NRMA Insurance has won a review that cut a child claimant's whole person impairment from 17% to 7%, pulling her below a key statutory threshold.
In a determination handed down on April 13, 2026, a Review Panel of the Personal Injury Commission of NSW revoked an earlier medical assessment and certified a markedly lower level of psychological impairment for Grace Carroll, who was struck by a car as a 10-year-old pedestrian in Warners Bay in September 2018.
The decision in Insurance Australia Limited t/as NRMA Insurance v Carroll [2026] NSWPICMP 256 turned on a principle CTP claims professionals know well but rarely see play out this starkly: impairment must be assessed as it is at the time of the assessment.
Carroll was hit at approximately 40km/h while crossing a road, landing on the vehicle's bonnet and roof before being thrown onto the road. She was admitted to John Hunter Hospital and discharged the next day. In the years that followed, she developed anxiety, poor sleep, excessive worry, and loss of interest in activities. She received therapy at the Hummingbird Centre and was prescribed antidepressants. Her school attendance steadily declined, and she dropped out in Year 10 in 2024.
In March 2024, Medical Assessor Paul Friend certified a WPI of 17%, diagnosing PTSD in partial remission and chronic major depressive disorder with melancholic features, assigning class 3 ratings across most categories of the Psychiatric Impairment Rating Scale.
NRMA Insurance challenged the assessment under the Motor Accident Injuries Act 2017, arguing the assessor relied on school records not provided to the insurer and had not adequately considered evidence from the Hummingbird Centre. The insurer also disputed the class 3 social functioning rating. The President's delegate found reasonable cause to suspect the assessment was incorrect in a material respect.
When the Panel re-examined Carroll in February 2026, her circumstances had shifted. She was 18, held a driver's licence, was working as a disability support worker around 15 hours a week, saw friends regularly, went to pubs every few weeks, and had travelled to New York for two weeks with family. The Panel noted inconsistencies - at one point she described herself as socially withdrawn, then described regular outings and driving to clients up to 50 minutes away.
The Panel confirmed the accident caused PTSD in partial remission and Persistent Depressive Disorder, found no pre-existing impairment, and made no apportionment for her parents' 2022 separation. But PIRS ratings came in well below the original - class 2 across five of six categories, with class 3 only for adaptation - producing a WPI of 7%.
Clause 6.21 of the Motor Accident Guidelines was central. It requires impairment be evaluated as it presents at the time of assessment. The Panel noted Carroll's presentation "was very different to the presentation described by Medical Assessor Friend" and found she was "functioning in a reasonably good manner."
For insurers managing long-tail psychological injury claims involving children, the takeaway is plain: a claimant's condition at one point does not lock in the assessment. Pursuing a review when the evidence supports it can meaningfully shift the outcome.
