What happened: A review panel cut a bus passenger's permanent impairment rating from 12% to 2%, dropping her below the threshold for damages for pain and suffering
Who's involved: Allianz Australia Insurance Limited and a claimant injured boarding a bus in western Sydney
What's at stake: The 10% whole person impairment threshold under NSW's Motor Accident Injuries Act - and with it, the right to non-economic loss damages
Why it matters: The decision shows how insurer-initiated reviews can produce dramatically different outcomes when re-examination does not replicate the original clinical findings
Where it stands: Decided - the review panel revoked the original medical certificate and issued a replacement at 2%
A passenger's impairment rating dropped from 12% to 2% after a review panel found none of the spinal findings that had underpinned the original assessment. The ten-percentage-point swing pushed the claim below the threshold for damages for pain and suffering under NSW motor accident law.
The case involves a woman who was injured boarding an Allianz-insured bus in Auburn, in Sydney's west, in September 2019. As she stepped through the rear doors, they closed and struck her, throwing her sideways into the side of the bus. A fellow passenger caught her before she fell.
She was 13 weeks pregnant at the time. Westmead Hospital could not perform a CT scan because of the radiation risk to the foetus, but clinically suspected rib fractures on the right side.
In October 2025, a medical assessor with NSW's Personal Injury Commission rated her permanent impairment at 12% whole person impairment. The rating was built on two spinal injury scores - 5% each for the neck and lower back, both based on a finding called dysmetria, where the spine moves unevenly or asymmetrically - plus 2% for the right shoulder.
Under the state's Motor Accident Injuries Act 2017, the 10% mark is the gateway to damages for non-economic loss - compensation for pain, suffering and loss of enjoyment of life. At 12%, she cleared it.
Allianz applied for review.
A three-member review panel re-examined the claimant in May 2026 and reached a starkly different conclusion on the spine injuries.
The neck exam showed normal, symmetrical movement with no muscle guarding, no spasm and no measurable nerve damage. The lower back showed reduced movement, but again no guarding, no spasm, no dysmetria and no neurological problems that could be measured.
Without those objective findings, the panel rated both spinal injuries at the lowest category - 0% each. That alone wiped ten percentage points off the rating.
The shoulder examination added a layer of complexity but did not change the bottom line.
The panel's examiner tested the claimant's right shoulder three times. On the first attempt, flexion measured 140 degrees. On the second, 120. On the third, 100. The same progressive decline appeared in extension and abduction.
The claimant said the worsening was caused by pain from prolonged writing while she prepared for exams. The panel did not treat the declining numbers as evidence of poor cooperation, but found the results were too inconsistent to support a standard impairment rating. Instead, it assessed the shoulder by comparing the injury to a similar listed condition and arrived at 2% - the same figure the original assessor had given.
Neck pain did not appear in the claimant's medical records until about five months after the accident. The insurer argued the original assessor had failed to consider pre-existing problems, pointing to a 2018 hospital admission for neck pain radiating to both arms.
The panel accepted the accident caused a neck injury, but on narrow grounds. It noted the GP record from January 2020 said the claimant "still" suffered from neck and upper back pain - suggesting earlier complaints that were never formally documented. It also weighed the severity of the accident (which caused rib fractures), communication difficulties arising from the claimant's limited English, and preoccupation with pregnancy in the months after the collision.
The 2018 episode had been assessed at the time as a stress reaction with "no red flag for neck pain" and had not recurred before the accident.
Even so, accepting the neck injury made no difference to the final number. It still scored 0% on re-examination.
The combined rating fell from 12% to 2%. The rib fractures had healed and carried no assessable impairment. The panel revoked the original certificate and issued a replacement.
For CTP claims teams and permanent impairment assessors, the case illustrates how a rating that clears the 10% threshold on one examination can fall well short on another when the re-examination does not replicate the clinical findings - particularly the spinal findings - that justified the higher category.
