The Personal Injury Commission determines as follows:

1. The claimant's Application for Personal Injury Benefits was made on 8 April 2024, more than 28 days after the motor accident of 13 December 2023.
2. Pursuant to s 6.13(2) of the Motor Accident Injuries Act 2017 (NSW) (the Act), weekly statutory benefits are not payable in respect of any period before the claim was made.
3. The claimant is not entitled to weekly statutory benefits for the period 13 December 2023 to 7 April 2024.
4. Weekly statutory benefits were payable from 8 April 2024 until cessation at the expiration of 52 weeks from the date of the accident, in accordance with s 3.28 of the Act.

1. The claimant, Mr Harry Mehr, was involved in a motor vehicle accident on 13 December 2023 at Mona Street, Auburn, New South Wales.
2. At the time of the accident, Mr Mehr was the driver of a motor vehicle. The other party involved subsequently lodged a claim against Mr Mehr's Compulsory Third Party (CTP) policy. In January 2024, AAI limited t/as AAMI (the insurer) contacted Mr Mehr in that context and arranged for an investigator to obtain his version of events.
3. The email material demonstrates that communications occurred between the insurer and the claimant in January 2024 concerning the investigator's role and the fact that a claim had been made against his policy. On 22 January 2024 and again on 24 January 2024, the insurer advised that the investigator's involvement was limited to obtaining Mr Mehr's account and that the investigation file was being closed. On 29 January 2024, the insurer invited Mr Mehr to identify any assistance he required.
4. In February and March 2024, the insurer corresponded with Mr Mehr regarding the lodgement of a CTP claim. On 5 March 2024, the insurer advised that a member of the lodgements team would contact him to assist in submitting a claim and provided a link to the online claim form. On 6 March 2024, further contact was attempted to advise him how to lodge a new CTP claim arising from the accident of 13 December 2023.
5. The claimant ultimately lodged an Application for Personal Injury Benefits on 8 April 2024, approximately four months after the date of the accident. The digital claim form records that, when prompted, he acknowledged that the accident had occurred more than three months earlier and elected to proceed with the claim.
6. By email dated 23 April 2024, the insurer advised the claimant that, because the claim had been lodged more than three months after the accident, a full and satisfactory explanation for the delay was required. The insurer set out the matters to be addressed in that explanation, including a chronological account of events from the date of the accident, details of medical consultations, and whether legal advice had been obtained.
7. An internal review was conducted in relation to the period payable for weekly statutory benefits. By notice dated 16 July 2024, the insurer affirmed the earlier decision concerning the period of payment.
8. The insurer subsequently paid weekly statutory benefits from 8 April 2024, being the date of lodgement of the claim. The material before the Personal Injury Commission (Commission) includes a payment schedule evidencing payments made for loss of income between April 2024 and December 2024, together with an adjustment payment in December 2024 following an acknowledged error in calculation.
9. On 25 November 2024, the insurer determined that the claimant was wholly or mostly at fault for the motor accident. In accordance with s 3.28 of the Motor Accident Injuries Act 2017 (NSW) (the MAI Act), weekly statutory benefits ceased at the expiration of 52 weeks from the date of the accident, namely 11 December 2024.
10. The present proceedings arise from Mr Mehr's application for miscellaneous claims assessment in respect of statutory benefits claim time limits. The issue for determination concerns the operation of s 6.13 of the MAI Act, including whether the claimant provided a full and satisfactory explanation for not making his claim within 28 days of the accident, and the consequences of late lodgement for entitlement to weekly statutory benefits.

1. The matter was listed before me for preliminary teleconference on 21 October 2025.
2. The claimant appeared self-represented with the assistance of a Farsi interpreter. The insurer was represented by Mr Matthew Seisun of Sparke Helmore Lawyers.
3. At the outset of the conference, I identified the nature of the dispute as one arising under Schedule 2(3)(k) of the MAI Act, namely a dispute concerning statutory benefits claim time limits. I confirmed with the insurer that the only issue properly before the Commission was the time-limit question under s 6.13 of the MAI Act.
4. I raised the fact that the file material referred to a determination that the claimant was wholly or mostly at fault, and to a medical assessment concerning causation of psychiatric injury. Mr Seisun confirmed that neither the fault determination nor the medical assessment was the subject of the present proceedings. I explained to the claimant, through the interpreter, that those matters were not before me and would not be determined in this application.
5. The claimant expressed frustration with the manner in which his claim had been handled. He stated that he had not been legally represented, that English is not his first language, and that he had found the process confusing. He asserted that he did not understand the timeframes for lodgement and considered that he had been misled or inadequately informed about what was required of him.
6. I explained carefully that the Commission's task was confined to determining whether the claimant had provided a "full and satisfactory explanation" for not lodging his claim within 28 days of the accident, and to consider the statutory consequences that follow under s 6.13. I emphasised that dissatisfaction with the investigation process or the amount of payments was not, of itself, determinative of the statutory question.
7. Mr Seisun submitted that s 6.13(2) of the MAI Act operates as a statutory bar upon payment of weekly statutory benefits for any period prior to the lodgement of a claim where the claim is made outside 28 days. He contended that, irrespective of the explanation offered, the legislation does not permit retrospective payment of weekly benefits prior to 8 April 2024, being the date on which the claim was lodged. I indicated that I would consider that submission in light of the statutory text.
8. Upon reviewing the material then before the Commission, I noted that the insurer's internal review outcome dated 16 July 2024 did not appear to record any substantive reasoning addressing whether the claimant's explanation for delay was "full and satisfactory" within the meaning of s 6.13(3). The decision appeared simply to affirm the earlier outcome.
9. I further observed that, although the insurer asserted that weekly statutory benefits had been paid from 8 April 2024 until cessation in December 2024, no payment schedules, remittance advices or records of calculation had been produced. In the absence of such documentation, the Commission was not in a position to verify whether statutory benefits had in fact been paid, and if so, in what amounts and for what period.
10. In those circumstances, I made directions requiring the insurer to provide documentary confirmation of any statutory benefits paid, including payment schedules or remittance advices identifying the dates, amounts and duration of payments made between 8 April 2024 and 13 December 2024. I indicated that, if that material demonstrated that statutory benefits had in fact been paid in accordance with the MAI Act, the present application might have no continuing practical utility and could be determined on that basis.
11. In the alternative, if the payment material was not provided, I directed that the insurer file the complete record of communications between itself and the claimant from the date of the accident to the date of lodgement of the claim, together with any supplementary submissions addressing the issue of full and satisfactory explanation. I further directed that the claimant be given an opportunity to respond in writing, and that the matter thereafter be determined on the papers unless otherwise directed.

1. By directions made on 21 October 2025, the insurer was required to provide documentary confirmation of any statutory benefits paid to the claimant, including payment schedules or remittance advices identifying the dates, amounts and duration of payments made between 8 April 2024 and 13 December 2024.
2. In response, the insurer filed further submissions dated 3 November 2025 together with a bundle described as an "Insurer's List of Documents". The material comprised:

(a) insurer's further submissions dated 3 November 2025;

(b) a document titled "NSW CTP - List of Payments" (treatment), and

(c) a document titled "NSW CTP - List of Payments" (loss of income).

1. In its further submissions, the insurer referred expressly to the directions of 21 October 2025 and stated that it was providing evidence of all statutory benefits paid to the claimant. It submitted that, in light of that material, the present application should be discontinued and the directions vacated.
2. The treatment payment schedule (page 3 of the bundle) is headed "NSW CTP - List of Payments" and records the claimant's name, the accident date (13 December 2023) and the claim number. The schedule lists multiple payments made under the cost category "Treatment", including general practitioner attendances, interpreter services, psychology services and transport services. The entries are dated from 15 May 2024 through to 16 September 2025. Each entry identifies the cheque payee, the day of cheque issue, the transaction amount and GST component. The grand total recorded for treatment payments is $10,692.68 (GST component $274.93).
3. The loss of income payment schedule (page 4 of the bundle) is likewise headed "NSW CTP - List of Payments" and records payments under the cost category "Loss of Income (Stat Weekly Pay...)". The entries commence on 18 July 2024 and continue on a weekly basis through to 13 December 2024. The majority of weekly payments are recorded in the amount of $1,192.80, with later entries reflecting $1,217.60 and a final entry in the amount of $173.94. The grand total recorded for loss of income payments is $40,469.48.
4. The loss of income schedule identifies, for each payment, the day of cheque issue, the payment period start and end dates, and the transaction amount. The final payment period recorded runs from 6 December 2024 to 7 December 2024, with the final transaction amount of $173.94 issued on 13 December 2024.
5. The payment material is consistent with the insurer's earlier submissions that weekly statutory benefits were paid from the date of lodgement of the claim, being 8 April 2024, and ceased at the expiration of 52 weeks from the date of the accident, namely 11 December 2024, with final processing occurring in December 2024.
6. No material was produced evidencing payment of weekly statutory benefits for any period prior to 8 April 2024. The payment schedules do not record any loss of income payments referable to the period between 13 December 2023 and 7 April 2024.
7. The material produced therefore establishes that:

(a) weekly statutory benefits were paid from mid-July 2024, with payment periods commencing in April 2024;

(b) weekly payments continued until early December 2024;

(c) an adjustment payment in the amount of $173.94 was issued in December 2024, and

(d) treatment expenses were met from May 2024 onward.

1. That is the entirety of the documentary evidence produced by the insurer in compliance with the directions of 21 October 2025.

1. The present dispute concerns the operation of s 6.13 of the MAI Act and, in particular, the consequences of the claimant's failure to make a claim for statutory benefits within 28 days of the motor accident.
2. The accident occurred on 13 December 2023. The claimant did not lodge his Application for Personal Injury Benefits until 8 April 2024, approximately four months later. It is therefore common ground that the claim was not made within 28 days of the accident.
3. Section 6.13(2) of the MAI Act provides, in substance, that if a claim for statutory benefits is not made within 28 days after the motor accident, weekly payments of statutory benefits are not payable in respect of any period before the claim is made.
4. The language of s 6.13(2) is expressed in mandatory terms. It does not confer a discretion to order payment of weekly benefits for any period prior to the making of the claim. The statutory consequence flows from the fact of late lodgement itself.
5. Section 6.13(3) provides that the insurer may accept a claim made more than three months after the accident if satisfied that the claimant has provided a "full and satisfactory explanation" for the delay. That provision concerns whether the claim is to be accepted notwithstanding late lodgement. It does not displace the express limitation in s 6.13(2) concerning payment of weekly benefits prior to the date of claim.
6. The claimant's central complaint in these proceedings has been that he did not receive weekly payments for the period between 13 December 2023 and 8 April 2024. He has also expressed dissatisfaction with the calculation and explanation of subsequent payments.
7. The insurer has now produced payment schedules evidencing the statutory benefits paid. That material establishes that:

(a) weekly statutory benefits were paid by reference to periods commencing after 8 April 2024;

(b) weekly payments continued until early December 2024;

(c) payments ceased at the expiration of 52 weeks from the date of the accident, consistent with s 3.28 of the MAI Act following a determination that the claimant was wholly or mostly at fault, and

(d) an adjustment payment in the amount of $173.94 was issued in December 2024 to correct an earlier error.

1. The payment schedules do not record any weekly payments referable to the period between 13 December 2023 and 7 April 2024. That is consistent with the operation of s 6.13(2).
2. Even if I were satisfied that the claimant had provided a full and satisfactory explanation for not making his claim within 28 days, the MAI Act does not empower the Commission to order weekly statutory benefits for any period before the claim was made. The statutory bar in s 6.13(2) is clear.
3. In those circumstances, the issue of whether the claimant's explanation meets the statutory definition of "full and satisfactory explanation" does not alter the outcome in relation to weekly payments for the pre-lodgement period. There is no power under the MAI Act to direct payment of weekly benefits for the period 13 December 2023 to 7 April 2024.
4. As to the period after lodgement, the documentary material demonstrates that weekly statutory benefits were paid from April 2024 until cessation at the 52-week mark in December 2024. The claimant's concerns regarding differing amounts and the absence of explanation are matters of administration and calculation. The evidence now before the Commission confirms that payments were made and identifies the amounts and payment periods.
5. The Commission's role in this miscellaneous claims assessment is confined to the statutory question under Schedule 2(3)(k). It is not a general supervisory jurisdiction over the insurer's communications or payment practices beyond determining whether the MAI Act has been correctly applied.
6. On the material produced, I am satisfied that:

(a) the claimant's application for statutory benefits was made outside 28 days of the accident;

(b) by operation of s 6.13(2), weekly statutory benefits were not payable for any period prior to 8 April 2024, and

(c) weekly statutory benefits were paid from the date of claim until cessation at the expiration of 52 weeks from the date of the accident.

1. Accordingly, there is no continuing basis upon which the Commission could grant the relief sought by the claimant in respect of payment for the period prior to lodgement. The insurer has complied with the statutory scheme.
2. For those reasons, the application under Schedule 2(3)(k) cannot succeed.