austlii:nsw/NSWPIC/2026/178
General information, not legal advice.
NSWPIC
2026-03-27
Original judgment source is linked above.
"Given your treating professionals have indicated you have a capacity to lift and carry under 5kg and participate in modified activities of daily living and manageable domestic duties, we do not consider the request for general pest control and rodent treatment as reasonable and necessary."
"1- maybe it is my mistake not to explain what is important and usually included in every spraying at my house as the requirement to do pest control is to go into the Roof Void/ attic , and in addition it is not safe for me to do this job due to health reasons as I'm elderly clearing, But also after the MVA it is definitely impossible for me to carry a ladder which is about 7 kg. and climb it and then jump into the roof void through roof duct, for all the reasons mentioned in the certificate of capacity by Dr. Dina Jami , and Dr. Raymond.
Also the job includes spraying inside & outside the house and the Roof Void / attic , and all the fences, trees, and outside upper ceilings, in addition to fill the outside boxes with rodent treatment and the boxes in the garage and roof void.
4- this spraying job is much more harder for me even than collecting dropped tree leaves which already cannot do it as your esteemed office approved it within gardening services.
As we all know we usually find inside & outside the house many kinds of pest, worms, insects, spiders, rodents, which require control and spraying..."
8 October 2024 decision. On 22 October 2024 an internal reviewer affirmed the insurer's decision to deny liability for the services. The reviewer's reasons for doing so differed from the original decision maker, the internal reviewer finding that the services: were not an "everyday task envisaged under the scheme"; were not "attendant care services" and did not fall within the definition of "treatment and care" in the MAI Act. It is this decision that gave rise to the dispute to be determined in these proceedings. 2. The dispute is not about whether treatment and care provided or to be provided to the claimant is reasonable and necessary in the circumstances or relates to the injury caused by the accident. Consequently, the dispute is not a "medical dispute" as that term is defined and falls to be determined by the Personal Injury Commission (Commission) as a miscellaneous claims assessment matter under Sch 2, cl 3(n) of the MAI Act.
"3.24 Entitlement to statutory benefits for treatment and care
(1) 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 -
(2) No statutory benefits are payable for the cost of treatment and care to the extent that the treatment and care concerned was not reasonable and necessary in the circumstances or did not relate to the injury resulting from the motor accident concerned.
(3) The Motor Accident Guidelines may provide for -
(a) circumstances in which the cost of treatment and care is taken to be reasonable for the purposes of this section, and
(b) circumstances in which treatment and care is taken to be reasonable and necessary for the purposes of subsection (2).
See Part 7 and Schedule 2 for provisions relating to disputes about whether treatment and care, or the cost or treatment and care, provided or to be provided to an injured person is reasonable and necessary."
23 March 2026. 2. In his Application for personal injury benefits dated 13 June 2023 the claimant described the circumstances in which the accident occurred as follows:
"I was stopped at a red light, when a car rear-ended me, causing me to hit the car in front of me."
"[10] One significant issue I now face is my ability to carry out pest control around my home. Before the accident, I undertook pest control at least twice a year, often more frequently depending on the season.
[11] It involved carrying a ladder, climbing, inspecting corners of the property, applying surface sprays and baits, and clearing out any debris that might attract pests. I never required external help to manage this.
[12] Since the accident, I cannot safely or effectively complete this task. I am physically incapable of lifting or positioning pest control equipment, moving furniture, crouching, or accessing high or low areas where pests typically are.
[13] As a result, my home has become vulnerable to infestation. Pests are now increasingly present, particularly in the kitchen, garage, and garden areas. This is not only unhygienic, but is deeply distressing."
"[20] I performed this task prior to the accident. I do not perform it now only because of my injuries. I am not seeking a benefit I didn't previously manage on my own, I am simply asking for support to maintain the standard of living I had before the accident disrupted my life.
[21] I am currently surviving on the Age Pension. The cost of professional pest control is expensive. The stress of living in a deteriorating environment I cannot physically manage has caused me distress. It is not just a matter of preference; it is a matter of necessity."
"General pest 6 months warranty internal 3 months warranty external Internal spray all skirting boards and dust roof void External Spray perimeter of the house, around the windows, eaves, dust weep holes, fence frame, letter box and rubbish bin
21 February 2026. These invoices are referred to in the insurer's written submissions dated 23 March 2026 at [4] and relied on in support of its submission that it "has supported domestic assistance services to [the claimant] for some time, both inside and outside the home...".
1 October 2024 in the sum of $460. At [9] he confirms the dispute is about whether the services are "treatment and care" for the purposes of s 3.24 of the MAI Act. 2. The claimant's case is that:
(a) prior to the accident, he routinely performed pest control around his home, at least twice a year;
(b) the pest control involved working with a ladder, lifting equipment, moving furniture and crouching, and
(c) as a result of his injuries, he is now physically incapable of performing these tasks and in order to maintain a safe, sanitary, and habitable home, is compelled to engage the services of a third-party professional.
(a) pest control is not a luxury or optional service; it is an essential component of maintaining a safe, sanitary, and habitable home;[3]
(b) not all care services are performed daily, but may nonetheless be essential;[4]
(c) tasks like lawn mowing, gutter clearing, and pest control are routine periodic duties that ensure a home remains habitable;[5]
(d) these tasks, while not daily, are recurring,[6] and
(e) the Commission has previously accepted services like lawnmowing and pool cleaning "as part of a person's daily living support when the individual is no longer capable of performing them due to accident-related injuries".[7]
(a) why the claimant performed "such services" on his home several times a year?
(b) whether the claimant had any training in undertaking pest control services?
(c) whether the claimant had any specialist equipment for undertaking the pest control services?
(d) if so, from where did he purchase the equipment?
(e) from where did the claimant purchase the chemicals required to undertake the pest control services?
(a) "attendant care services" should be given its ordinary English meaning;
(b) the purpose of s 3.24(1) is to secure assistance to injured persons with everyday tasks in and around the home;
(c) pest control services "would not fit this definition, as it is generally a task which occurs on an annual basis", and
(d) even if the definition of everyday tasks was expanded to include home maintenance, pest control should not be considered as home maintenance "in any regard".
(a) pest control involved going into the roof void/attic and required him to carry a 7kg ladder, climb it, and jump into the roof void through the roof duct, and
(b) "the job" includes spraying inside and outside the house and the roof void/attic, and all the fences, trees, and outside upper ceilings and filling the outside boxes with rodent treatment and the boxes in the garage and roof void.
(a) prior to the accident the claimant carried out pest control around his home at least twice a year;
(b) the pest control undertaken by the claimant prior to the accident involved the following tasks: entering the roof/attic, carrying a ladder, climbing, inspecting corners of the property, applying surface sprays inside and outside his home, laying baits, and clearing out debris that might attract pests;
(c) prior to the accident the claimant never required external help to manage this work;
(d) the claimant now requires assistance with pest control tasks, and
(e) post-accident pests are increasingly present in the claimant's home, particularly in the kitchen, garage, and garden areas.
"...The evident purpose of s 3.24(1) is, as the definition of "attendant care services" makes clear, to secure assistance to injured persons with everyday tasks, including in and around the home..."
"[16] It might be observed of the definition of 'attendant care services':
(1) The words before the first comma contain the main operative part of the definition (in the sense of stating the meaning of the defined term).
(2) Those words have a purposive dimension: 'services that aim to provide assistance to people with everyday tasks'. The 'service' may or may not consist of directly performing the identified 'task: the' language of 'assistance' would include but is not limited to that. Moreover, it is the task' which is described as 'everyday', not the 'service'.
(3) The words after the first comma are capable of more than one reading. On what is the most natural reading, the words 'and includes ...' identify four types of services that are taken to be 'attendant care services'. The words after the first comma bring within the term 'attendant care services' services that do not necessarily fall within the natural and ordinary meaning of the words before the first comma (i.e., that do not necessarily, as a matter of ordinary English, involve assistance with 'everyday tasks'): see McTye v Ching Yu Chang by his tutor Leo Alexander Birch [2025] NSWCA 3 at [32]- [33]. On this reading, if the 'task' is clearing the gutters of a claimant's three-storey house (where that task requires use of a harness attached to a point on the roof), that may not readily be seen as an 'everyday task'. But it may well be 'home maintenance', and come within the definition on that basis.
(4) On another reading, the four types of services identified after the first comma (which are described as 'example[s]') are all 'attendant care services' because they fall within the words before the first comma. On that reading, the types of services identified after the first comma assist in understanding the meaning of the preceding words, and in particular the scope of 'everyday tasks'. Thus, if clearing the gutters of a three-storey house is 'home maintenance', that would suggest a broad understanding of what constitutes an everyday task.
(5) In any event, it is uncontroversial that "attendant care services" include services which fall outside the four examples after the comma. All that is required is that the service meet the description before the comma, namely, that it aims to provide assistance to people with everyday tasks."
"[20] Defined terms are not to be construed in the abstract. The orthodox approach is to read the words of a definition into the operative provision which employs it, and then to construe the substantive enactment in its context and bearing in mind its purpose: see Workers Compensation Nominal Insurer v Sako (2025) 116 NSWLR 422; [2025] NSWCA 12 at [43]. However, because of the nested definitions here and the way in which they are expressed, including the use of examples, it is not straightforward to transpose the definitions into the operative provision, s 3.24(1). By isolating the immediately relevant language from what are otherwise lengthy definitions of both 'attendant care services' and, especially, 'treatment and care', that exercise risks omitting other parts of those definitions which may have contextual significance.
Bearing that in mind, and attempting to read the immediately relevant words of the definitions into the substantive enactment with maximum fidelity to the statutory language, the operative part of s 3.24(1) is relevantly to the following effect:
An injured person is entitled to statutory benefits for the following expenses ... incurred in connection with providing [services that aim to provide assistance to people with everyday tasks ... includ[ing] ... domestic services] for the injured person -
[21] On its face, that language - especially 'everyday tasks' - states a potentially very broad entitlement."
"[t]here may also be reasons of policy supporting a construction of the statutory language that allows a degree of flexibility, constrained by notions of reasonableness, to address the real needs of injured people."
[1] Insurer's written submissions dated 5 February 2026 at [2].
[2] See claimant's statement at [14], [17] - [19].
[8] See insurer's written submissions dated 5 February 2026 at [2] and 23 March 2026 at [4].
[11] Insurer's submissions dated 5 February 2026 at [12].
Al-Tawil
Youi Pty Ltd [2026] NSWPIC 178;
(2025) 116 NSWLR 422