austlii:nsw/NSWPIC/2025/498
General information, not legal advice.
NSWPIC
2025-08-12
Original judgment source is linked above.
AAI Limited t/as GIO v CIM [2025] NSWPIC 498
MOTOR ACCIDENTS - Motor Accidents Compensation Act 1999; discretionary exemption pursuant to section 92 and rule 99 of the Personal Injury Commission Rules 2021 (PIC Rules); claimant is self-represented; claim involves a long history after the insurer lodging an application with the Commission; claimant makes varied and complex allegations in respect of her entitlements, validity of Commission medical assessments, and the conduct of the insurer; unusually large amount of material lodged by the claimant to date; difficulties directing the claimant to the various legislative provisions that govern her claim; Held - recommended that the claim is not suitable for assessment given the varied allegations made, the amount of material relied upon, difficulties in having the claimant directed to relevant legislation, and the anticipation that any hearing would be lengthy; court a more suitable forum, where proper examination and cross examination can take place, and with a power to compel witnesses; matter referred to Division Head; recommendation subsequently approved by the Division Head, as the President's delegate.
19 March 2025, I raised my preliminary views that in light of the various allegations made by the claimant and the fact that she disputes the validity of the medical assessments that it may be that the matter is not suitable for assessment. I provided the parties with the opportunity to provide written submissions in this regard.
"(1) A claim is exempt from assessment under this Part if -
(2) If a claim is exempt from assessment under this Part, the President must, as soon as practicable, issue to the insurer and the claimant of a certificate to that effect (enabling court proceedings to be commenced in respect of the claim concerned)."
"(1) A claimant or insurer may apply for an exemption from assessment under section 92(1)(b) of the MAC Act or section 7.34(1)(b) of the MAI Act by lodging an application.
(2) In determining whether a claim is not suitable for assessment for the purposes of section 92(1)(b) of the MAC Act or section 7.34(1)(b) of the MAI Act, the Commission must consider the objects of the PIC Act and the circumstances of the claim.
(3) Without limiting the matters that may be considered, the Commission may consider the following -
(a) whether the claim involves complex legal or factual issues, or complex issues in the assessment of the amount of the claim,
(b) whether the claim involves issues of liability, including contributory negligence, fault or causation,
AAI Limited t/as GIO
CIM [2025] NSWPIC 498;