs associated with the
acquisition of a property and, in the event that the applicant died before trial be
prejudiced in its recovery of those costs through a reduction in damages. There is
no evidence that the applicant’s life expectancy has been reduced as a result of the
accident, and, as Byrne J did in McMullen v Suhr, I shall proceed on the basis that it
is almost certain that the applicant will survive for many years. In any case, the
applicant instructed her Counsel to give an undertaking to agree to any proposals
put forward in reasonable terms to protect the respondent’s position by way of
security over her existing home and/or any premises in which she resides either by
way of a newly constructed project home or a modified existing dwelling that is
registered in her name.
The interpretation of s 51(9) and s 51(9A)
[71] The remaining issue is whether, as the respondent contends, s 51(9A) operates to
prevent a reduction in damages in respect of part of the cost of rehabilitation
services, in particular to the extent to which the capital costs of the acquisition
56 The affordability of compulsory insurance is a matter to which regard should be had in determining
what is a reasonable rehabilitation service: see the objects of the Act, s 3(aa) and Chapter 2, clause 6
of the Commission’s Rehabilitation Standard.
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22
would not be recoverable by the applicant as part of her damages claim. For the
reasons that I have already given, the extent of any capital gain to which the
defendant would be entitled to credit on an assessment of damages should not be
overstated. After all, the applicant is not proposing to move from the backstreets to
the beachfront. She proposes to move to a location near her present home to a home
with the same number of bedrooms, and a substantial part of the difference between
the market value of her existing home and such a home may be due to its more
modern, open style design and other features that the applicant requires to meet her
accident-related needs. However, I shall assume that the provision of financial
assistance to acquire such a home may result in her receiving a benefit to which she
would not be entitled on an assessment of damages, and which would be brought
into account in the ordinary assessment of damages.
[72] The applicant contends that the respondent will suffer no prejudice as the
mechanism provided for by s 51(4) of the Act will enable the respondent henceforth
to ask the court to take the cost of the rehabilitation services that it provides into
account in the assessment of damages. In a case in which the insurer contends that
the provision of the rehabilitation services is likely to affect the assessment of
damages, and has given the claimant the statement required under s 51(4), the cost
to the insurer of providing rehabilitation services under s 51 may be taken into
account pursuant to s 51(9) through a reduction in damages.
[73] The provisions of s 51(9A) arguably compel a different result, by dictating how the
cost is to be taken into account “[I]f the cost of rehabilitation services is to be taken
into account in the assessment of damages”. The applicant contends otherwise, and
submits that s 51(9A) is specifically concerned with the assessment of damages in
cases involving contributory negligence, whereas in a case such as this the
assessment is governed by s 51(9). I am not persuaded that s 51(9A) only applies
where contributory negligence is found. The use of the words “any reduction”
rather than “the reduction” at the start of s 51(9A)(b) tends to suggest that in a case
in which the cost of rehabilitation services is to be taken into account in the
assessment of damages, and in which there is no reduction of damages on account
of contributory negligence, the claimant’s damages are assessed on the assumption
that the claimant incurred the cost, and then the cost is set-off against the amount
assessed.
[74] The literal reading of s 51(9A) supports the respondent’s submission, but that
interpretation produces an apparently unintended result. Section 51(9) appears to be
intended to achieve the purpose of permitting the costs of providing rehabilitation
services under s 51 to be taken into account in the assessment of damages to the
detriment of the claimant, only where the claimant has received notice by a
statement under s 51(4) of such an effect before the services are provided. A literal
interpretation of s 51(9A) would preclude the reduction of damages in a case in
which they should be reduced in accordance with ordinary principles of
compensation, and in which the claimant was on notice of such a possible outcome
before receiving the services. It would be an odd result if s 51(9A) operates as the
respondent contends so as to result in overcompensation.
[75] Section 51(9A) was introduced, along with other amendments to s 51, by the Motor
Accident Insurance Act Amendment Act 2000. Reference to the relevant
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Explanatory Notes 57 does not suggest that these amendments were intended to alter
the operation of s 51(9) envisaged by Byrne J in McMullen v Suhr58 and to prevent
recovery of rehabilitation costs through a reduction in damages. The Explanatory
Notes to clause 28 (which amended s 51) state that one of two “fundamental
changes to the existing arrangements” (the second being the introduction of a
mediation process) was:
“a requirement for the insurer, if it wishes to recover any costs
incurred in the rehabilitation of the claimant, to give a written
notice stating how the cost of rehabilitation is to be taken into
account in assessment of damages. A typical example would be
where there is some contributory negligence. If a notice is not given,
other than in the case of fraud, the insurer is not entitled to seek any
recovery of costs.” (emphasis added)
The Explanatory Notes support the view that an insurer may seek to recover
rehabilitation costs notwithstanding the enactment of s 51(9A).
[76] Prior to the 2000 amendments s 51(9) simply provided that:
“The cost to an insurer of providing rehabilitation services under this
section must be taken into account in the assessment of damages on
the claim.”
The amendment in 2000 to s 51(9) provided that this was to happen only if a
statement had been given under s 51(4). Any ambiguity concerning the meaning of
s 51(9) and s 51(9A) should be resolved by reference to the Explanatory Notes
which indicate that the legislature intended an insurer to be able to seek to “recover
any costs incurred in the rehabilitation of the claimant”. The respondent’s
construction of s 51 does not permit this.
[77] An interpretation that accords with the purpose of s 51(9) should be adopted.
Provided the insurer has given the claimant the statement required by s 51(4),
s 51(9) permits the cost to the insurer of providing rehabilitation services to be taken
into account to the insurer’s benefit in an appropriate case, and, in effect, to recover
all or part of the cost through a reduction in damages. Such a reduction will be open
where the cost incurred by the insurer has the effect of placing the claimant in a
better position than he or she would have occupied were it not for the wrong. An
example is the payment of expenses incurred in respect of ordinary living expenses,
such as rent, to the extent that such expenses would have been incurred by the
claimant had the wrong not occurred.
[78] In other cases in which a statement under s 51(4) has not been given, and in which
there is no fraud,59 there is no scope for a reduction in damages on account of the
cost of rehabilitation services. Section 51(9A) applies on the assumption that the
claimant has incurred the cost of the rehabilitation services as a result of the
57 Consideration of the Explanatory Notes is appropriate in this case pursuant to s 14B(1) of the Acts
Interpretation Act 1954 (Qld) to resolve any ambiguity about whether recovery of rehabilitation
costs is permissible notwithstanding the enactment of s 51(9A) and to confirm the interpretation that
s 51(9) permits such recovery, being an interpretation that is conveyed by the ordinary meaning of
s 51(9) in its context.
58 (supra) at 408 lines 20 and 43.
59 Fraud cases permit recovery pursuant to s 51(10).
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accident, and then, subject to any reduction to be made on account of contributory
negligence, the total cost of rehabilitation services are set off.
[79] In this way ss 51(9) and (9A) operate to permit a reduction in damages. A typical
example will be where there is some contributory negligence, but that is not the
only example. The reduction contemplated in McMullen v Suhr is permitted. A
reduction also is permitted in a case in which the defendant discharges its
evidentiary onus of proving that a capital gain should be brought into account. The
statute only permits such a recovery of rehabilitation costs where notice is given by
a statement under s 51(4), other than a case of fraud which is governed by s 51(10).
The recovery of costs in an appropriate case, provided the claimant has been placed
on notice of this possibility, achieves the purpose of the Act and s 51. The
rehabilitation of claimants is facilitated, and in appropriate cases the cost of
rehabilitation services may be brought into account in reduction in damages.
Claimants are suitably rehabilitated and not overcompensated.
[80] The insurer’s statement given under s 51(4) does not automatically entitle it to
recover the rehabilitation costs, since whether it is entitled to recover any such costs
and the extent of recovery is a matter for the Court’s assessment. The amendments
in 2000 make the giving of such a statement a pre-condition to the costs being taken
into account in the assessment of damages. The manner in which they are taken
into account is a matter for the court, subject to the requirements of s 51(9A).
[81] If the respondent’s contention is correct, the only occasion for recovery of costs
incurred in the rehabilitation of the claimant would be in a case of contributory
negligence pursuant to s 51(9A). Yet, the apparent purpose of s 51 is to permit the
recovery of costs in other instances. These instances should include cases where the
provision of rehabilitation services provided pursuant to s 51(3) would result in
overcompensation unless there was a reduction in damages.
[82] Section 51(9A) avoids the complexity of damages being assessed, subject to
refunds. In a case in which there has been no contributory negligence the
assessment pursuant to s 51(9A) is made on the false assumption that the claimant
incurred the cost of the rehabilitation services and then the cost is set-off against the
amount assessed. Contrary to the respondent’s argument, the applicant’s
contentions do not render s 51(9A) redundant. Section 51(9A) creates the simple
fiction that the claimant incurred costs, and avoids the risk of overcompensation by
providing that those costs will be set-off against the amount assessed. It avoids the
complexity of assessing damages on a different basis, for instance that the claimant
is entitled to have damages assessed on the basis of a need created for services that
were paid for by the insurer, which becomes entitled to a refund out of a damages
award.
[83] Section 51(9A) addresses the assessment of damages, including cases in which a
reduction in damages is to be made on account of contributory negligence. It does
not oust other principles governing the assessment of damages, including the
principle that damages may be reduced on account of a gain made by a claimant.
Section 51(9) is to the effect that recovery of rehabilitation costs by way of a
reduction in damages is only permissible where a statement under s 51(4) is given.
Permitting such a recovery achieves the purpose of the Act and accords with the
intent of the legislature, as expressed in the Explanatory Notes to the 2000
amendments, that rehabilitation costs may be recovered by the insurer, provided a
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notice is given under s 51(4).60 The interpretation of s 51 contended for by the
respondent does not accord with the purpose of the Act that claimants are suitably
rehabilitated and not overcompensated.
[84] Accordingly, I prefer the applicant’s interpretation of the operation of s 51. If,
however, s 51(9A) has the operation contended for by the respondent, leaving no
scope to bring a capital gain or other benefit into account in an appropriate case,
then this feature of the statutory scheme would point to the need for caution in not
readily concluding that the provision of services that would result in
overcompensation should be found to be “reasonable and appropriate” in the
circumstances. I do not consider that the fourth option is likely to lead to
overcompensation that makes that option unreasonable or inappropriate, provided
the purchase price of the home is kept within reasonable limits, and, as envisaged,
the net proceeds of sale of the applicant’s home help fund the acquisition.
[85] I conclude that the fourth option is a reasonable and appropriate rehabilitation
service in the circumstances. The respondent’s position can be adequately protected
in the event that its contention about the operation of s 51(9A) is adopted by the trial
judge, by the provision by the applicant of appropriate security in accordance with
the undertaking offered, or some other form of agreed security. The applicant
accepts that upon the giving of a statement under s 51(4) she may be required to
bring into account in the assessment of damages under the general principles of
compensation and pursuant to s 51(9) of the Act, a capital gain or other benefit to
which she is not entitled by way of damages. This understanding should be
reflected in the terms of any security to be provided to the respondent.
Conclusion
[86] I have decided that the fourth option, namely one in which the respondent is to fund
the purchase of a single-storey, wheelchair-accessible dwelling and then receive the
net proceeds of the sale of the applicant’s current home, is a rehabilitation service
that is reasonable and appropriate in the circumstances of the case.
[87] This option has distinct advantages over the other options that I have canvassed. It
avoids the delay associated with the “modified project home” option. It is more
suitable for the applicant’s rehabilitation than the “modify and rent” option for the
reasons that I have canvassed. The fact that it also addresses long-term
accommodation needs that were caused by the accident does not disqualify it from
being a “reasonable and appropriate rehabilitation service” within the meaning of
s 51(3) of the Act in the circumstances. Those circumstances include the present
absence of a suitable rental property that has an open plan and other features that
make it suitable for the applicant’s rehabilitation. The fourth option provides
greater stability for the applicant than the “modify and rent” option.
[88] The perceived problems with the fourth option are overstated, and do not render that
option unreasonable or inappropriate. It does not require the respondent to sustain
the total cost of buying an existing home for the applicant, since the net proceeds of
the applicant’s current home will be paid to the respondent, and the respondent’s
legitimate interests can be protected by appropriate security. The risk of such an
option overcompensating the applicant can be addressed by the terms of an order,
including specification of a maximum purchase price above which the respondent is
60 Acts Interpretation Act 1954 s 14A, 14B.
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not required to consent to funding. The risk or extent of overcompensation by the
acquisition of a property a single-story, open plan home such as the Sassifras Street
property should not be overstated, given the likely award of damages on account of
the accommodation needs that were caused by the accident, including the need for
the applicant to move from her current two-storey home. The respondent’s interests
may be protected by it giving a statement under s 51(4), and the operation of s 51(9)
which permits the costs of rehabilitation to be taken into account in reduction of
damages, notwithstanding s 51(9A). If my interpretation of s 51(9) and s 51(9A) is
not followed by the trial judge, who concludes that s 51(9A) prevents such a
reduction in damages to take account of a proven capital gain to which the applicant
in not entitled by way of damages, then the respondent’s interests may be protected
by a suitably-worded term in the undertakings to be given by the applicant to the
respondent.
[89] Senior Counsel for the respondent requested that draft orders be dealt with after I
had given my reasons. This is a sensible course. The draft orders submitted at the
hearing by the applicant in respect of this option will be of assistance to the parties
in bringing in minutes of order, and the parties can also negotiate terms that secure
the respondent’s position in the event that the option results in the provision of a
capital gain or other benefit. The only order that I will make at this stage is a
direction that the applicant prepare and submit proposed minutes of order. Subject
to any further submissions on costs, the success of the applicant in having one of her
preferred options accepted, and her success on the issue of interpretation justify an
order that the applicant be paid her costs of and incidental to the application.
[90] In conclusion, the fourth option is a reasonable and appropriate rehabilitation
service, and the most suitable option in the circumstances. It meets both short-term
and long-term accommodation needs that were caused by the accident, and which
should be met to optimise, as far as reasonably possible, the quality of the
applicant’s life. The option is reasonable and appropriate because any capital gain
that the applicant receives above that required to meet her accident-related needs,
and which the respondent proves at trial, may be brought into account according to
well-established principles governing the assessment of compensation, provided a
notice is given under s 51(4). The respondent’s legitimate interests will be
protected by the terms of the order to be submitted.
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Official source: https://www.sclqld.org.au/caselaw/QSC/2009/257