In accordance with Division 7.6 of the Motor Accident Injuries Act 2017

1. the insurer has no liability to pay any damages to the claimant under the Motor Accident Injuries Act 2017; and
2. no costs are awarded to the claimant.

A statement setting out the Commission's reasons for the assessment is included with this certificate.

1. [BVV] was involved in a motor accident on 11 March 2024. [BVV] had a medical episode at the wheel of his own car before colliding with four cars stationary at traffic lights on the Cumberland Highway.
2. [BVV] made a claim for statutory benefits under the Motor Accident Injuries Act 2017 (the MAI Act). The claim was made against QBE the third-party insurer of [BVV]'s own motor vehicle. Liability was denied and the matter proceeded before me for miscellaneous claims assessment. On 17 April 2025 I determined (for the purposes of the statutory benefits claim) that [BVV] was not wholly or mostly at fault.[1]
3. On or about 21 May 2025, [BVV] made a claim for damages. At some stage, the insurer issued a liability notice to the claimant denying liability for the claim for damages.[2]
4. The insurer invited the claimant to seek an internal review which the claimant did on

8 August 2025. On the same day, QBE wrote to the [BVV] declining to undertake an internal review. 5. The claimant has referred his damages claim to the Personal Injury Commission (the Commission) for assessment in accordance with Division 7.6 of the MAI Act.

1. The proceedings were allocated to me, and I conducted a preliminary conference on

18 September 2025. 2. The parties were notified of the timetable for the proceedings by a notice dated 22 August 2025. 3. In accordance with the timetable set by the Commission, the insurer's reply was due by 10 September 2025. I was advised by an officer of the Commission that no reply has been filed by the insurer. 4. [BVV] attended the preliminary conference conducted by way of a teleconference at 10.30am. There was no attendance by the insurer. 5. I am advised by the Commission that attempts were made to contact the insurer and I also attempted to bring the insurer into the conference. 6. In the light of the issues in dispute, and after discussing the matter with [BVV], I was of the view that it was not necessary to defer the proceedings to hear from the insurer and the preliminary conference proceeded.

1. The claim and the claimant's entitlements are covered by the provisions of the MAI Act. That Act provides:

(a) a scheme of compulsory third-party insurance for all motor vehicles registered in NSW, and

(b) a scheme for the provision of statutory benefits and damages to persons injured in car accidents in NSW.

1. Statutory benefits are paid in accordance with Part 3 of the MAI Act on a no-fault basis for the first 52 weeks after the accident.[3] Thereafter the insurer's liability to pay ongoing statutory benefits depends upon whether the claimant is wholly or most at fault.[4]
2. Part 4 of the MAI Act concerns the claim for damages and the awarding of damages. Section 4.1 provides that:

"This Part applies to and in respect of an award of damages that relates to the ... injury to a person caused by the fault of the owner or driver of a motor vehicle in the use or operation of the vehicle."

1. The term "fault" is defined in s 1.4 of the Act means "negligence or any other tort." The three elements of the tort of negligence which must be proved by an injured person in order for them to recover damages are:

(a) a duty of care exists to the person injured;

(b) the duty of care was breached, and

(c) the person's injury was caused by that breach which has resulted in loss.

1. The quantum or amount of the damages that can be awarded for the loss sustained is regulated and limited by the provisions of Part 4 of the MAI Act. There is no dispute in [BVV]'s case concerning whether he has sustained injury, loss and damage. He says he has not worked since the accident and provides a medical report which indicates he has mental health issues caused by the accident.
2. Part 5 of the MAI Act provides for "no-fault motor accidents" as follows:

(a) a no-fault accident is a motor accident "not caused by the fault of the owner or driver of any motor vehicle involved in the accident in the use or operation of the vehicle and not caused by the fault of any other person"[5];

(b) the injury to a person resulting from a no-fault accident is "deemed to have been caused by the fault of the owner or driver of the motor vehicle in the use or operation of the vehicle"[6];

(c) the accident is presumed to be a no-fault accident if there is "an averment by the plaintiff that the motor accident ... unless there is evidence to the contrary"[7], and

(d) damages can be reduced for the injured person's contributory negligence[8].

"(1) There is no entitlement to recover damages because of the operation of this Part in respect of the death of or injury to the driver of a motor vehicle if the motor accident concerned was caused by an act or omission of that driver.

(2) The death of or injury to a person is taken to have been caused by an act or omission of the driver for the purposes of subsection (1) even if -

(a) the act or omission does not constitute fault by the driver in the use or operation of the vehicle, or

(b) the act or omission was involuntary, or

(c) the act or omission was not the sole or primary cause of the death or injury."

1. The insurer's liability notice sent to the claimant and provided by [BVV] to the Commission denied liability for the claim for the following reasons:

(a) the claim for damages was lodged with QBE, the third-party insurer of the claimant's own vehicle;

(b) the claimant needs to establish fault (negligence) in the causative use or operation of the vehicle by the owner or driver of a vehicle (s 4.1 of the MAI Act);

(c) the claimant's vehicle is the at fault vehicle;

(d) the claimant cannot bring an action in negligence against himself;

(e) negligence, fault or breach of duty of care cannot be "deemed" in a situation where no duty of care exists, and

(f) the claimant cannot satisfy the no-fault motor accident provisions in Part 5 of the Act because s 5.4 prevents the recovery of damages to drivers of the vehicle deemed to be at fault.

1. The insurer's liability notice invited the claimant to apply for an internal review if he did not agree with the decision and set out how to make such an application.
2. In an email addressed to the insurer on 8 August 2025 (sent at 2.44am) which appears to be the claimant's application for internal review the claimant says:

(a) he was injured in a car accident due to an unexpected medical episode;

(b) the Commission found he was not at fault;

(c) he has been affected since the accident and is "totally and permanently disabled" and he relies on a report from his psychologist;

(d) he has applied to QBE for damages, but his application has been declined "because I am not at fault" and he does not understand the logic behind this decision, and

(e) he says there is fault in his case because, during the collision, his airbag did not deploy which was why he sustained the mid-sternal fracture and damages to scars on his chest. He says the police and witnesses said his speed was 70 km/h and the airbag must deploy if the speed is over 24 - 30 km/h and he relies on a letter from Toyota about the airbag.

QBE's response to the application for internal review

1. On 8 August 2025, QBE wrote to the claimant advising him that under Schedule 2 of the MAI Act "this is not a reviewable decision" and therefore no internal review would be conducted.
2. While QBE does refer to Schedule 2 to the MAI Act, QBE does not refer to s 7.9 of the Act which provides for the internal review of merit review matters, medical assessment matters or miscellaneous claims assessment matters. Schedule 2 provides at cl 3 a list of miscellaneous claims assessment matters that must be internally reviewed before they can proceed to assessment.
3. [BVV]'s dispute with QBE is not a miscellaneous claims assessment matter. [BVV] has made a damages claim and wants to have that claim assessed (including liability for the claim and quantum of the claim). This is not a miscellaneous claims assessment matter under Division 7.6 subdivision 3 but a matter for claims assessment under subdivision 2.

1. In the application form lodged with the Commission the claimant takes issue with QBE's decision saying:

(a) the insurer's decision is based on "some kind of irrelevant rules and regulations which I can't understand";

(b) that "my life has turned upside down as a result of the accident" and he has become totally disabled;

(c) the "rules and regulations must support human life survival" and he has lost everything and cannot survive;

(d) he wants economic and non-economic loss in order to survive;

(e) QBE has refused to undertake an internal review;

(f) he says "I was not at fault, and I am claimant against my own insurance, I don't understand CTP insurance must cover it regardless of the person at fault or no one at fault";

(g) he says that QBE can sue Toyota if they need to, because "the cause of injury was due to airbag nondeployment at accident";

(h) he would be happy with any amount of compensation for his losses including future wage loss, superannuation, loss of family life, posttraumatic stress and loss of social life, and

(i) the Commission can determine a lump sum for all these losses.

1. [BVV] says "I request Personal Injury Commission to instruct QBE to accept the liability for common law damages claim both economical and non-economical" loss.
2. [BVV] repeats that "injury happened due to air bag deployment. QBE can blame Toyota as at fault".
3. [BVV] has provided a schedule of damages which sets out as follows:

(a) future wage loss from 11 March 2025 until 30 May 2032 which is six years and two months - no weekly sum is set out but the claimant says his taxable income for 2022 - 2023 was $101,774 and his income for 23-24 was $122,181 (he has attached taxation assessments in support);

(b) pain and suffering from the date of the accident and ongoing pain due to fracture on sternum and ongoing pain and inflammation on keloid scars on the chest - "any amount that PIC suggests is acceptable to me", and

(c) "loss of social and family life, became helpless now, single, severe psychological issues including depression, insomnia, memory loss, posttraumatic stress and anxiety disorders."

1. At the preliminary conference, [BVV] said he did not understand QBE's decisions. I asked him whether he had seen a solicitor. He said he had spoken to many solicitors, but no one understood what he was saying.
2. I explained to [BVV] about:

(a) the scheme of insurance in the MAI Act which is a third-party scheme of insurance and that is it covers the owner or driver of a motor vehicle for losses incurred and allowed under the Act;

(b) the Act concerns "motor accidents" that is incidents or accidents arising out of the use or operation of a motor vehicle during the driving of the vehicle, a collision with the vehicle, the vehicle running out of control, or a dangerous situation concerning a motor vehicle;

(c) the Act provides in Part 3 for statutory benefits to third parties (such as pedestrians or passengers) and to the driver in a motor accident regardless of who was at fault;

(d) the Act provides in Part 4 an entitlement to damages for those who can prove fault (negligence) on the part of the owner or driver in the use or operation of a motor vehicle. [BVV] admitted he was the owner of the motor vehicle he was driving and says he was not at fault. This means that [BVV] must be able to prove fault on the part of some other owner or driver and he admitted that there was no other owner or driver who caused the accident, and

(e) the Act provides in Part 5 an entitlement to damages for those involved in no-fault or blameless accidents but that s 5.4 prevents the driver from recovering damages in such an accident.

1. In summary I explained to [BVV] that he received statutory benefits because he had a medical episode and was not at fault, but in order to recover damages he has to prove fault on the part of some other owner or driver or come within the no-fault provisions of Part 5.
2. [BVV] said that he was of the view Toyota was at fault because his accident occurred at high speed and the airbag did not deploy, and it was the failure of the airbag that caused his injury. [BVV] said that QBE can sue Toyota if they want to.
3. I explained to [BVV] that it is a matter for him to decide whether he wants to sue Toyota or not. I again asked him whether he had spoken to a solicitor about this and he said that he had and he had made enquiries with the Department of Fair Trading. I explained to Mr Sebsatian that the Commission had power only to determine disputes involving injured persons and motor vehicle insurers in respect of motor accidents in accordance with the MAI Act.
4. I said to [BVV] that I was of the preliminary view QBE had no liability for his damages and asked if he had any further evidence to put before me or anything else to say. He did not. I informed him I would be issuing a decision about this and once he had the decision, he may again wish to seek legal advice. He understood this.

1. I do not propose to restate the evidence summarised within the previous decision at paragraphs 36 to 133 including the oral evidence given by [BVV] in the course of those proceedings. I adopt that evidence review.
2. [BVV] confirmed at the preliminary conference in these proceedings that he was the owner of the motor vehicle he was driving on the day of the accident. He agreed there were no other vehicles the drivers of which may have caused the accident. He accepted that it was his medical episode that caused the accident.
3. I have summarised below the additional evidence provided by the claimant with his application.
4. [BVV] included a letter from Toyota dated 4 June 2025. The author of the letter, Chris Mitchell Senior Technical Operations Manager, had a history of the accident caused by the claimant's glycaemic attack and that [BVV] had raised an issue as to why his airbag did not deploy.
5. Mr Mitchell says that Toyota has investigated the matter and he referred to photographs of the vehicle and said:

(a) the vehicle was involved in a low-speed frontal collision;

(b) the degree of impact damage is minimal based on the images;

(c) the cabin remained intact with no glass breaking;

(d) the bulbar has been pushed back into the bonnet deforming the bonnet and breaking the headlight lens assembly but the front fenders showed no obvious sign of damage;

(e) the threshold for an airbag deployment has not been met, and

(f) some degree of injury can occur in any accident event at low speed.

1. Toyota says, "the vehicle has performed as intended ... and the airbag deployment would not have been appropriate at this time."
2. Toyota says the function of an airbag is assist reducing the risk of death of very serious injury but "the primary focus is not to prevent life-threatening injury." Toyota further says:

"SRS Airbags are complementary to the vehicle's other safety features which include, its crumple zones ...and the vehicle's primary restrain system - seat belts. The SRS (Supplemental Restraint System) front airbags fitted to your vehicle are designed to provide protection in addition to the seatbelts. It I also designed to be activated in response to a severe frontal impact."

1. The claimant was referred back to the owner's manual for further information.
2. Ms McLaren, psychologist wrote a report concerning the claimant's mental health state dated 10 July 2025.
3. She diagnosed the claimant with a severe Major Depressive disorder in accordance with the current version of the Diagnostic Statistical Manual of Mental Disorder (DSM-5-TR) and she addresses in her report the various criteria of that disorder.
4. She provides the following opinions about [BVV]:

(a) his return to employment is not realistic or achievable;

(b) he cannot return to functional tasks such as cleaning, cooking and attending social activities due to lack of motivation and memory loss. He has chronic insomnia and has no contact with family or friends;

(c) he is having multifaceted treatment from her including Acceptance and Commitment Therapy, Cognitive Behavioural Therapy, Trauma Focussed Therapy and Motivational interviewing but "has showed no signs of improvement";

(d) there will be no significant change as his cognitive deficits are unlikely to resolve and are likely to worsen with time;

(e) treatment has been finalised, the claimant continues to drive himself to medical appointments and shopping but cannot participate in hobbies or recreational activities, and

(f) she does not believe he will ever return to work.

1. The definition of a motor accident in s 1.4 of the MAI Act is:

"... an incident or accident involving the use or operation of a motor vehicle that causes the ... injury to a person where the ... injury is a result of and is caused (whether or not as a result of a defect in the vehicle) during -

(a) the driving of the vehicle, or

(b) a collision, or action taken to avoid a collision, with the vehicle, or

(c) the vehicle's running out of control, or

(d) a dangerous situation caused by the driving of the vehicle, a collision or action taken to avoid a collision with the vehicle, or the vehicle's running out of control.

1. There was no dispute in the statutory benefit matter that [BVV] was involved in an accident on 11 March 2024 while he was using and operating (driving) his vehicle. There was no dispute in the previous proceedings that the accident caused him injuries while he was driving the vehicle and as a result of it colliding with other vehicles. No additional evidence or arguments have been provided suggesting the previous findings should be revisited.
2. Having considered all the evidence provided in the previous matter and the current proceedings I am satisfied that [BVV] was injured in a motor accident within the meaning of the legislation.

Was the motor accident caused by the fault of the owner or driver of a motor vehicle?

1. Section 4.1(1) provides that damages are awarded if the injury to the claimant was "caused by the fault of the owner or driver of a motor vehicle in the use or operation of the vehicle." There were at least five motor vehicles involved in [BVV]'s accident, his own motor vehicle and the four motor vehicle he collided with.
2. In April 2025 I determined, on the base of the evidence put before me at that time, that [BVV] was not wholly or mostly at fault in causing the accident. The insurer has provided no additional evidence to suggest there is any fault on the part of [BVV].
3. Fault, in a damages claim, means the tort of negligence. While there is no doubt [BVV] has sustained injury, loss and damage as a result of the accident, he does not owe himself a duty of care and therefore cannot be in breach of a duty of care. He therefore cannot sue himself for his accident related losses[9].
4. At the preliminary conference on 18 September 2025, Mr Sebsatian accepted that none of the other owners or drivers of the motor vehicles involved were at fault and that none of them caused the accident. As there is no other owner or driver who was negligence or breached their duty of care to [BVV], there is no other owner or driver for him to sue.

Is the accident a no-fault accident within the meaning of s 5.1?

1. The definition of a no-fault motor accident in s 5.1 is

"a motor accident in the State not caused by the fault of the owner or driver of any motor vehicle involved in the accident in the use or operation of the vehicle and not caused by the fault of any other person." [my emphasis]

1. As [BVV] agrees that his accident was not caused by the fault of any of the owners or drivers of the motor vehicles involved in the collision, the accident would be a no-fault accident as long as there is no fault on the part of any other person relevant to causation of the accident.
2. In that regard, [BVV] has argued that Toyota was at fault for having an airbag in his car which did not deploy upon impact. If I was satisfied that there was a failure of the airbag and that failure was caused by the fault of someone at Toyota, I note that this failure has not caused the accident. The failure, if it was proved that there was a failure, may have contributed to the claimant's injury but the accident involved a collision between [BVV]'s vehicle and four other vehicles. The alleged failure of the airbag happened at or after the collision and did not in any way contribute to the why or how the collision occurred.
3. As the accident (the collision) was not caused by the fault of any of the other owners or drivers and the collision was not caused by the alleged failure of an airbag, I am therefore satisfied that [BVV]'s accident is a no-fault accident.

Can [BVV] recover damages for his no-fault accident?

1. Section 5.4(1) of the Act provides that damages cannot be recovered by the injured driver of a motor vehicle involved in a no-fault accident "... if the motor accident concerned was caused by an act or omission of that driver".
2. Section 5.4(2) deems an injury to have been "caused by an act or omission of the driver, even if:"

(a) "the act or omission does not constitute fault by the driver in the use or operation of the vehicle." [BVV] accepts he was the driver of the motor vehicle that caused the collision (the accident). It was his act of driving the vehicle that led to the collision. [BVV] was not at fault;

(b) "the act or omission was involuntary." The way in which [BVV] was driving the vehicle was affected by the medical episode he experienced. The medical episode caused him to lose consciousness and his driving became, "an involuntary act". It was his loss of consciousness that caused a loss of control of the motor vehicle which resulted in the collision, and

(c) "the act or omission was not the sole or primary cause of the ... injury." The focus here is on the injury and not the accident. If Mr Sebsatian's allegation against Toyota was proven and his airbag did fail to deploy this failure was not the sole or primary cause of his injury. Had he not had the medical episode he would not collided with the other vehicles and he would not have needed the airbag.

(a) even if [BVV] was not at fault, s 5.4(1) applies;

(b) even if [BVV]'s driving which led to the collision was involuntary, s 5.4(1) applies, and

(c) even if [BVV]'s driving, which led to the collision, was not the sole or primary cause of the injury, s 5.4(1) applies.

1. Section 5.4(1) clearly prevents [BVV] as the driver in a no-fault accident from recovering damages.

1. On the information and evidence placed before me:

(a) [BVV]'s accident was a motor accident;

(b) it was not caused by his fault;

(c) it was not caused by the fault of any other person, and

(d) it was therefore a no-fault accident in accordance with Part 5 of the MAI Act.

1. As the driver of the vehicle that caused the accident, [BVV] has, by operation of s 5.4(1) no entitlement to recover damages.
2. [BVV] has indicated that he believes the airbag in his motor vehicle was faulty. If Mr Sebsatian wishes to make a claim against Toyota in negligence or under any consumer protection law, he will need to do that elsewhere. The Commission has no jurisdiction to determine claims which arise beyond the scope of the MAI Act.
3. As the statutory benefits decision was deidentified at the request of the claimant before it was published, I direct that this decision also be de-identified in accordance with Rule 132(1) of the Personal Injury Commission Rules 2021.

[1] BVV v QBE Insurance (Australia) Limited [2025] NSWPIC 158 - PIC Bulletin 216

[2] The copy of the insurer's liability notice provided by the claimant does not include a date.

[3] See s 3.1(2) of the MAI Act which provides that statutory benefits are payable regardless of whether anyone is at fault and even if it is the claimant who is at fault.

[4] See ss 3.11 and 3.28 of the MAI Act. Ongoing benefits also depend on whether the injured person's only injuries are "minor injuries" within the definition in s 1.6 but that is not relevant in this claimant's case.

[9] See Whitfield v Melenewycz [2016] NSWCA 235 at [31].