Choi v QBE Insurance (Australia) Limited
[2025] NSWPIC 433
•27 August 2025
| CERTIFICATE OF DETERMINATION OF MEMBER | |
| CITATION: | Choi v QBE Insurance (Australia) Limited [2025] NSWPIC 433 |
| CLAIMANT: | Sangmin Choi |
| INSURER: | QBE Insurance (Australia) Limited |
| SENIOR MEMBER: | Susan McTegg |
| DATE OF DECISION: | 27 August 2025 |
CATCHWORDS: | MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; claimant was injured in a motor vehicle accident; claim for removalist expenses; referred as a miscellaneous claims dispute under Schedule 2, clause 3(n) to determine whether there is any liability for the services in dispute on the basis they meet the definition of “treatment and care”; Held – removalist expenses do not constitute everyday tasks; insurer’s liability for statutory benefits does not extend to the claim for removalist expenses where it does not constitute treatment and care within section 1.4. |
| DETERMINATIONS MADE: | CERTIFICATE Issued under s 7.36 of the Motor Accident Injuries Act 2017 The findings of the assessment of this dispute are as follows: 1. The insurer’s liability for statutory benefits under s 3.24 of the Motor Accident Injuries Act 2017 (MAI Act) does not extend to the claim for removalist expenses where it does not constitute treatment and care within s 1.3 of the MAI Act. 2. The dispute as to whether the domestic cleaning services are reasonable and necessary in the circumstances and whether the domestic cleaning services relate to the injury caused by the accident is a medical dispute and is referred to Medical Services for referral to a Medical Assessor in accordance with Division 7.5 of the MAI Act. |
STATEMENT OF REASONS
INTRODUCTION
Mr Sangmin Choi (the claimant) sustained injury in a rear end collision on 8 August 2024 (the accident).
Mr Choi asserts the accident caused a whiplash type injury and the development of progressive symptoms including nausea, headache, cervical and thorolumbar pain with signs of radiculopathy.
QBE Insurance (Australia) Limited is the relevant insurer with liability to pay statutory benefits to the claimant under the Motor Accident Injuries Act 2017 (MAI Act).
On 20 May 2025 a claim was made for domestic cleaning services at a frequency of six services over 12 weeks and for reimbursement of removalist expenses.
On 2 June 2025 the insurer declined to fund domestic cleaning services and removalist expenses as requested on 20 May 2025 on the basis it was not reasonable and necessary in the circumstances.
On 11 June 2025 Mr Choi requested an internal review of that decision.
On 23 June 2024 the insurer affirmed the decision to decline payment of domestic cleaning services and to reimburse removalist expenses. The insurer declined payment of domestic cleaning services on the basis it was not reasonable and necessary in the circumstances. The insurer declined to reimburse the claimant for removalist expenses on the basis it does not fall within the definition of attendant care services in s 1.3 of the MAI Act where it is not an everyday task and where it does not fall within the definition of personal, domestic or nursing assistance.
The claimant filed an application in the Personal Injury Commission (Commission) on
15 July 2025. The dispute which was identified in that application was: “Treatment and care reasonable and necessary”.The dispute has been referred to me as a miscellaneous claims dispute under Schedule 2 cl 3(n) of the MAI Act where there is a preliminary dispute as to the liability for statutory benefits, that is, whether there is any liability for the services in dispute on the basis they meet the definition of “treatment and care”.
Relevant legislative provisions
Section 1.4 of the MAI Act provides treatment and care means the following:
(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, and
(l) such other kinds of treatment, care, support or services as may be prescribed by the regulations for the purposes of this definition, but does not include any treatment, care, support or services of a kind declared by the regulations to be excluded from this definition.
Section 1.4 of the MAI Act defines attendant care services as meaning “services that aim to provide assistance to people with everyday tasks, and includes (for example) personal assistance, nursing, home maintenance and domestic services.”
Section 3.24 of the MAI Act provides:
“3.24 Entitlement to statutory benefits for treatment and care
(1) 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.
(2) No statutory benefits are payable for the cost of treatment and care to the extent that the treatment and care concerned was not reasonable and necessary in the circumstances or did not relate to the injury resulting from the motor accident concerned.
(3) The Motor Accident Guidelines may provide for—
(a) circumstances in which the cost of treatment and care is taken to be reasonable for the purposes of this section, and
(b) circumstances in which treatment and care is taken to be reasonable and necessary for the purposes of subsection (2).
Note—
See Part 7 and Schedule 2 for provisions relating to disputes about whether treatment and care, or the cost or treatment and care, provided or to be provided to an injured person is reasonable and necessary.”
Pursuant to Schedule 2, cl 2 various matters are declared to be medical assessment matters including:
“(b) whether any treatment and care provided or to be provided to the injured person is reasonable and necessary in the circumstances or relates to the injury caused by the motor accident for the purposes of section 3.24.”
Pursuant to Schedule 2, cl 3 of the MAI Act, various matters are declared to be miscellaneous claims assessment matters including:
“(n) any issue of liability for a claim, or part of a claim, for statutory benefits not otherwise specified…”
Domestic cleaning services
Section 1.4 of the MAI Act provides the definition of treatment and care includes “attendant care services” and attendant care services include domestic services.
Pursuant to Schedule 2, cl 2(b) of the MAI Act, a dispute as to whether treatment and care is reasonable and necessary in the circumstances or relates to the injury caused by the accident is a medical assessment matter and a medical assessment matter is determined by a Medical Assessor in accordance with Division 7.5 of the MAI Act.
The dispute has been referred to me as a miscellaneous claims dispute under Schedule 2, cl 3(n) of the MAI Act where there is a preliminary dispute as to the liability for statutory benefits, that is, whether there is any liability for the services in dispute on the basis they meet the definition of “treatment and care”.
However, there is no dispute that domestic cleaning services meets the definition of treatment and care and under Schedule 2, cl 2(b) of the MAI Act the dispute as to whether that treatment is reasonable or necessary is a medical assessment matter. Accordingly, I propose to refer that dispute to Medical Services for referral to a Medical Assessor for determination.
Removalist services
The dispute as to removalist expenses is not as straight forward and gives rise to a preliminary dispute as to whether there is any liability for those services on the basis they meet the definition of “treatment and care”.
Accordingly, the dispute to be determined by me will be whether the insurer has any liability for the removalist expenses on the basis they meet the definition of “treatment and care” in
s 1.3 of the MAI Act.
Preliminary conference on 25 August 2025
Ms Sujeong Yoon of Littles Lawyers appeared for the claimant and Ms Allisa Hollier of Meridian Lawyers for the insurer.
I indicated to the parties that I did not consider there was any dispute that domestic cleaning services met the definition of treatment and care and accordingly I propose to refer that dispute to Medical Services for referral to a Medical Assessor for determination.
However, there is a dispute as to whether the removalist expenses meet the definition of treatment and care and whether the insurer has any liability for those expenses. I indicated I proposed to deal with that dispute under Schedule 2, cl 3(n) of the MAI Act.
Both parties agreed it was appropriate to deal with the matter on the papers.
Ms Hollier indicated the insurer relied upon the decisions of Warner v Insurance Australia Limited trading as NRMA Insurance[1] and Ellis v AAI Limited.[2]
[1] Warner v Insurance Australia Limited trading as NRMA Insurance [2023] NSWPICMP 334.
[2] Ellis v AAI Limited [2025] NSWPIC 162.
THE EVIDENCE
On 15 July 2025 the claimant uploaded a bundle of documents paginated from page 1 to page 36 (claimant’s documents). On 7 August 2025 the insurer provided a bundle of documents paginated from page 1 to page 65 (insurer’s documents).
Application for personal injury benefits
In the Application for personal injury benefits dated 1 October 2024 the claimant described the accident as follows:
“Due to the impact being rear-ended, my body was thrown forward, and the seatbelt held me in place, but I received the full impact as I bounced back against the seat. About three hours after the accident, I began to feel nauseous and developed a headache, so I went to the hospital. Since then, I have experienced pain in my neck, back, and lower back, along with tingling sensations in my arms and legs.”
Medical evidence
On 20 December 2024 Dr Perla and Dr Antoun of Medical Assist Network noted that whilst the claimant was certified fit for two hours a day five days a week with limited lifting it was considered he should be able to undertake increased hours and in fact, should be able to work normal hours.
In a Certificate of Capacity/Certificate of Fitness dated 7 March 2025 Dr Lee, general practitioner certified the claimant fit for suitable duties two hours a day, two days a week with lifting/carrying, pushing/pulling, bending/squatting and standing restrictions.
On 27 March 2025 Dr Yingda Li, neurosurgeon diagnosed:
“Chronic neck and back pain, with superimposed right L5 radiculopathy, secondary to cervical and lumbar spondyloses including L4/5 exacerbated and/or accelerated by motor vehicle accident. Non-specific unexplained upper limb symptoms.”[3]
[3] Claimant’s documents p 31.
Dr Li noted the claimant’s symptoms were manageable and he wished to avoid any further intervention including an epidural steroid injection.
Rehab Dynamics completed an Activities of Daily Living (ADL) Retraining & Review Assessment/Report dated 20 May 2025.[4] Ms Sonia Suen, occupational therapist recommended the following pacing strategies:
· using a timer to complete activities or to schedule breaks in order to avoid overexertion;
· prioritising tasks to focus on completing essential activities first;
· the use of assistive devices or tools to make tasks easier and less physically demanding;
· guidance on how to gradually increase activity levels without worsening symptoms, and
· emphasising the importance of rest and recovery between activities.
[4] Claimant’s documents p 18.
Rehab Dynamics supported a need for removalist expenses stating:
“… following the MVA, he now experiences restricted physical function including neck and back pain and reduced squatting, bending and prolonged standing capacities, preventing him from safely participating in the moving process….
Due to Mr Choi’s inability to pack and lift his luggage as a result of MVA, he now hired a removalist to assist with the packing process. Given that this limitation is MVA-related, a once off partial removalist reimbursement for packing and unpacking cost is recommended to ensure a safe transition to his new residence and to prevent further physical strain or injury.”
Mr Micah Gardner psychologist in a report dated 13 June 2025 diagnosed post-traumatic stress disorder. He reported the claimant’s ongoing pain symptoms and functional limitations contribute to the severity of the claimant’s psychological symptoms.
Medico-legal reports
Dr Tej Dugal, radiologist provided a report dated 13 December 2024 and concluded there were no evidence of cervical spine injury related to the accident and no MRI evidence of acute changes to the lumbar spine related to the accident.
Other evidence
A Tax Invoice dated 27 May 2025 from Channel for house moving is in the total sum of $2,365. It is not clear what component of that quote relates to packing and unpacking.
SUBMISSIONS
Claimant’s submissions
The claimant provided submissions dated 15 July 2025.
The claimant notes that Dr Yingda Li diagnosed chronic neck and back pain with superimposed right L5 radiculopathy, secondary to cervical and lumbar spondyloses including L4/5 stenosis, which were exacerbated by the accident.
The claimant submits prior to the accident the claimant routinely moved house independently with help from his partner. However, his current impairments render him physically incapable of doing so. He is unable to safely participate in packing or relocation activities. Pain is aggravated by standing and bending and further strain may cause deterioration.
The claimant submits that the removalist reimbursement is a one-off, injury related support that enables the claimant to complete a life task and is an intervention that facilitates safe relocation, prevents symptom aggravation and supports overall recovery.
The claimant submits whilst relocation is not a daily activity, it was routine for this claimant prior to the accident.
It is submitted that s 3.24 of the MAI Act and the Guidelines permit funding for temporary and non-repetitive services that assist the injured person to manage the effects of injury, and this would include the removalist expenses.
The claimant also relies upon the opinion of Mr Gardner who states the claimant’s severe psychological symptoms including emotional withdrawal, disrupted routine, and diminished capacity to manage daily tasks, interact with his physical limitations to compound his functional capacity.
It is submitted the provision of professional removalist support is clinically justified as it mitigates both physical and psychological barriers to relocation and is consistent with the multidisciplinary care approach recommended by the treating psychologist.
Insurer’s submissions
The insurer provided submissions dated 7 August 2025.
The insurer highlights that the question is not whether the claimant has the physical capacity to complete the task of moving house, but whether funding of a removalist constitutes ‘treatment and care’ for the purposes of s 3.24(1)(a). Removalist expenses must be considered ‘treatment and care’ to fall within the scope of s 3.24(1)(a).
The insurer submits:
“The Insurer submits that the intention of Section 3.24 of the Act is to meet payment of medical treatment and traditional attendant care services such as personal, domestic and nursing assistance to assist in recovery so that a claimant is able to return to work and everyday tasks in a timely manner. Accordingly, the task of moving house is not an everyday task, and a removalist service does not fall within the definition of personal, domestic or nursing assistance.
The request for reimbursement of removalist expenses is also not a treatment or care request with the goal of achieving optimum recovery from the injuries sustained because of the subject accident. Additionally, removalists do not fall under the category of attendant care services providers, as moving and relocating furniture to a separate residence is not considered an everyday task.”
CONSIDERATION
In accordance with s 52(3) of the Personal Injury Commission Act 2020 (PIC Act) and Procedural Direction PIC2 I am satisfied that sufficient information has been supplied to the Personal Injury Commission (Commission), and I consider it appropriate to determine the matter on the papers.
Schedule 2(3)(n) of the MAI Act provides me with the power to determine “any issue of liability for a claim, or part of a claim, for statutory benefits not otherwise specified in this schedule”.
The dispute to be determined by me will be whether the removalist expenses meet the definition of treatment and care under s 1.4 of the MAI Act.
I am not required to determine whether the removalist expenses relate to the injury caused by the accident or whether it was reasonable and necessary in the circumstances but merely whether it meets the definition of treatment and care under s 1.4 of the MAI Act.
In Warner v Insurance Australia Limited trading as NRMA Insurance[5] a Review Panel in the context of a treatment dispute concluded where the proposed home modifications were not for the purposes of alleviating or addressing the physical limitations and restrictions caused by Mr Warner’s injuries the dispute about the home modifications did not constitute a treatment dispute.
[5] Warner v Insurance Australia Limited trading as NRMA Insurance [2023] NSWPICMP 334 (Warner).
I do not accept the claimant’s submission that the assistance of a removalist with packing and unpacking would assist him to manage the effects of injury by facilitating a safe relocation, preventing symptom aggravation and supporting an overall recovery where it did not constitute medical treatment provided for the purposes of alleviating or addressing the physical limitations and restrictions caused by the claimant’s injuries.
Of the categories listed in s 1.4 of the MAI Act the only possible applicable category is “attendant care services”. However, attendant care services are defined as “services that aim to provide assistance to people with everyday tasks”. Examples of everyday tasks include personal assistance, nursing, home maintenance and domestic services.
In Suttie v QBE Insurance (Australia) Limited I found the operation and maintenance of an irrigation system on a 200-acre property was an everyday task within the definition of attendant care services given that it was necessary for the provision of water for the house and garden and where by reason of her injuries Ms Suttie required assistance with those tasks.[6] However, I found that significant repairs to the irrigation system were not every day or commonplace tasks which would have been performed by Ms Suttie had the accident not occurred and did not constitute attendant care services.
[6] Suttie v QBE Insurance (Australia) Ltd [2024] NSWPIC 355.
Whilst the insurer relied on the decision in Ellis I am not sure it is of relevance to the current dispute where I found bathroom, bedroom and kitchen modifications constituted “home modifications” and came within the definition of treatment and care as defined by s 1.4 of the MAI Act.[7]
[7] Ellis v AAI Limited [2025] NSWPIC 162.
In Haddad v Lifetime Care and Support Authority, Member Cassidy noted that everyday tasks are not necessarily tasks that are undertaken every day but suggested synonyms for “everyday” would include “usual, ordinary, mundane, routine or regular”.[8]
[8] Haddad v Lifetime Care and Support Authority [2024] NSWPIC 96.
The claimant himself has conceded that the removalist expenses are a one-off injury related support and whilst not an unusual task it would not constitute an everyday task.
Section 1.3(2) of the MAI Act sets out the objects of the Act including:
(a) to encourage early and appropriate treatment and care to achieve optimum recovery of persons from injuries sustained in motor accidents and to maximise their return to work and other activities.
However, s 1.3(3)(a) provides that in the application and administration of the MAI Act:
(a) that participants in the third-party insurance scheme have shared and integrated roles with the overall aim of benefiting all members of the motoring public by keeping the overall costs of the scheme within reasonable bounds so as to keep premiums affordable and of promoting the recovery and return to work or other activities of those injured in motor accidents.
Engaging a removalist to pack is not an attendant care service and does not constitute treatment and care noting it is not designed to facilitate the recovery of the claimant or to maximise his return to work and other activities. To find otherwise would not only be wrong but would be inconsistent with the shared role of participants in the third-party scheme to keep the overall costs of the scheme within reasonable bounds.
The removalist expenses do not come within the definition of treatment and care for which the claimant is entitled to receive statutory benefits under s 3.24 of the MAI Act.
CONCLUSION
The insurer’s liability for statutory benefits under s 3.24 of the MAI Act does not extend to the claim for removalist expenses where it does not constitute treatment and care within s 1.4 of the MAI Act.
The dispute as to whether the domestic cleaning services are reasonable and necessary in the circumstances and whether the domestic cleaning services relate to the injury caused by the accident is a medical dispute and is referred to Medical Services for referral to a Medical Assessor in accordance with Division 7.5 of the MAI Act.
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