austlii:nsw/NSWPIC/2025/206
General information, not legal advice.
NSWPIC
2025-05-07
Original judgment source is linked above.
Forrest v QBE Insurance (Australia) Limited [2025] NSWPIC 206
MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; claim for statutory benefits; whether dog walking services for the claimant's pet dog are a form of treatment and care within the definition in ; whether they are payable as a statutory benefit under ; , , and distinguished; - dog walking services are domestic services and therefore a form of attendant care service; as a result a type of treatment and care and subject to the limits and restrictions of Division 3.3; a statutory benefit payable by the insurer.
In accordance with Division 7.6 and Schedule 2(3)(n) of the Motor Accident Injuries Act 2017, the Personal Injury Commission's assessment is:
A statement setting out the Commission's reasons for the assessment is included with this certificate.
26 February 2025, pursuant to s 3.2(3), the Lifetime Care and Support Authority (Authority) became the relevant insurer. 4. As the current dispute is limited to dog walking service expenses incurred in October and November 2024 it is a dispute between Dr Forrest and QBE and does not concern the Authority.
"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) reasonable and necessary travel and accommodation expenses incurred by the injured person in order to obtain treatment and care for which statutory benefits are payable,
(c) if the injured person is under the age of 18 years or otherwise requires assistance to travel for treatment and care, reasonable and necessary travel and accommodation expenses incurred by a parent or other carer of the injured person in order to accompany the injured person while treatment and care for which statutory benefits are payable is being provided."
(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[3],
but does not include any treatment, care, support or services of a kind declared by the regulations to be excluded from this definition[4]."
"services that aim to provide assistance to people with everyday tasks, and includes (for example) personal assistance, nursing, home maintenance and domestic services".
(a) section 3.24(1)(a) says that while the insurer has to pay for treatment and care expenses incurred, it only has to pay the reasonable costs incurred;
(b) section 3.24(2) provides that no statutory benefits are payable if the treatment and care is not reasonable and necessary in the circumstances or did not relate to the injuries caused by the accident;
(c) section 3.25 provides that no statutory benefits are to be paid for gratuitous care;
(d) section 3.27 requires treatment and care expenses to be verified and there are provisions in the Motor Accident Guidelines about this, and
(e) section 3.28 provides for the cessation of statutory benefits after 52 weeks for a person with threshold injuries or if they were wholly or mostly at fault.
Resolution of disputes about treatment and care
(a) schedule 2(1)(i) permits a merit reviewer to determine disputes about whether the cost of treatment and care provided or to be provided is reasonable[5];
(b) schedule 2(2)(b) allows a medical assessor to determine whether any treatment and care provided or to be provided, "is reasonable and necessary in the circumstances or relates to the injury caused by the motor accident."
(c) schedule 2(3)(n) provides a Member of the Commission with power to determine "any issue of liability for a claim, or part of a claim, for statutory benefits not otherwise specified in this Schedule".
(a) they were not reasonable and necessary as the claimant has now sufficiently recovered from his recent surgery;
(b) dog walking is not treatment, rehabilitation or care as defined in the MAI Act, and
(c) the Activities of Daily Living Assessment from 5 February 2024 (in a report dated 18 June 2024) records that the claimant was responsible for home and yard maintenance and does not say he was responsible for dog walking.
(a) the insurer referred the claimant to IPAR Rehabilitation for an activities of daily living assessment. Mr Dilon wrote a report on 9 February 2024 which included recommendations for housecleaning and gardening services and did not mention dog walking services;
(b) on 20 February 2024 QBE advised "for good will" they would pay for dog walking services and pool cleaning and approved the request on 7 March 2024;
(c) to be payable under s 3.24(1)(a), dog walking services must be considered "treatment and care" within the definition in s 1.4;
(d) dog walking services can only fall under "attendant care services ... if at all";
(e) the objects of the MAI Act include the encouragement of "early and appropriate treatment and care to achieve optimum recovery from injuries ... to maximise their return to work and other activities". Dog walking services will not "assist your recovery ... so that you can return to work and everyday tasks." Dog walking services are not medical treatment or attendant care services, and
(f) while previous expenses have been paid, s 3.31(3)(a) provides a discretion on the part of insurer to pay for expenses not covered by the MAI Act and "there is no requirement that the insurer continue to pay non-mandatory expenses if it has initially exercised the discretion."
"I do not believe that Griffiths v Kerkemeyer, or any of its extensions, includes the provision of care to an injured persons' pets or a hobby. The cases have accepted domestic care at home, in the garden and shopping. But counsel has found no case which extends domestic assistance to the care of domestic pets or the retention of a hobby."
(a) the definition is not exhaustive but gives guidance (examples) as to what might fall within it [11] and dog walking is not personal assistance, nursing or home maintenance [12];
(b) in relation to the example of "domestic services" the insurer submits at [13] that there is no definition in the MAI Act of domestic services but that s 15B of the Civil Liability Act 2002 provides such a definition, that is "services of a domestic nature". The insurer quotes from the decision of Saedi v Allianz Australia Insurance Limited[14] where I said at [78] "It is quite clear that domestic services would include household services such as laundry, cooking, cleaning, bed-making ..."
(c) the insurer cites at [14] Haddad v Lifetime Care and Support Authority[15] and my comment at [49] that "the term attendant care services therefore is quite wide and might include pet care services (for someone with limited mobility), gardening assistance and hair care assistance". The insurer emphasizes that "might" means "could" and not "would" [17];
(d) the insurer says at [19] that s 3.24(1) requires treatment and care to be provided "for the injured person" and argues that it might only cover treatment and care provided directly for, and therefore to the claimant [20];
(e) the insurer submits at [22] that s 3.24(1) may allow for treatment and care services to be provided to other human beings (such as childcare services) but that services provided to a claimant's pets are "too remote" to be a benefit to the claimant. The insurer repeats at [29] that treatment and care should be provided for the claimant personally;
(f) the insurer refers at [23] to Geaghen and cites a decision of Merit Reviewer Ruschen in Frost v NRMA[16];
(g) the insurer also cites my decision in Fowler v Youi Pty Limited[17] and Lau v QBE Insurance (Australia) Limited[18] and other observations I made about treatment and care in those decisions which dealt with a new car and painting and handyman services;
(h) the insurer also submits at [33] that a clear requirement of attendant care is that it is assistance with everyday tasks and says at [34] the claimant had not provided evidence that walking the dog was an everyday task or a task that was specifically his. The insurer submits that the claimant would need to establish that the dog walking was something the claimant would have done had the accident not occurred;
(i) the insurer says at [37] - [42] that one of the objects of the act is to encourage early and appropriate treatment, optimum recovery from injuries and maximise the injured person's return to work and activities. The insurer says that dog walking services if provided would be disproportionate to the overarching object to provide treatment and care to enable his optimal recovery and maximise his return to work. Finally, the insurer says dog walking services are too far removed from the purpose and context of treatment and care modalities that were intended to be covered.
(a) the accident occurred shortly before the claimant's 31st birthday;
(b) the claimant had a previous accident and claim "QBE many years ago after a not at fault MVA";
(c) the accident occurred at 11.50 am on the Camden Bypass;
(d) the claimant was driving, wearing a seatbelt;
(e) his car was hit from behind while he was looking in the rear-view mirror;
(f) he felt a "slight twinge in the left side of my neck";
(g) he exchanged details with the driver and both cars drove off, and
(h) later while visiting the doctor "I felt weakness [in] my left hand and shooting pains into my left arm."
(a) the reasonable cost of treatment and care within the definition of s 1.4;
(b) the reasonable and necessary travel and accommodation costs of obtaining the treatment and care, and
(c) if the claimant is an infant or otherwise needs a carer, their reasonable and necessary travel and accommodation costs while the claimant obtains their treatment and care.
What sort of attendant services can be allowed?
"... I agree with the claimant's submission that the word "everyday" used in the definition of attendant care is not restricted to tasks that are done every day. BLI's example of lawn mowing is a good example. Lawn mowing is an everyday activity in that it is a usual or commonplace activity, but domestic lawns do not need to be mown every day..."
"Whichever way it is put, on a 'needs' basis, general damages or remoteness, it seems to me that Griffiths v Kerkemeyer does not extend to a plaintiff's hobby and his Honour was entitled to reject the care of the animals on that basis. Nor do I believe that it would be appropriate to extend Griffiths v Kerkemeyer to cover the care of animals kept as a hobby."
"The mere fact that, by reason of her injuries, Mr Judd provides care for pets that, prior to her injuries, she provided, does not establish that she is in need of those services. The concept of 'need' involves more than a mere desire. Compensation for need does not encompass compensation for services that are not reasonably necessary for the plaintiff's well-being."
"There are suggestions in the reasoning which would conflate the keeping of pets with a 'hobby' in all cases. If it were necessary for the resolution of a case, I would respectfully doubt whether the ratio of Geaghan goes so far. It may be that a hobby should be understood as something involving an activity or occupation, so that if the injured plaintiff can no longer engage in the hobby, it falls into the category of activities which are no longer open and should thus be compensated as part of the diminution of the enjoyment of life, by way of general damages. Pets, by way of contrast, provide various benefits within the home and garden. If a person who is quadriplegic obtains enjoyment from listening to a canary, rather than the radio, there is no reason in principle why assistance which might extend to switching a radio on and off and changing channels, should not include feeding the canary. There is no principle which requires that a person rendered impotent by a tortious injury can only receive compensation for the bare necessities of life. The reason why the caselaw may not include reference to caring for pets is probably because it had not previously been thought necessary to require a plaintiff to distinguish between general house cleaning and cleaning up after a pet, or any similar or related distinction. Caring for pets, like caring for furniture, is an inherent part of the concept of domestic assistance, provided to a plaintiff, and does not form some impermissible extension of the kind which occurred in Sullivan v Gordon, overturned in CSR Ltd v Eddy. However, no final view is required, because, as Ipp JA has explained, no need, caused by the accident, for assistance with pets was established on the evidence" (emphasis added).
(a) the resolution of any medical assessment matter (were the services reasonable and necessary in the circumstances or related to the injuries caused by the accident), and
(b) the resolution of any merit review matter as to the reasonableness of the cost of the treatment.
[1] See s 52(3) of the Personal Injury Commission Act 2020.
[2] The decision of Member Bolton, Senior Medical Assessor Dixon and the late Medical Assessor Stubbs is found at page 24 of the claimant's bundle.
[3] There are no additional kinds of treatment, care, support or services provided for in the Motor Accident Injuries Regulation 2017 (the Regulation).
[4] There are no excluded forms of treatment, care, support or services in the Regulation.
[5] Section 3.24(1)(a) refers to the reasonable cost of treatment and care and does not include the word "necessary".
[8] While referred to as the "Motor Vehicle Accident Guidelines 2021" this is clearly a reference to the Motor Accident Guidelines.
[9] (1977) HCA 45 (Griffiths v Kerkemeyer).
[13] The numbers in square brackets are a reference to the paragraph number in the submissions.
[20] Page 12 of the claimant's additional documents.
[21] Page 15 of the claimant's additional documents.
[22] Page 423 of the claimant's bundle.
[23] Page 11 of the claimant's additional documents.
[24] [2024] NSWPIC 436 (BLI).
[26] [2002] NSWCA 260; (2002) 36 MVR 542 (Geaghan).
[27] A monetary unit is currently worth $124.53, 16 monetary units therefore equals $1,992.48 which is rounded down in accordance with Schedule 3(3) of the Regulation.
Forrest
QBE Insurance
(2002) 36 MVR 542