A NSW review panel more than doubled a psychiatric impairment rating in a CTP claim against NRMA Insurance - from 9% to 19%.
The decision, handed down on April 15, 2026, revoked an earlier assessment that had placed claimant Ngar Man Maggie Siu just below the 10% whole person impairment (WPI) threshold under the Motor Accident Injuries Act 2017. That threshold is significant - without clearing it, a claimant cannot access damages for non-economic loss.
Ms Siu was injured on July 25, 2023, when another vehicle turned right into her path at the entrance to the M5 in Bexley, pushing her car into a traffic light. She sustained a sternal fracture along with injuries to her neck, lower back, right shoulder, and right ankle. Over the months that followed, she developed serious psychiatric symptoms.
She brought a claim against Insurance Australia Limited trading as NRMA Insurance, the third-party insurer of the vehicle she says caused the accident. Medical Assessor Shen examined her on May 19, 2025, and certified a 9% WPI for post-traumatic stress disorder and major depressive disorder. He rated her as mildly impaired across four of six categories on the Psychiatric Impairment Rating Scale (PIRS).
Ms Siu lodged her review application on May 29, 2025. By August 27, 2025, a delegate of the President was satisfied there was reasonable cause to suspect the assessment was incorrect in a material respect, and the matter was referred to a review panel.
The panel - Senior Member Susan McTegg with Medical Assessors Christopher Canaris and Steven Yeates - examined Ms Siu by videolink on March 31, 2026. What they saw was starkly different from the original assessment. She appeared in pyjamas, hair dishevelled, looking down for much of the session. The panel described "significant psychomotor retardation" and noted "obvious deficits in concentration" during the interview.
The panel reclassified her diagnosis to persistent depressive disorder (dysthymia) with a persisting major depressive episode, applying DSM-5-TR criteria. They found she had experienced depressed mood for most of the day, more days than not, for more than two years - and had never been free of symptoms for any significant period.
Two PIRS categories shifted materially. Social functioning moved from Class 2 to Class 3, reflecting a breakdown in her relationship with her adult son and serious marital strain - her husband had mentioned divorce, and the couple had been sleeping separately since the accident. Concentration, persistence and pace also moved from Class 2 to Class 3, with the panel observing those deficits firsthand during the examination.
The final ratings - 2, 2, 3, 3, 3, 4 - produced a median of 3, an aggregate score of 17, and a WPI of 19%.
The insurer's own psychiatrist, Dr Brendan Smith, had assessed 17% - much closer to the panel's 19% than to the original 9%.
The panel found no evidence of prior psychiatric illness, no basis for apportionment, and confirmed the accident caused Ms Siu's condition. Her symptoms had persisted for two and a half years despite psychological therapy and the antidepressant Desvenlafaxine.
For CTP insurers, the case carries a clear signal. Psychiatric impairment assessments that land just below the 10% threshold can shift dramatically on review. Here, the jump from 9% to 19% came down to how the PIRS categories were scored - not any change in the claimant's underlying condition. Claims professionals would do well to test initial assessments against the full clinical record before relying on them for reserving and settlement decisions.
