1. NRMA confirms at [1] - [6] that it was the relevant insurer to 3 December 2024 and that Lifetime Care became the relevant insurer thereafter.
2. NRMA summarises what it believes is in dispute at [7] - [11] and says at [12] that the Commission only has jurisdiction to determine a dispute about treatment if there has been a request for it, a declinature of it, a request for internal review from the claimant and an internal review has been done.
3. NRMA says at [13] that the request about building works made by the claimant lacks particularisation. NRMA identifies at [15] other claims made.
4. NRMA says at [14] and [16] that it has no liability to pay treatment and care requested or expenses incurred after 3 December 2014.
5. NRMA asks that the disputes in the current proceedings related to CTP Care's decisions be dismissed pursuant to s 54 of the Personal Injury Commission Act 2020 (PIC Act).
6. In relation to what it calls "backyard works", NRMA refers at [19] to a request made on

30 July 2024 and at [20] a decision made on 27 August 2024 and says that NRMA had declined to pay these. On internal review, NRMA says at [21] that it sought particularisation from the claimant and that the claimant provided receipts for the labour portions of the repairs in the sum of $31,800. NRMA says at [22] it conducted the internal review and affirmed the original decision. 7. The insurer says at [27] and [28] that the backyard works are not home modifications and they are not everyday tasks within the meaning of attendant care services and refers to the cases of BLI v Allianz Australia Insurance Limited[3] and Ellis v AAI Limited t/as GIO[4]. The insurer says at [35] that the backyard works are a project and that the tasks involved in that project are not frequent, ordinary, common place and so on and therefore not everyday attendant care tasks. 8. The insurer asks that the expenses be properly verified as paid [51] - [53].

1. At the preliminary conference, Ms Berzins for the claimant and Mr Gil for the insurer agreed that the claimed and disputed statutory benefits can be summarised as:

(a) building works - reimbursement of the cost of building works that the claimant has already paid tradespersons to complete and which were completed before

3 December 2024;

(b) ongoing physiotherapy not yet provided - with no limit and no end date after

May 2025, and

(c) home and maintenance not yet provided:

(i) car washing for more than one car, more frequently that once a month;

(ii) solar panel cleaning;

(iii) bathroom cleaning, and

(iv) services beyond the period referred to in a letter of 26 May 2025.

1. Mr Gil confirmed that NRMA was only involved in the first dispute that is the dispute about building works. Mr Gil confirmed that NRMA was denying the claim made for the building works on the basis that this is not a form of treatment and care within the statutory definition found in s 1.4.
2. As Lifetime Care was the relevant insurer and potentially liable in respect of the physiotherapy, home and maintenance disputes, and as Lifetime Care was not nominated as a respondent to the current proceedings it was agreed that only the building works dispute against NRMA should be determined and that a fresh set of proceedings against Lifetime Care should be commenced by the claimant in respect of the other disputes.
3. Mr Gil and Ms Berzins agreed that the building works dispute was a dispute about liability for part of the claim for statutory benefits and I had power under Schedule 2(3)(n) to determine such as dispute. The dispute is a miscellaneous claims assessment matter.
4. Ms Berzins sought an opportunity to lodge brief submissions in response to the insurer's submissions about the definition treatment and costs.
5. A timetable was set as follows:

(a) the insurer was to upload a message by 2 September 2025 indicating whether the insurer agreed the claimant was entitled to costs;

(b) by 3 September 2025 the claimant was to lodge submissions addressing the substantive issue and costs, and

(c) the decision would be issued by 17 September 2025. The parties agreed that it was appropriate for the matter to be determined on the papers.

1. The insurer did not respond.
2. The claimant lodged additional submissions as follows:

(a) the claimant sought costs in the sum of 16 monetary units [2];

(b) the claimant sustained serious injuries and has had treatment including surgery [3] - [10];

(c) the claimant has ongoing issues with the unhealed right femur fracture and requires further treatment, ongoing physiotherapy and domestic assistance and help with household activities [11];

(d) the claimant had further surgery on29 July 2025 [15] and has pain in his left knee and lower back, left shoulder and neck [16] - [19];

(e) the claimant asks the insurer to reimburse him for the cost of the labour costs associated with the backyard works as the claimant cannot do that work himself and has evidence that "but for the injury he would have conducted the work himself" [22] - [29];

(f) Dr Endrey-Walder in a report dated 29 October 2024 supports the claim for help with the building works which is reasonable and necessary [30], and

(g) the claimant says the works were necessary to ensure the integrity and safety of the yard and deck so that the claimant can safely manoeuvre through the property [31].

1. The claimant submits at [31] that the labour expenses associated with the work to make his premises safe:

"should be regarded as rehabilitation or modifications that are clearly related to and required to assist with our client's day to day living and to reduce the risks of further injury."

1. The claimant's bundle comprises 288 pages. Some of these documents are not necessary to include in this evidence review such as the claimant's statement of particulars and the submissions made to the Commission to place the damages claim in the not ready list. The claimant has also included documents related to disputes not before me such as physiotherapy declined by NRMA in September 2024 and the CTP Care decisions.
2. On 10 September 2025 the claimant uploaded an additional bundle of documents comprising amended submissions dated 4 September 2025, photographs of the completed backyard works, invoices and bank statements showing payments made for the backyard works. All of these additional documents are admitted into evidence and have been considered.
3. The insurer provided documents concerning the settlement of the common law claim and the referral of the statutory benefits claim to Lifetime Care's CTP Care scheme.
4. While I have reviewed all the documents provided, I have included only those documents of relevance to the dispute before me.

1. The claim form is dated 8 December 2019.[5] The claimant describes the accident and lists his injuries as including a broken femur, fractured knee and spine, burst vessels, a black eye, scratches and bruises.
2. The claimant provided a statement dated 5 August 2025.[6] The statement concerns the accident; the settlement of the common law claim, and the ongoing issues with Mr Abdo's right leg. The statement also concerns many of the issues associated with requests made to and decisions made by CTP Care.
3. The claimant says at [20] that he is unable to do the gardening, outdoor maintenance and heavy cleaning because of his injuries. He says before the accident he used to do his own handyman work and provides photographs in support [24] and [30]:

(a) in 2004 he demolished the backyard and excavated it for the pool, did the drainage work and electrical work associated with the pool, built the retaining wall, paths, steps and installed the above ground pool, decking and built an outdoor toilet;

(b) in 2012 he removed lawn at the front of the property, levelled the ground, added drainage, purchased rock, broke it and laid crazy paving;

(c) in 2013 he cut stone and built a border for a centre garden and added a drain and power supply for a water feature;

(d) in 2013 he built cabinets and a bench in the garage;

(e) in 2016 he bought an investment property and rebuilt it (he had sold his business and worked full time on this);

(f) in 2016 he stripped a vehicle down, fabricated components and rebuilt and reassembled the vehicle (a few years in the making between other projects);

(g) in 2017 he repaired a shower with new lower tiles and renewed grout, and

(h) in 2017 he built a granny flat at the rear of the investment property and did work on the driveway and paths.

1. I note that in one of the photographs of the backyard taken in 2004, there are three people working in the garden and in other photographs there are different people working. There are several photographs of an excavator and a person operating it while another person is working.
2. The claimant has provided photographs of the completed backyard works with the new retaining wall, new deck (and stairs up to the deck) and the new pool and surrounds.

1. In an email dated 18 June 2024,[7] the claimant advises NRMA that he is obtaining quotes:

(a) for the "corroded and leaning above ground pool", and

(b) concerning the "failing retaining wall and deck".

1. He advises NRMA that he would "normally be carrying out the labour myself" and refers to the "pool replacement".
2. On 27 August 2024 NRMA wrote to the claimant[8] denying the claim for the building works saying:

(a) the works are not related to the accident, and

(b) the works are not home maintenance but home improvements due to wear and tear and not reasonable and necessary.

1. In an email dated 1 September 2024[9] the claimant expresses his disappointment to NRMA with the decision to deny reimbursing the labour costs of the maintenance works on his home. The claimant refers to having done the original work on them 25 years ago[10] and has photos "to prove my competence". He said he was hands on and particular with projects.
2. Mr Abdo refers to the insurer labelling these works "home improvement" but he says, "it's essential to have a safe environment as the decking was a tripping and injury hazard with splintered and lifting timber" and that "not being able to maintain it has more than likely contributed to its demise."
3. The insurer provides[11]:

(a) a copy of the invoice from a landscaping firm to dismantle an old leaning wall and take it to the skip bin; prepare the area for a new retaining wall; supply and install a new block wall and wall drainage at a cost of $21,263, which is noted as "paid in full";

(b) an additional receipt for "extra works" not identified further in the sum of $3,000 other than 24 hours of labour for two men and materials at a cost of $850;

(c) an invoice from a pool company to "remove and replace rested sterns on an above ground pool in the sum of $5,000 noted as paid;

(d) a quote from a patio company for 42 square metres of composite decking with aluminium frame and internal and external step in the sum of $24,200 with "estimated labour $12,000" and "2K deposit paid 24 June 2024, and

(e) an invoice for the labour cost for the decking only in the sum of $12,000.

1. On 9 September 2024 the claimant responded by email to a series of questions from the insurer.[12] He says:

(a) the works "are maintenance related due to material and age";

(b) he was planning to do this work before the accident (five years ago at the time this email was written);

(c) about 3.5 years ago he had the deck sanded back and the top of the retaining wall tied back to stop it leaning further, and other work was done on the retaining wall;

(d) he was planning to rectify this when he had recovered;

(e) walking on the decking is a trip and injury hazard as are the wall and pool, and

(f) had he not been injured he would have done the work himself as he had done before.

1. Mr Abdo provided the insurer with four photographs of the parts of his home including the decking, the retaining wall and the pool wall. It appears that the back of the house is at a higher level than the back garden with steps down to the decking around the pool. There is a retaining wall next to the steps and below the house adjacent to the decking. The pool is an above ground pool with decking part of the way around it but not all of the way around it. The side of the pool furthest away from the house is open to the elements and it appears that this is where the rusted posts are.
2. On 23 September 2024 the insurer completed its internal review of the decision to decline the payment for the building works[13].
3. The insurer affirmed the original decision saying it was not in dispute that the claimant cannot, because of his injuries, do the work himself. The insurer says the backyard project is home maintenance and accepts that but for the injuries the claimant would have done the work himself and he has had to source professional services to do the work.
4. The insurer says that what is in dispute is whether the works fall within the scope of "treatment and care" as defined in s 1.4 of the MAI Act. The insurer notes the definition of attendant care services and says the building works are not "everyday tasks" and that "major works such as the subject backyard works would be considered outside of "everyday tasks". The insurer says the works are not therefore attendant care services and are therefore not treatment and care. NRMA is therefore not liable for payment of the services provided.

1. Dr Endrey-Walder, general and trauma surgeon provided a report to the claimant's solicitors on 11 April 2022.
2. He provided an opinion of the claimant's injuries and suggested the claimant was unemployable and it was unlikely he would never work again. He also expressed the view the claimant had no capacity to perform meaningful and physically demanding chores around the home and that he "will likely need paid help with repair and maintenance in the long term." He records that after four surgeries the claimant has virtually no union of the fractured femur.
3. He assessed whole person impairment (WPI) at over 20% without any impairment assessment of the claimant's injured right leg.
4. Dr Endrey-Walder saw the claimant again and reported on 8 May 2023. The claimant was waking with a marked limp and relying heavily on a walking stick. There were no neurological deficits in the lower limbs and there was evidence of impingement in the left shoulder when abducted. The claimant had lower back pain, but the sciatic pain had resolved.
5. The doctor noted there was "little evidence of any healing at the fracture site" and that the claimant had still not yet reached maximum medical improvement.
6. Doctor records the claimant was using an electric wheelchair to get out of his home.
7. In his third report dated 29 October 2024, Dr Endrey-Walder again notes the claimant's reliance on a walking stick and observed a limp. He says there has been little change.
8. In terms of the building works, the claimant is said to have explained to Dr Endrey-Walder that he was considering undertaking significant repair and maintenance work at his home at the time of the accident and they he would be doing this himself if the accident had not occurred. The doctor supports the claimant's assertion that he has been unable to do this work since the accident.
9. Dr Rastogi examined the claimant for the purposes of his psychiatric injuries and reported to the claimant's solicitors on 12 August 2022. She did not diagnose a post-traumatic stress disorder saying he did not fulfill the criteria, but she did diagnose a major depressive disorder. She assessed his WPI at 15%.
10. There are other reports and records from treatment providers and a report from the insurer's occupational therapist, Ms McLean dated 18 March 2025. Her report includes photographs of the claimant's back garden, side garden and front garden and shows the new retaining wall, pool and deck.
11. The claimant's solicitor uploaded photographs of the completed works showing the deck, the new steps up to the deck and the new retaining wall.

1. The claimant submits that Dr Endrey-Walder "supports that the building works were reasonable and necessary and that the Claimant should be reimbursed." It is true that Dr Endrey-Walder's report of 29 October 2024 supports the claimant's submission that he cannot do the building works himself, but that is a matter that has never been in issue in these proceedings. The insurer has at all times conceded that the claimant would have done the work had he not been injured, that the work needed to be done and that the claimant's injuries prevent him from doing the physical work associated with the backyard building works. What is in dispute in the current proceedings is whether the building works in issue are a form of treatment and care or not and with respect that is not a matter about which Dr Endrey-Walder can provide an expert view. That is an issue of statutory interpretation and not a matter for medical opinion.
2. Section 3.24(1), establishes the entitlement to treatment and care benefits as follows:

"An injured person is entitled to statutory benefits for the following expenses (treatment and care expenses) incurred in connection with providing treatment and care for the injured person"

(a) the reasonable cost of treatment and care;

(b) the cost of travel and accommodation to obtain treatment and care, and

(c) if the claimant is a minor or otherwise needs a carer, the travel and accommodation costs of the parent or carer who takes the claimant to obtain treatment and care.

1. The phrase "treatment and care" is defined in s 1.4 as follows:

(a) medical treatment (including pharmaceuticals),

(b) dental treatment,

(c) rehabilitation,

(d) ambulance transportation,

(e) respite care,

(f) attendant care services,

(g) aids and appliances,

(h) prostheses,

(i) education and vocational training,

(j) home and transport modification,

(k) workplace and educational facility modifications,

(l) such other kinds of treatment, care, support or services as may be prescribed by the regulations for the purposes of this definition,

but does not include any treatment, care, support or services of a kind declared by the regulations to be excluded from this definition."

1. There are no forms of treatment and care included in the Motor Accident Injuries Regulations 2017 (the Regulations) and no types of treatment or care excluded by the Regulations.
2. The claimant's submissions suggest the backyard building works are either "rehabilitation or modifications that are clearly related to and required to assist with our client's day to day living and to reduce the risks of further injury". The insurer's submissions address whether the backyard works are home modification or "attendant care services."

Are the backyard building works home modifications?

1. The claimant submits the backyards works are "modifications." One of the listed types of treatment is said to be "home and vehicle modification". This phrase is not further defined in the Act however the following two cases illustrate their application and meaning.
2. In the case of Fowler v Youi Pty Limited [2025] NSWPIC 82 the claimant had requested the insurer purchase him a new car because while his pre-accident motor vehicle had been modified to allow him to drive it, that car could not be further modified to allow him to drive it independently as he required someone to help him stow and retrieve his wheelchair. I determined at [187] that "transport modification means modification (as in change or alteration) to the transport the claimant was using at the time of his accident to accommodate his injuries." I considered this would encompass modifying the pre-accident vehicle for hand controls and modifying any other vehicle for hand controls and a hoist for the wheelchair but would not extend to replacing the vehicle that cannot be modified with the vehicle that can.[14]
3. In Ellis v AAI Limited t/as AAMI [2025] NSWPIC 162 Member McTegg determined a dispute about whether home renovations (including a total renovation of a bathroom and kitchen with new fixtures, fittings and appliances) were a form of treatment. While the Member found these renovations were not everyday or common place tasks within the meaning of attendant care services, she said that if the home renovations proposed were home modifications designed to alleviate or address limitations and restrictions caused by the accident then they were a form of treatment and whether they should be allowed or not would involve a medical dispute.
4. The meaning then of "home modification" is modifying or changing the home with a view to accommodating the claimant's injuries or things done to the home which are "designed to alleviate or address limitations and restrictions caused by the accident" as Member McTegg said in Ellis. "Home modification" does not, in my view, extend to all forms of home renovation, repair or restoration.
5. Mr Abdo said he had to repair the retaining wall because it was leaning and in danger of collapsing. He had to replace the pool because parts of its support were corroded. He was required to replace the deck because it was splintered and damaged. The before and after photographs show that these works did not involve any form of alteration of change in the structures that were previously there and there is no indication that any alteration or change was made in order to accommodate the claimant's injuries. What was done was the replacement of what was there because the works were needed to address wear, tear and failings in the structures.

Are the backyard building works part of the claimant's rehabilitation?

1. The claimant submits that the backyard works could also be considered as rehabilitation which assists him with daily living. Rehabilitation is defined in s 1.4 of the MAI Act as:

"the process of enabling or attempting to enable the person to attain and maintain -

(b) full physical, mental, social and vocational ability, and

(c) full inclusion and participation in all aspects of life."

1. The claimant does not explain in any detail in his submissions how the building works "assist with our client's day to day living" as he has submitted or how it would otherwise come within the definition of rehabilitation. Mr Abdo provides no evidence about whether he uses this part of the garden for example and whether he swims in the pool. He gives no evidence as to how he has used these spaces and how often he uses them.
2. Dr Endrey-Walder reports that the claimant has a limp, walks with the aid of a walking stick and in 2023 was utilising a wheelchair to leave his home. Mr Abdo's original submissions lodged with the application form also refer to him having significant mobility issues. The pictures provided by the claimant show steps down from the rear of the house to the pool area, steps up to the deck around the pool and steps into the pool. It is not clear to me whether Mr Abdo has had sufficient mobility to enable him to access the pool and this part of the garden since the accident.
3. The bulk of the evidence before me focuses on the fact Mr Abdo wanted to do the backyard work before the accident, how he planned to do it himself and how he could not do it now because of his injuries. These things are not disputed but there is no evidence that I have been taken to that explains why he needs the work to be done as part of the process of his rehabilitation.

Are the backyard building works a form of attendant care?

1. The insurer has said in its correspondence to the claimant and in its submissions that the backyard works are not a form of attendant care services. The claimant has not, in his submissions, addressed this or the cases referenced by the insurer.
2. Attendant care services are defined as:

"services that aim to provide assistance to people with everyday tasks, and includes (for example) personal assistance, nursing, home maintenance and domestic services."

1. In Haddad v Lifetime Care and Support Authority [2024] NSWPIC 96 there was a request from the claimant to the relevant insurer, for the cost of painting of the interior and exterior of his home. Mr Haddad said that painting his home was something he had done before and was not out of the ordinary for him. As the decision maker in that case, I found that while spot painting might be contemplated by the definition, painting the whole of the claimant's house, inside and out, was not an "everyday task" as in a routine or regular home maintenance task and therefore did not fall within the definition of attendant care services and was therefore not a form of treatment and care. I arrived at a similar decision in the case of BLI v Allianz Australia Insurance Limited [2024] NSWPIC 436. In that case, the claimant requested the insurer pay for the exterior painting of his weatherboard home which was a major endeavour done every few years and for which the claimant had taken three weeks off work to complete.
2. Following those two cases, I accept the insurer's submission. The definition of attendant care services are services that help a person with everyday tasks including the four stated examples of personal assistance, nursing, home maintenance and domestic services.
3. The labour associated with Mr Abdo's new pool, deck and retaining wall are not a form of personal assistance or nursing service. I also do not accept it is a form of domestic service which in my view would incorporate services such as cleaning, cooking, shopping and so on.
4. The need for the backyard works appears to be an aspect of the need to maintain the home. The maintenance of these parts of the claimant's home was needed before the accident (on the claimant's evidence) and has likely been delayed as a result of the accident. Mr Abdo in his submissions asserted the works should be done to reduce the risk of further injury. The assumption in that statement is that the works should be done to reduce the risk of further injury to him. It would of course, also be necessary to keep the pool and garden area safe for all users of the home.
5. While the work on the pool, the deck and the garden could be a form of home maintenance, the work done (or its components) could not be described as an "everyday task". While I accept the claimant may have been able to do some, or all of the work himself, the extent of the work done, like the painting in the Haddad and BLI cases, was a major project costing about $50,000 and which would have required significant time and effort to complete.
6. The claimant has said that he did all the original work 25 years ago (likely to be 21 years ago) although the photographs provided suggest he may have had help. The claimant has also said that he had planned on doing the renovation, repair and restoration of the original work before the accident as part of the maintenance of his property. Gardening, pool cleaning and possibly the annual oiling of a wooden deck would, in my view, be "everyday" tasks contemplated by the definition of attendant care services and in particular home maintenance or domestic services. Minor repairs to the deck, the pool or the retaining wall might also be contemplated by the definition. However, in my view, removing and rebuilding a retaining wall, replacing a pool and replacing a deck with entirely new products and materials is not an everyday task and therefore not an attendant care service for which the insurer could be liable.

1. The Regulations declare in Schedule 1 that certain disputes are regulated miscellaneous claims assessment matters. One of these is the dispute about "any issue of liability for a claim, or part of a claim, for statutory benefits referred to in clause 3(n) of Schedule 2 to the Act. The maximum sum that can be awarded in legal costs for such a matter is 16 monetary units.
2. The claimant seeks costs in the sum of $1,992 (the current sum that is the equivalent of 16 monetary units). No disbursements are claimed. The insurer has not provided any submissions as to costs.
3. I do not propose to allow the maximum sum. The claimant's application nominated only NRMA as the respondent but included submissions and documents addressing matters involving CTP Care. Both the original submissions and the additional submissions provided much detail about matters not in dispute (the claimant's significant injuries, his abilities to do the work but for the accident and his inability to do the work because of the accident). The submissions filed by the claimant did not engage with the insurer's argument (about attendant care) and did not provide any meaningful details of the claimant's arguments as to why the building works came within the statutory definition of "treatment and care".
4. I will allow the claimant costs in the sum of $1,000 to which should be added Goods and Services Tax.

1. I am not satisfied that the labour services claimed in respect of the backyard building works are, on the information before me a form of treatment and care. They are not home modifications or a form of rehabilitation or attendant care services.
2. It follows therefore that the insurer has no liability to pay for the costs claimed in relation to the backyard building works.

[1] The original liability notice dated 20 March 2020 is at page 116 of the claimant's application and the internal review decision is at page 123 of the claimant's bundle.

[2] Numbers in square brackets are a reference to the paragraph number of the submission.

[3] [2024] NSWPIC 436 (BLI v Allianz).

[4] [2025] NSWPIC 162 (Ellis v GIO)

[6] There is another statement dated 10 February 2020 at page 80 of the claimant's bundle which deals primarily with the circumstances of the accident.

[10] Based on the timeline provided in his statement, the retaining wall, pool and deck were built in 2004 which was 20 not 25 years before.

[11] From page 37 of the insurer's bundle.

[14] The new car was however allowed on the basis that Mr Fowler was still in the rehabilitation phase after his accident, and the new car would allow him to maximise his participation in social events, work and independent living.