(2) If a claim is exempt from assessment under this Division, the President must, as soon as practicable, arrange for the issue to the insurer and the claimant of a certificate to that effect (enabling court proceedings to be commenced in respect of the claim concerned)."

1. Rule 99 of the Personal Injury Commission Rules 2021 (Rules) applies to the application, and reads as follows:

"99 Consideration of discretionary exemption from claims assessment

(1) A claimant or insurer may apply for an exemption from assessment under section 92(1)(b) of the MAC Act or section 7.34(1)(b) of the MAI Act by lodging an application.

(2) In determining whether a claim is not suitable for assessment for the purposes of section 92(1)(b) of the MAC Act or section 7.34(1)(b) of the MAI Act, the Commission must consider the objects of the PIC Act and the circumstances of the claim.

(3) Without limiting the matters that may be considered, the Commission may consider the following -

(a) whether the claim involves complex legal or factual issues, or complex issues in the assessment of the amount of the claim,

(b) whether the claim involves issues of liability, including contributory negligence, fault or causation,

(c) whether a claimant or witness, considered by the Commission to be a material witness, resides outside the State,

(d) whether a claimant or insurer seeks to proceed against one or more non-CTP parties,

(e) whether the insurer alleges that a person has made a false or misleading statement in a material particular in relation to the injuries, loss or damage sustained by the claimant in the accident giving rise to the claim."

1. Procedural Direction MA5 applies to the application.
2. In determining whether the claim is not suitable for assessment I must consider the objects of the PIC Act. Those objects include, relevantly, to enable the Commission to resolve the real issues in proceedings justly, quickly, cost effectively and with as little formality as possible.
3. The guiding principle for the PIC Act and the Rules, in their application to proceedings in the Commission, is to facilitate the just, quick and cost-effective resolution of the real issues in the proceedings. The Commission must seek to give effect to the guiding principle when it exercises any power given to it by the PIC Act or the Rules or interprets any provision of the MAI Act or the Rules: s 42(2) PIC Act.

1. All the evidence in the application and reply has been considered.
2. Included in the material filed by the claimant are his statements, a chronology, reports from Dr Rastogi, psychiatrist, reports from Ms Hill, psychologist, treatment records, records from NSW Fire and Rescue, and a NSW Police report. The material also includes the claim form, various decisions made by the insurer with respect to liability, a request for particulars and the claimant's response.
3. The material filed by the insurer includes the liability notice dated 19 September 2025, the insurer's notice of rejection of the claim dated 13 October 2025, and correspondence between the insurer, the insurer's solicitors, and the claimant's solicitors.

1. The claimant relies on written submissions dated 9 September 2025. The submissions record that he joined the fire brigade in 2007 as a full-time firefighter. He was exposed to traumatic events during his employment as a firefighter and was medically discharged from the fire brigade in 2022 due to his post-traumatic stress disorder.
2. The submissions refer to the chronology in the claimant's bundle and record that prior to the accident he had, over a period of time, been exposed to a large number of traumatic events and fatal accidents. It is stated that the claimant would "attempt to bury the memories of these events" and that while he started to suffer psychological symptoms, he remained at work with the fire brigade and in his building company.
3. The claimant's case is that the "main incident which triggered [him] to decompensate into full blown PTSD was the accident...". Details of the circumstances in which the accident occurred are recorded as are the symptoms the claimant experienced following the accident.
4. Reference is made in the submissions to the reports of Dr Rastogi, psychiatrist, all of which have been considered.
5. The submissions note the insurer has denied that any injury has arisen out of the accident. In the claimant's submission the issues of liability and causation are complex, and the claim is not suitable for assessment by the Commission.

1. The insurer relies on written submissions dated 16 January 2026. The submissions confirm that: liability for the claim has been denied; the claimant's explanation for the delay in lodging the application for damages has been rejected, and the insurer consents to the claimant's application for exemption.
2. The insurer submits the claim is not suitable for assessment given the "multiple issues of complexity" surrounding the denial of liability. In this regard, primary liability has been denied, the insurer relying on s 30 of the Civil Liability Act 2002 (CLA). The insurer's case is that as the claimant did not witness the victim "in peril", and attended the scene after she had been killed, "the provisions of the CLA" exclude him from bringing his claim.

1. In the insurer's submission, the claim raises novel issues and will likely require the attendance of multiple witnesses at any hearing. The insurer notes that all relevant witnesses are yet to be identified as the complete police and coronial files are not to hand.
2. The insurer highlights that the Commission does not have the power to compel non-parties to give evidence, and submits that given the liability issues in contention it is likely the hearing will run for multiple days on liability alone.
3. Additionally, the claim has also been denied on procedural grounds, given the late lodgement of the damages claim and the claimant's failure to provide a full and satisfactory explanation for the delay in making the claim.

1. Liability for the claim is in dispute. There are clear factual and legal issues relating to Part 3 of the CLA, in particular s 30(2)(a). I accept the submission that the legal issues are complex. There are likely to be multiple lay and expert witnesses required to give evidence. The hearing will take a number of days. Additionally, and on this background, a determination by the Commission with respect to liability will not bind the parties: s 7.38 MAI Act.
2. If the claim is not exempted from assessment, there is a real prospect the parties will be required to run the case in both the Commission and the District Court with the result that significant duplication of work will be required and significant costs incurred. These considerations, together with those referred to at [23], support a conclusion that the claim is not suitable for assessment by the Commission.
3. I am satisfied the determination of the claim by a court is more likely to result in the just, quick and cost-effective resolution of the real issues in the proceedings.
4. Having made a preliminary assessment of the claim I determine the claim is not suitable for assessment by the Commission under Div 7.6 of the MAI Act. I recommend to the President that the claim be exempt from assessment.
5. In accordance with s 7.34(1)(b) of the Motor Accident Injuries Act 2017, the Division Head (Motor Accident Division) as Delegate of the President, on 4 March 2026, approved Senior Member Brett Williams' recommendation that the claim is not suitable for assessment.