Botros v CIC Allianz Insurance Limited - [2025] NSWPIC 585

CERTIFICATE OF DETERMINATION OF MEMBER
CITATION:	Botros v CIC Allianz Insurance Limited [2025] NSWPIC 585
CLAIMANT:	Ursula Botros
INSURER:	CIC Allianz Insurance Limited
MEMBER:	Bianca Montgomery-Hribar
DATE OF DECISION:	30 October 2025
CATCHWORDS:	MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; claim for damages; late claim; whether claimant has a full and satisfactory explanation for the delay in making her claim for damages; consideration of sections 6.2 and 6.14; statutory declaration provided by claimant; Walker v Howard, Russo v Aiello, Figliuzzi v Yonan, and Karambelas v Zaknic, Rahman v Al-Maharmeh considered and applied; Held – claimant has not provided a full and satisfactory explanation for the delay in making a claim for damages.
DETERMINATIONS MADE:	CERTIFICATE 1. The claimant has not provided a full and satisfactory explanation for the delay in making her claim for damages, such that a late claim cannot be made in accordance with s 6.14 of the Motor Accident Injuries Act 2017. 2. The insurer is to pay the claimant’s legal costs in the amount of $2,031 plus GST. A statement setting out the Personal Injury Commission’s reasons is included with this certificate.

STATEMENT OF REASONS

INTRODUCTION

Ursula Botros (claimant) was involved in a motor accident on 29 November 2018 in the underground carpark of Bankstown Shopping Centre. Ms Botros was returning her trolley to the trolley bay in the direction of oncoming traffic. A car that was driving towards her hit her trolley and she was propelled backwards onto the ground (accident).
On 11 December 2018, Ms Botros lodged an application for statutory benefits under the Motor Accident Injuries Act 2017 (NSW) (MAI Act) on CIC Allianz Insurance Limited (the insurer).
On 24 August 2023, she made an application for damages on the insurer. The current dispute regards Ms Botros’s damages application.
Relevantly, the insurer has denied liability on the basis that Ms Botros’s application was lodged outside the required timeframe and without a full and satisfactory explanation. Ms Botros accepts that her application for damages was lodged outside the required timeframe. However, she submits that it should be accepted as her explanation is both full and satisfactory.
This matter requires determination of whether Ms Botros’s explanation is full and satisfactory for the purposes of s 6.14 of the MAI Act, such that a late claim can be made.
This dispute constitutes a miscellaneous claims assessment matter under schedule 2, cls 3(h) and (l) of the MAI Act.

RELEVANT LEGISLATION

Section 6.14 of the MAI Act provides for the time for the making of a claim for damages and reads:
“6.14   Time for making of claims for damages
(1)    (Repealed)
(2)     A claim for damages must be made within 3 years after the date of the motor accident to which the claim relates. The regulations may amend this subsection to change the period within which the claim must be made.
(3)    A claim for damages may be made after the time required by subsection (2) (a late claim) if the claimant…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

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Details

Case: [2025] NSWPIC 585
Decision Date: 30 October 2025

CaseChat Overview and Summary

The case of Case title: Botros v CIC Allianz Insurance Limited involved a claim for damages following a motor accident. The plaintiff, Botros, sought compensation from the defendant, Allianz Insurance Limited, under the Motor Accident Injuries Act 2017. The primary issue was whether Botros had provided a full and satisfactory explanation for the significant delay in making her claim for damages. This matter was heard in the Supreme Court of New South Wales.

The court was tasked with interpreting and applying sections 6.2 and 6.14 of the Motor Accident Injuries Act 2017, which pertain to the requirement for a claimant to provide a satisfactory explanation for any delay in making a claim. The court also considered relevant precedents, including Walker v Howard, Russo v Aiello, Figliuzzi v Yonan, and Karambelas v Zaknic, Rahman v Al-Maharmeh. These cases provided guidance on what constitutes a full and satisfactory explanation and the standards to which such explanations should be held.

The court found that Botros had not provided a full and satisfactory explanation for the delay in making her claim. Despite the statutory declaration she submitted, the court determined that it did not adequately address the reasons for the delay or sufficiently meet the statutory requirements. The court held that the explanation provided by Botros was insufficient under the Act and did not meet the necessary standards set by the precedents. Consequently, the claim was dismissed.

As a result of the court's decision, Botros's claim for damages was denied, and no further orders were made. The dismissal hinged on the insufficiency of the explanation provided for the delay, which failed to meet the statutory and precedential standards.

Orders