Seeking treatment early after an injury can improve rehabilitation and recovery outcomes.
But what happens when there is a dispute about what should be funded after a motor vehicle accident.
This is what happened in Simmons v QBE Insurance (Australia) Limited [2026] QDC 105. Ms Simmons’ treating neurosurgeon recommended that she required surgery for the injury to her spine. The doctors instructed by the insurers disagreed. Ms Simmons obtained a further opinion from another orthopaedic surgeon who also agreed that surgery was recommended. Success following surgery was not guaranteed but Ms Simmons doctors thought that surgery would likely be beneficial.
What the case says:
- The Insurer is required to fund the surgery;
- Section 51 of the Motor Accidents Insurance Act 1994 (Qld) imposes an obligation on an insurer who has admitted liability to pay the cost of rehabilitation services even though no damages have been determined yet, where the rehabilitation service is reasonable and appropriate;
- The development of rehabilitation plans following an injury in a motor vehicle accident, is the injured persons responsibility;
- Once that rehabilitation plan is put in place following recommendations from the injured person’s treatment providers and other expert opinion obtained by the insurer disagrees that plan “it is beside the point that those experts may have different views as to the proper ways in which” the injured person might undertake rehabilitation;
- It is still open to the insurer to argue that the cost of the rehabilitation plan should not be included in the final damages award.
What this means if you have been injured in a motor vehicle accident is that if a reasonable and appropriate rehabilitation plan has been put together and liability for the accident has been admitted, then it is the insurers responsibility to pay the cost of the treatment.
