AAI Limited t/as AAMI v Delamont
[2025] NSWPIC 522
•1 October 2025
| CERTIFICATE OF DETERMINATION OF MEMBER | |
| CITATION: | AAI Limited t/as AAMI v Delamont [2025] NSWPIC 522 |
| CLAIMANT: | Jeffrey Delamont |
| INSURER: | AAI Limited t/as AAMI |
| MEMBER: | Michael Inglis |
| DATE OF DECISION: | 1 October 2025 |
CATCHWORDS: | MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; section 6.23; claimant self-represented; claimant sustained injury as a result of a motor vehicle accident including fracture at the base of the left big toe resulting in synovial thickening with increased vascularity in the first MTP joint; claimant off work for 17 weeks and return to normal duties; past economic loss $11,500.00 ongoing symptoms of pain and discomfort in the foot; claimant able to continue working until normal retirement; buffer for future economic loss $40,000.00; Held – settlement of $51,500.00 approved as just, fair and reasonable and within the range of likely outcomes. |
| DETERMINATIONS MADE: | CERTIFICATE 1. The proposed settlement in the sum of $51,500 is approved under s 6.23(2)(b) of the Motor Accident Injuries Act 2017. |
STATEMENT OF REASONS
INTRODUCTION
Jeffrey Delamont (the claimant) is currently 56 years of age.
At the time of his accident, the claimant was employed as a train cleaner by Sydney Trains.
On 21 September 2024, as the claimant entered a roundabout on his bike, he slowed to give way to traffic before proceeding. He was hit from behind by the insured motor vehicle and thrown from his bike. He has no recollection of the incident. He estimated his speed at impact was 20kmph. Neither police nor an ambulance service attended the scene.
He was able to pick himself up and complete the 4km ride home. He was subsequently taken by his wife to the accident and emergency department at Wyong Hospital where he was assessed. At the hospital it was noted that he had a fracture of the base of the left big toe, superficial abrasions over the left lower leg below the knee and some left-sided chest and abdominal discomfort. He remained overnight before being discharged the following day.
The claimant followed up with his local doctor and was referred for physiotherapy and provided with a CAM boot for the left foot which remained in place for about three weeks.
At the time of the accident, as is noted above he was employed by Sydney Trains working as a cleaner at the Hornsby Depot. He had worked in that position for the past 15 years in a full-time role. He was off work for around four weeks before performing life duties for a week then resuming to his full pre- injury duties. He continues in that role.
The claimant made a claim for damages on 31 March 2025. The insurer admitted liability for the claim on 29 May 2025.
STATUTORY PROVISIONS
Restrictions on the settlement of a claim for damages are found in s 6.23 of the MAI Act, which is in the following terms:
“6.23 Restrictions on Settlement of Claim for Damages
(1) (Repealed)
(2) A claim for damages cannot be settled unless –
(a)The claimant is represented in respect of the claim by an Australian legal practitioner,
Or
(b)The proposed settlement is approved by the Commission.
(3) The Commission is not to approve the settlement of a claim unless satisfied that the settlement complies with any applicable requirements of or made under this Act or the Motor Accidents Guidelines."
Clause 7.37 of the Motor Accident Guidelines states as follows:
"7.37U under section 6.23(3) of the Act, before the Personal Injury Commission may approve the settlement of a claim for damages, it must be satisfied that:
(a)The proposed settlement satisfies the timing requirements in section 6.23(1) of the Act;
(b)The proposed settlement is just, fair and reasonable and within the range of likely potential damages assessments for the claim were the matter to be assessed by the Commission, taking into account the nature and extent of the claim and the injuries, disabilities, impairments and losses sustained by the claimant, and taking into account any proposed reductions or deductions in the proposed settlement;
(c)The claimant understands that they are entitled to be represented in respect of the claim by an Australian legal practitioner;
(d)The claimant understands the nature and effect of the proposed settlement and is willing to accept the proposed settlement."
Procedural Direction MA3 concerns the requirement for the Commission to approve settlement of a claim for damages in circumstances where the claimant is not represented by an Australian legal practitioner, and the process for obtaining the Commission's approval of the settlement of the claim.
MEDICAL EVIDENCE
The material before me establishes that the claimant underwent X-ray of his left foot on 25 October 2024 and again on 4 December 2024. The second X-ray revealed a well-corticated body bony fragment along the dorsal aspect of the base of the distal phalanx measuring 6 by 1.7mm. No acute fracture was evident.
The claimant also underwent ultrasound of the left great toe on 9 December 2024 which revealed synovial thickening with increased vascularity at the first MTP joint.
It was referred for podiatry assessment with Blueprint Podiatry. In a report dated 17 December 2024 it was noted that the claimant reported ongoing concerns regarding changes in gait and functional discomfort. Custom orthotics and shoes and strapping were recommended. A further report was provided on 11 February 2025 in which it was noted that the claimant continued to experience difficulty with prolonged standing and stair navigation and increased fatigue with weight-bearing activities and gait alterations.
The insurer arranged for the claimant to be examined by Dr Powell, orthopaedic surgeon. He reported to the insurer on 18 April 2025. In that report Dr Powell noted that the claimant complained of minor ongoing symptoms in relation to the left big toe including intermittent discomfort overlying the dorsal aspect of the interphalangeal joint with some stiffness and restricted range of motion. Symptoms were aggravated after periods of prolonged standing and walking, typically at the end of the work day.
Dr Powell diagnosed superficial abrasions and a fracture of the left hallux distal phalanx. Dr Powell reported that the claimant had made a good recovery with mild ongoing symptoms. Clinical examination revealed some minor stiffness and crepitus in the joint but no other significant abnormality.
There is also a report from Mr Matt Shanahan from a Blueprint Podiatry dated
11 February 2025. In that report Mr Shanahan recommended the continued use of orthotics with further assessment if symptoms persisted including potential imaging or specialist referral. Mr Shanahan also recommended ongoing monitoring of gait mechanics and footwear suitability. Mr Shanahan opined that the claimant was fit for modified work duties due to standing restrictions.
The claimant was treated by his general practitioner Dr Riju George. Dr George certified the claimant was fit to resume his pre-injury duties from 18 January 2025.
PRELIMINARY CONFERENCE
The claimant confirmed that he was aware that he was entitled to legal representation but preferred to self-represent.
He also understood that if the proposed settlement was approved, he would retain his right to claim for medical and related treatment reasonably necessary as a result of the injuries that he sustained. In conference, the claimant confirmed the ongoing symptoms complained of to Dr Powell and Mr Shanahan and said the ongoing pain is bearable but at the end of the day it is worse and he suffers cramps.
The only medication he takes is over-the-counter Panadol and he said that he thought that his symptoms had improved a little bit in recent months. I specifically enquired as to whether or not he thought he would be able to continue with his normal duties until retirement age and the claimant said that he was confident that he would be able to continue.
I noted from the report of Dr Powell that the claimant had previously worked as a forklift driver, storeman and process worker. The claimant said that he would be able to do these jobs as well if necessary. I found the claimant to be a stoic individual and I note that Dr Powell stated that there was no suggestion or overreaction or exaggeration.
SUBMISSIONS
The claim is for economic loss only. The insurer had submitted that the appropriate allowance for past economic loss was $11,500. The calculations contained in the insurer’s submission would indicate that that is the appropriate sum to be allowed.
Concerning future economic loss, the insurer notes that Dr Powell assessed the claimant as being fit to continue his full pre-injury duties on 18 January 2025 and that that opinion was supported by the assessment of the opinion of the claimant's treating general practitioner Dr George.
It is submitted that the appropriate allowance for future economic loss was a buffer of $40,000.
CONSIDERATION
I confirm that the allowance of $11,500 for past economic loss is appropriate.
Concerning future economic loss, I am mindful of the claimant's statement that that he will be able to continue with his current work until retirement age. I note further that if for some reason he were to lose his current employment the claimant says that he would be able to return to work as a forklift driver, a storeman and/or process worker. In these circumstances it seems to me that the proposed buffer is within the appropriate range.
I am satisfied that the total proposed settlement sum of $51,500 is just, fair and reasonable and within the range of likely potential damages assessments for the claim were the matter to be assessed by the Commission, taking into account the nature and extent of the claim and the injuries, disabilities, impairments and losses sustained by the claimant.
I am satisfied that the claimant understands that he was entitled to be represented in respect of the claim by an Australian legal practitioner and does not wish to be represented. I am also satisfied that the claimant understands the nature and effect of the proposed settlement and is willing to accept the proposed settlement sum.
Having considered all material available, I am satisfied that the proposed settlement should be approved.
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