Forrest v QBE Insurance (Australia) Limited
[2025] NSWPIC 206
•7 May 2025
| CERTIFICATE OF DETERMINATION OF MEMBER | |
| CITATION: | Forrest v QBE Insurance (Australia) Limited [2025] NSWPIC 206 |
| CLAIMANT: | Jeffrey Forrest |
| INSURER: | QBE Insurance (Australia) Limited |
| MEMBER: | Belinda Cassidy |
| DATE OF DECISION: | 7 May 2025 |
CATCHWORDS: | MOTOR ACCIDENTS - Motor Accident Injuries Act 2017; claim for statutory benefits; whether dog walking services for the claimant’s pet dog are a form of treatment and care within the definition in section 1.4; whether they are payable as a statutory benefit under section 3.24(1); Geaghen v D’Aubert, Teuma & Anor v C P & P K Judd Pty Ltd, and Makaroff v Nepean Blue Mountains Hospital Health District distinguished; Held – dog walking services are domestic services and therefore a form of attendant care service; as a result a type of treatment and care and subject to the limits and restrictions of Division 3.3; a statutory benefit payable by the insurer. |
| DETERMINATIONS MADE: | CERTIFICATE OF DETERMINATION In accordance with Division 7.6 and Schedule 2(3)(n) of the Motor Accident Injuries Act 2017, the Personal Injury Commission’s assessment is: 1. The provision of dog walking services is a form of “treatment and care” as defined in s 1.4 of the Act. 2. The proceedings are returned to the Commission for medical assessment in accordance with Division 7.5 of the Act to determine under Schedule 2(2)(b) whether the dog walking services provided to the claimant are reasonable and necessary in the circumstances and related to the injuries caused by the accident. A statement setting out the Commission’s reasons for the assessment is included with this certificate. |
STATEMENT OF REASONS
INTRODUCTION
General
Jeffrey Forrest was involved in a motor accident on 25 February 2020. He was stopped in a line of traffic when his vehicle was hit from behind by another vehicle.
Dr Forrest says he injured his neck, left shoulder, left arm, left hand and that he developed a psychological injury including posttraumatic stress disorder as a result of the accident.
On or about 27 February 2020, Dr Forrest made a claim for statutory benefits under the Motor Accident Injuries Act 2017 (the MAI Act). The claim was made against QBE, the third-party insurer of the vehicle he says caused his accident.
On 3 September 2024 the claimant requested the insurer pay for dog walking services as part of his statutory benefits claim. While QBE had approved funding for some dog walking services before this on 3 September 2024, QBE advised the claimant it refused to fund any more on the basis that dog walking is not a “reasonable and necessary cost” and is not treatment or care and is not attendant care services. On 17 October 2024, in an internal review decision, the insurer affirmed this decision.
The claimant referred the dispute about the dog walking services to the Personal Injury Commission (the Commission) for medical assessment.
The proceedings were allocated to me because of an issue raised by the insurer in its reply as to whether dog walking services are a form of treatment and care that can be paid as a statutory benefit. I held a preliminary conference with the parties on 17 March 2025. A timetable was set for the provision of further documents and submissions. As there was sufficient information and the issue in dispute was within a narrow scope, it was decided that the proceedings could be determined without holding a formal hearing[1].
[1] See s 52(3) of the Personal Injury Commission Act 2020.
Other matters
QBE had denied liability for the claimant for statutory benefits on the basis the claimant’s only injuries in the Accident were threshold injuries.
On 9 January 2024 a review panel found[2] the claimant’s physical injuries were non-threshold injuries due to the presence of a C8 radiculopathy. Dr Forrest has now made a claim for damages, and I understand liability for that claim has been accepted. An assessment of WPI did not occur at the time of the threshold injury assessment and therefore if there is a dispute about WPI, that will need to be referred to the Commission for medical assessment at some other time.
[2] The decision of Member Bolton, Senior Medical Assessor Dixon and the late Medical Assessor Stubbs is found at page 24 of the claimant’s bundle.
In accordance with s 3.2(2), QBE was the relevant insurer liable to pay the claimant’s treatment and care expenses for the first five years after the accident however on
26 February 2025, pursuant to s 3.2(3), the Lifetime Care and Support Authority (Authority) became the relevant insurer.
As the current dispute is limited to dog walking service expenses incurred in October and November 2024 it is a dispute between Dr Forrest and QBE and does not concern the Authority.
LEGISLATIVE FRAMEWORK
The entitlement to treatment and care benefits
The MAI Act establishes a scheme for the payment of statutory benefits under Part 3, and the awarding of damages under Part 4, to persons injured in motor accidents in New South Wales.
Statutory benefits include weekly income replacement type benefits pursuant to Division 3.3 of the MAI Act and treatment and care benefits pursuant to Division 3.4.
Section 3.24(1), which is in Division 3.4 provides for the payment of treatment and care benefits (expenses) as follows:
“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.”
The phrase “treatment and care” is defined in s 1.4 as follows:
‘‘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,
(l)such other kinds of treatment, care, support or services as may be prescribed by the regulations for the purposes of this definition[3],
but does not include any treatment, care, support or services of a kind declared by the regulations to be excluded from this definition[4].”
[3] There are no additional kinds of treatment, care, support or services provided for in the Motor Accident Injuries Regulation 2017 (the Regulation).
[4] There are no excluded forms of treatment, care, support or services in the Regulation.
Attendant care services are also defined in s 1.4 and are:
“services that aim to provide assistance to people with everyday tasks, and includes (for example) personal assistance, nursing, home maintenance and domestic services”.
Limits to treatment and care benefits
There are a number of limits and restrictions to what can be claimed as a statutory benefit under Division 3.4, starting with the definition of treatment and care in s 1.4 of the MAI Act. The list of 11 things in the definition is a finite list. If a type of treatment, care, support or service is not listed or does not come within one of the items in the list, statutory benefits are not payable for it.
Other limits and restrictions include:
(a) section 3.24(1)(a) says that while the insurer has to pay for treatment and care expenses incurred, it only has to pay the reasonable costs incurred;
(b) section 3.24(2) provides that no statutory benefits are payable if the treatment and care is not reasonable and necessary in the circumstances or did not relate to the injuries caused by the accident;
(c) section 3.25 provides that no statutory benefits are to be paid for gratuitous care;
(d) section 3.27 requires treatment and care expenses to be verified and there are provisions in the Motor Accident Guidelines about this, and
(e) section 3.28 provides for the cessation of statutory benefits after 52 weeks for a person with threshold injuries or if they were wholly or mostly at fault.
Despite all of these limitations and restrictions, s 3.31(3) does not prevent an insurer from paying for treatment and care it is not required to pay or approving treatment and care not yet provided.
Resolution of disputes about treatment and care
Under the MAI Act, disputes are resolved at the Commission. Schedule 2 to the MAI Act declares 47 different types of disputes to be either merit review matters, medical assessment matters or miscellaneous claims assessment matters.
Treatment and care disputes can be resolved by Merit Reviewers, Medical Assessors and Members of the Commission as follows:
(a) schedule 2(1)(i) permits a merit reviewer to determine disputes about whether the cost of treatment and care provided or to be provided is reasonable[5];
(b) schedule 2(2)(b) allows a medical assessor to determine whether any treatment and care provided or to be provided, “is reasonable and necessary in the circumstances or relates to the injury caused by the motor accident.”
(c) schedule 2(3)(n) provides a Member of the Commission with power to determine “any issue of liability for a claim, or part of a claim, for statutory benefits not otherwise specified in this Schedule”.
[5] Section 3.24(1)(a) refers to the reasonable cost of treatment and care and does not include the word “necessary”.
The dispute between Dr Forrest and QBE is not a dispute about the cost of the pet walking services provided to Scarlett.
Dr Forrest referred the dispute to the Commission as a medical assessment matter indicating on the form there was a dispute about whether the dog walking services were reasonable and necessary in the circumstances. The form did not indicate (because no box was ticked) that there was a dispute about the relationship between the claimant’s accident-caused injuries and the dog walking services.
The insurer’s reply states there is a dispute about whether the dog walking services are a form of “treatment and care” and therefore payable as a statutory benefit. Neither Merit Reviewers nor Medical Assessors have been given any specific power in schedule 2 to determine whether a type of treatment, care, support or service is or is not “treatment and care”. As the dispute between the parties is whether QBE has a liability to pay for the cost of dog walking services in Dr Forrest’s statutory benefits claim, this would appear to be a matter than I can determine as a member of the Commission in accordance with schedule 2(3)(n).
SUBMISSIONS AND INSURER’S DECISION MAKING
Insurer’s decisions
In an email from a QBE claims officer to IPAR, QBE approved some treatment and said, “For goodwill we would like to extend the services … to pool cleaning and dog walking.”
On 7 March 2024 QBE wrote to the claimant saying it supports various requests “as we consider the requests to be reasonable and necessary” including dog walking with Mad Dogs and Englishmen at a cost of $39.95 per session.
On 3 September 2024[6] the insurer wrote to the claimant concerning his request to fund further dog walking services. The insurer declined and its reasons were:
(a) they were not reasonable and necessary as the claimant has now sufficiently recovered from his recent surgery;
(b) dog walking is not treatment, rehabilitation or care as defined in the MAI Act, and
(c) the Activities of Daily Living Assessment from 5 February 2024 (in a report dated 18 June 2024) records that the claimant was responsible for home and yard maintenance and does not say he was responsible for dog walking.
[6] Page 16 of the claimant’s bundle.
A request was made by the claimant’s solicitor for an internal review and on 17 October 2024 the insurer determined the review deciding “… the services of a dog walker are not reasonable and necessary in the circumstances from the date of the decision … QBE will not fund any dog walking expenses past this date.” In addition, QBE states:
(a) the insurer referred the claimant to IPAR Rehabilitation for an activities of daily living assessment. Mr Dilon wrote a report on 9 February 2024 which included recommendations for housecleaning and gardening services and did not mention dog walking services;
(b) on 20 February 2024 QBE advised “for good will” they would pay for dog walking services and pool cleaning and approved the request on 7 March 2024;
(c) to be payable under s 3.24(1)(a), dog walking services must be considered “treatment and care” within the definition in s 1.4;
(d) dog walking services can only fall under “attendant care services … if at all”;
(e) the objects of the MAI Act include the encouragement of “early and appropriate treatment and care to achieve optimum recovery from injuries … to maximise their return to work and other activities”. Dog walking services will not “assist your recovery … so that you can return to work and everyday tasks.” Dog walking services are not medical treatment or attendant care services, and
(f) while previous expenses have been paid, s 3.31(3)(a) provides a discretion on the part of insurer to pay for expenses not covered by the MAI Act and “there is no requirement that the insurer continue to pay non-mandatory expenses if it has initially exercised the discretion.”
Claimant’s original submissions
The claimant’s original submissions lodged with the application were dated 13 November 2024.[7] Paragraphs [1] – [9] note the timetable of request, denial and internal review. The claimant quotes at length from the internal review decision.
[7] Page 1 of the claimant’s bundle.
The claimant refers at [9] and [10] to the Guidelines[8] and says the requested treatment is reasonable and necessary. The claimant refers at [11] to the Review Panel’s decision as to the claimant’s non-threshold injuries. The claimant cites other medical evidence concerning his injuries and disabilities and says at [22] that because of these injuries he had a need for dog walking services and at [23] that these services are directly related to his injuries, are aimed at helping him get back to his usual activities, are appropriate for his injury, provided by an appropriate health professional and are cost effective.
[8] While referred to as the “Motor Vehicle Accident Guidelines 2021” this is clearly a reference to the Motor Accident Guidelines.
At [24] the claimant says the insurer should pay for these “reasonable and necessary treatment expenses.” At [25] the claimant also submits the dog walking services will improve the claimant’s recovery and that the services relate to the injuries sustained by the claimant.
All of these submissions are matters relevant to the medical assessment matter and not the preliminary issue of whether the dog walking services are a form of treatment and care that can be the subject of a medical assessment matter.
Insurer’s original submissions
The insurer’s original submissions dated 2 December 2024 requested at [1] that the dispute lodged by the claimant be referred to a Member to determine whether dog walking services are a form of treatment and care before it is referred for medical assessment.
The insurer cited at [3] the definition of treatment and care in s 1.4 and at [4] cites section 3.24(1) and (2). The insurer says at [5] that the only possible kind of treatment or care listed which might cover dog walking services in s 1.4 is “attendant care services” and cites at [6] the definition of attendance care services also found in s 1.4.
While the insurer acknowledges at [7] that statutory benefits are not damages assessed at common law, the insurer says that domestic services under the MAI Act are like the services which were allowed under the common law in the case of Griffths v Kerkemeyer[9]. The insurer submits at [8] the common law cases about care should be considered and refers to the case of Geaghan v d’Aubert[10] and quotes paragraph [61] as follows:
“I do not believe that Griffiths v Kerkemeyer, or any of its extensions, includes the provision of care to an injured persons’ pets or a hobby. The cases have accepted domestic care at home, in the garden and shopping. But counsel has found no case which extends domestic assistance to the care of domestic pets or the retention of a hobby.”
[9] (1977) HCA 45 (Griffiths v Kerkemeyer).
[10] [2002] NSWCA 260 (Geaghan).
The insurer relied on the decision of Ipp JA in Teuma & Anor v CP & PK Judd Pty Limited[11] and Makaroff v Nepean Blue Mountains Hospital Health District[12] and says at [12] these cases establish that services providing care for pets, “are not domestic services of a kind in respect of which compensation or damages are payable.”
[11] [2007] NSWCA 166 (Teuma).
[12] [2019] NSWSC 715(Makaroff).
The remainder of the insurer’s submissions deal with the medical issues of causation of injury and need for treatment and the reasonableness and necessity of treatment.
Claimant’s further submissions[13]
[13] The numbers in square brackets are a reference to the paragraph number in the submissions.
The claimant lodged additional submissions on 2 April 2025.
The claimant submits at [3] that due to the claimant’s cervical spine injury, shoulder injury and thoracic outlet syndrome he has limited ability to perform his domestic duties including dog walking.
The claimant outlines at [4] the medical evidence that supports this and at [5] refers to the documentation concerning the disputed treatment. The claimant says no written request for dog-walking services was made, it was a verbal request.
The claimant says at [6] that the dog’s name is Scarlett and has been in the family since 2018. The claimant also says at [7] that the dog walking services commenced in March 2024 at the time of surgery and that QBE ceased paying for the services in September 2024. The claimant pain for the services in October and November but has been unable to continue to pay for them and they have ceased.
Again, the claimant’s submissions do not appear to engage with the insurer’s argument and the matter that I have to decide, that is whether dog walking services are a form of treatment and care that can be compensated as part of the claimant’s statutory benefits claim.
Insurer’s further submissions
The insurer lodged further submissions dated 15 April 2025.
The insurer clarified at [4] that it had previously approved and paid for dog walking services on 20 February and 7 March 2024.
The insurer referred at [7] to the definition of treatment and care in s 1.4 and notes at [8] that the claimant submits dog walking services are “attendant care services”. The insurer cites at [9] the definition of attendance care services and submits at [10] that dog walking services are not “attendant care services” for the following reasons:
(a) the definition is not exhaustive but gives guidance (examples) as to what might fall within it [11] and dog walking is not personal assistance, nursing or home maintenance [12];
(b) in relation to the example of “domestic services” the insurer submits at [13] that there is no definition in the MAI Act of domestic services but that s 15B of the Civil Liability Act 2002 provides such a definition, that is “services of a domestic nature”. The insurer quotes from the decision of Saedi v Allianz Australia Insurance Limited[14] where I said at [78] “It is quite clear that domestic services would include household services such as laundry, cooking, cleaning, bed-making …”
(c) the insurer cites at [14] Haddad v Lifetime Care and Support Authority[15] and my comment at [49] that “the term attendant care services therefore is quite wide and might include pet care services (for someone with limited mobility), gardening assistance and hair care assistance”. The insurer emphasizes that “might” means “could” and not “would” [17];
(d) the insurer says at [19] that s 3.24(1) requires treatment and care to be provided “for the injured person” and argues that it might only cover treatment and care provided directly for, and therefore to the claimant [20];
(e) the insurer submits at [22] that s 3.24(1) may allow for treatment and care services to be provided to other human beings (such as childcare services) but that services provided to a claimant’s pets are “too remote” to be a benefit to the claimant. The insurer repeats at [29] that treatment and care should be provided for the claimant personally;
(f) the insurer refers at [23] to Geaghen and cites a decision of Merit Reviewer Ruschen in Frost v NRMA[16];
(g) the insurer also cites my decision in Fowler v Youi Pty Limited[17] and Lau v QBE Insurance (Australia) Limited[18] and other observations I made about treatment and care in those decisions which dealt with a new car and painting and handyman services;
(h) the insurer also submits at [33] that a clear requirement of attendant care is that it is assistance with everyday tasks and says at [34] the claimant had not provided evidence that walking the dog was an everyday task or a task that was specifically his. The insurer submits that the claimant would need to establish that the dog walking was something the claimant would have done had the accident not occurred;
(i) the insurer says at [37] – [42] that one of the objects of the act is to encourage early and appropriate treatment, optimum recovery from injuries and maximise the injured person’s return to work and activities. The insurer says that dog walking services if provided would be disproportionate to the overarching object to provide treatment and care to enable his optimal recovery and maximise his return to work. Finally, the insurer says dog walking services are too far removed from the purpose and context of treatment and care modalities that were intended to be covered.
[14] [2025] NSWPIC 71.
[15] [2024] NSWPIC 96.
[16] [2021] NSWPICMR.
[17] [2025] NSWPIC 82.
[18] [2024] NSWPIC 724.
REVIEW OF THE EVIDENCE
The claimant provided an initial bundle of over 500 pages. The insurer provided an initial bundle of 402 pages of documents. Both the insurer and the claimant provided additional documents of 13 and 17 pages respectively. Most of these bundles comprise medical reports and records. It is unnecessary for me to refer to all of these at this time. There is a significant amount of duplication. For example, both the claimant and the insurer have included in their bundles the Review Panel decision, the IPAR report and the quotes and emails concerning the dog walking services.
There is no statement from the claimant.
Dr Forrest’s claim form[19] was signed and dated 27 February 2020. It was primarily typed and made on the form applicable to the previous, 1999 scheme. It includes the following relevant information:
(a) the accident occurred shortly before the claimant’s 31st birthday;
(b) the claimant had a previous accident and claim “QBE many years ago after a not at fault MVA”;
(c) the accident occurred at 11.50 am on the Camden Bypass;
(d) the claimant was driving, wearing a seatbelt;
(e) his car was hit from behind while he was looking in the rear-view mirror;
(f) he felt a “slight twinge in the left side of my neck”;
(g) he exchanged details with the driver and both cars drove off, and
(h) later while visiting the doctor “I felt weakness [in] my left hand and shooting pains into my left arm.”
[19] Page 7 of the claimant’s bundle.
Dr Forrest reported the matter to police the next day.
Dr Forrest records his injuries as “likely whiplash left neck; shooting pains left shoulder to hand, weakness left upper limb and headache.” He provided details of a previous condition “I had had neck pains that have been investigated by neurosurgeon Prof Sheridan. My GP has all the details.”
He identifies his employment as a General Practice (GP) Registrar at the My Family Health Medical Centre in Gregory Hills.
Dr Tuxford of My Health practice in Oran Park provided a medical certificate dated 27 February 2020. He noted the claimant had a C6/7 spondylosis with bilateral foraminal stenosis” before the accident.
The claimant has provided two invoices from Mr Manzini of Mad Dogs and Englishmen[20]. The first is dated 2 October 2024 and lists 12 dog walking services provided during September and a cost of $479.40. This invoice notes that a payment of $36.32 had been made leaving a balance owing of $443.08. The second invoice is dated 4 November 2024 and lists nine services provided in October for a total of $359.55.
[20] Page 12 of the claimant’s additional documents.
The claimant has provided screen shots from his mobile phone[21] showing that payments of $443.08 and $359.55 were made on 29 October 2024 and 4 November 2024 respectively.
[21] Page 15 of the claimant’s additional documents.
Mr Vickers of IPAR Rehabilitation Pty Ltd provided a report to the insurer dated 14 February 2024.[22] Mr Vickers sets out the background to the accident, the details of the claimant’s history and his pre-accident medical state. He sets out in great detail the claimant’s symptoms, his disabilities and impairments. Dr Forrest was noted to have limitations on sitting, he could only walk 50 to 100 metres, had difficulty reaching overhead and he felt he was a burden on his wife due to the functional impact of his injuries.
[22] Page 423 of the claimant’s bundle.
Mr Vickers visited the claimant at home and documents his living arrangements noting that his mother and brother assist (on a gratuitous basis) with household tasks and childcare (the claimant’s children were two years and seven months old at the time. The claimant was receiving incapacity payments, his wife was looking for work and the claimant had sold an asset to assist with his mortgage.
The house was described, as was the access to it. It was noted that the claimant’s “wife assists him daily with completing all tasks, including personal care, childcare, as well as domestic chores.” She was said to have her own mental health issues “due to the amount of childcare, domestic cleaning, meal preparation, laundry tasks, and general household maintenance that she has undertaken …”
Dr Forrest was assessed, and it was noted he was able to do some lighter laundry and ironing, light cleaning and light meal preparation. It was noted he had been responsible for all external home maintenance and gardening tasks and pool cleaning.
There is no mention of the dog in this report or of dog walking, feeding or washing. One of the photographs of the exterior of the claimant’s home shows what appears to be a dog bed.
Mr Vickers identified that the claimant’s “wife is at risk of experiencing Carer’s burnout due to the amount of [her] increased responsibilities to assist” her husband.
Mr Vickers sent an email[23] on 7 March 2024 to the claims officer at QBE “I have received the attached quoted for the recommended services …”. Several services are listed the final of which was dog walking and two quotes were given, from Mad Dogs and Englishmen at $39.95 or Salty Pack at $55 per session.
[23] Page 11 of the claimant’s additional documents.
The insurer has provided copies of pre-accident records indicating there is (or was) an issue of causation in respect of the claimant’s injuries. The Review Panel dealt with that issue in respect of the threshold injury dispute.
Physiotherapy notes from 9 December 2021 suggest there are lumbar spine issues (possibly related to a fall from a height and S2 fracture seven years before his first treatment) and knee problems (a sudden moment of pain when doing city to surf).
Records from the claimant’s GP records a prior history of vestibular migraines in February 2017, a left knee sports injury in March 2017 and three episodes of shooting pain and paraesthesia in the thoracic spine in September 2019. After the accident the claimant has had regular attendances on his GP for accident and unrelated matters. He has complained of radicular symptoms. He has had sleep issues, rectal bleeding and chest pains all of which have been investigated.
The evidence suggests the claimant moved to Queensland in 2021.
The claimant had surgery on 7 March 2023 for thoracic outlet syndrome and had physiotherapy after that. He presented at Emergency in February 2024 after three weeks of increasing involuntary movements of his left hand.
CONSIDERATION OF THE ISSUES
What can be allowed as a treatment expenses?
The opening words of s 3.24(1) establish the entitlement to treatment and care expenses as part of the statutory benefits claim by the words “An injured person is entitled to for the following expenses … incurred in connection with providing treatment and care for the injured person.”
The “following expenses” are limited to three things:
(a) the reasonable cost of treatment and care within the definition of s 1.4;
(b) the reasonable and necessary travel and accommodation costs of obtaining the treatment and care, and
(c) if the claimant is an infant or otherwise needs a carer, their reasonable and necessary travel and accommodation costs while the claimant obtains their treatment and care.
The phrase “treatment and care” is defined in s 1.4 as meaning the 11 different types of treatment, care, support and services listed. There is a regulation making power enabling other things to be added to the list by way of the Regulation and things that might otherwise be treatment and care can be excluded in the Regulation.
The claimant has not addressed this issue in his submissions. The insurer identifies the only possible type of treatment and care listed in the definition as “attendant care services”. Having looked at the list in s 1.4 and considered the other items on that list, I agree with the insurer that dog walking services could be a type of attendant care services.
What sort of attendant services can be allowed?
Attendant care services are defined in s 1.4 and are “services that aim to provide assistance to people with everyday tasks”. Everyday tasks are not necessarily tasks that are done every day. In BLI v Allianz Australia Insurance Limited, in a case about house painting, I said at [72][24]
“… I agree with the claimant’s submission that the word “everyday” used in the definition of attendant care is not restricted to tasks that are done every day. BLI’s example of lawn mowing is a good example. Lawn mowing is an everyday activity in that it is a usual or commonplace activity, but domestic lawns do not need to be mown every day...”
[24] [2024] NSWPIC 436 (BLI).
Everyday tasks then are tasks that are usual, mundane, normal or ordinary. In Dr Forrest’s case, the dog walking services were not provided every single day and there are 21 services provided over two months roughly every second day.
The definition then goes on to give four examples of attendant care that is “personal assistance, nursing, home maintenance and domestic services”. This is not an exhaustive list but a list of four examples of the sorts of things that might come within the definition.
The claimant has not addressed this definition in his submissions however the insurer says that dog walking services are not “personal assistance, nursing or home maintenance.” I agree. Personal assistance would cover in my view things such as help with bathing, dressing and hair care. Home maintenance would cover spot painting, minor home repairs, lawn and garden care and so on. It is not necessary to consider “nursing” which is clearlynot applicable.
The only likely example of the four examples from the definition that could cover dog walking services is that of “domestic services”.
Are dog walking services domestic services?
The example of “domestic services” is not further explained or defined in s 1.4. The insurer referred to the definition of domestic services in s 15B of the Civil Liability Act 2002 which is “services of a domestic nature.”
The term “gratuitous domestic services” is defined in s 3.26(5) as services of a domestic nature where the person providing the services “has not been paid and is not entitled to be paid”. While this definition says it only applies to s 3.26 I note the decision of Qantas Airways Limited v Chief Commissioner of State Revenue, where Handley JA said at [38] that “there is a presumption that defined words in a statute have their defined meanings which is not to be displaced without good reason.”[25] The definition of gratuitous domestic services elsewhere in the MAI Act provides some guidance and suggests that the words “domestic services” as an example in the definition of attendant care services are services of a domestic nature.
[25] [2008] NSWSC 1049.
The insurer referred in its submissions to the Court of Appeal decision of Geaghan.[26] Stein JA, with whom Handley JA and Foster AJA agreed, discussed whether damages could be awarded for the claim for the “care of the animals” concluding at [66]:
“Whichever way it is put, on a ‘needs’ basis, general damages or remoteness, it seems to me that Griffiths v Kerkemeyer does not extend to a plaintiff’s hobby and his Honour was entitled to reject the care of the animals on that basis. Nor do I believe that it would be appropriate to extend Griffiths v Kerkemeyer to cover the care of animals kept as a hobby.”
[26] (2002) 36 MVR 542 (Geaghan).
In the Teuma case, the claimant had been injured in a motor accident in November 2007 and sustained injuries including fractured ribs, sternum and spine. At the time of the accident, Mrs Teuma was responsible for all of the domestic duties including the care of the family’s “dogs, cats and birds.” Because there had been no evidence presented that the claimant had an accident-caused need for the services, the care was not allowed with Ipp JA saying at [49]:
“The mere fact that, by reason of her injuries, Mr Judd provides care for pets that, prior to her injuries, she provided, does not establish that she is in need of those services. The concept of ‘need’ involves more than a mere desire. Compensation for need does not encompass compensation for services that are not reasonably necessary for the plaintiff’s well-being.”
Basten JA in Teuma agreed with Ipp JA and said this about the Geagan case at [98]:
“There are suggestions in the reasoning which would conflate the keeping of pets with a ‘hobby’ in all cases. If it were necessary for the resolution of a case, I would respectfully doubt whether the ratio of Geaghan goes so far. It may be that a hobby should be understood as something involving an activity or occupation, so that if the injured plaintiff can no longer engage in the hobby, it falls into the category of activities which are no longer open and should thus be compensated as part of the diminution of the enjoyment of life, by way of general damages. Pets, by way of contrast, provide various benefits within the home and garden. If a person who is quadriplegic obtains enjoyment from listening to a canary, rather than the radio, there is no reason in principle why assistance which might extend to switching a radio on and off and changing channels, should not include feeding the canary. There is no principle which requires that a person rendered impotent by a tortious injury can only receive compensation for the bare necessities of life. The reason why the caselaw may not include reference to caring for pets is probably because it had not previously been thought necessary to require a plaintiff to distinguish between general house cleaning and cleaning up after a pet, or any similar or related distinction. Caring for pets, like caring for furniture, is an inherent part of the concept of domestic assistance, provided to a plaintiff, and does not form some impermissible extension of the kind which occurred in Sullivan v Gordon, overturned in CSR Ltd v Eddy. However, no final view is required, because, as Ipp JA has explained, no need, caused by the accident, for assistance with pets was established on the evidence” (emphasis added).
The insurer also referred to the case of Makaroff where the court was concerned with a claim for the future care of the claimant’s 20 horses which were either kept as a hobby or a small business being run by the claimant. Associate Justice Harrison’s decision does not mention Teuma. At [553] she said that if the horses were kept as a hobby, in accordance with Geaghan, the claimant could not recover damages for their future care.
The three cases above concerned the award of lump sum damages in claims made under previous motor accident compensation schemes for care that had been provided gratuitously. Dr Forrest’s claim is a claim for statutory benefits and he has paid for the dog walking services in dispute. The legal principles relevant to an award of damages for gratuitous services may be difficult to apply to a scheme of defined and prescribed commercial benefits. It should also be noted that s 3.25 provided no statutory benefits are payable for gratuitous attendant care services.
While not part of the ratio of the Teuma case, the highlighted words of Justice Basten suggest to me that dog walking services could be a form of domestic assistance which may be compensable after a motor accident. Each case will depend on it own facts.
The insurer says that services (such as childcare services) may be provided to other human beings in the claimant’s household and are not services provided directly to the claimant. The insurer submits that dog walking services are “too remote” to be a statutory benefit to the claimant.
I do not accept this argument. The care of multiple animals that were the subject of the disputes in Geaghen (dogs and horses) and Makaroff (20 horses) are different to pets kept in the family home and garden where they are part of the claimant’s “household.” As Justice Basten’s words suggest, caring for (including walking of) dogs is an inherent part of this claimant’s domestic situation for which he may require assistance.
The insurer also argues that the claimant has provided no evidence that he walked the dog every day or that it was his job to do the dog walking. The insurer submits that the claimant should receive the benefit only if he had done the dog walking before the accident. In my view this may be a matter that would likely go to the merit review matter and the reasonable cost of the treatment and care dog walking services. However, I note that in the evidence put before me is material that suggests the claimant’s brother and mother are providing gratuitous domestic assistance and the claimant’s wife is doing much of the domestic duties, caring for their two small children and looking for a job. It may be that dog walking was not something the claimant did before the accident but something his wife or his family members may have done. It may also be that the claimant’s wife and family have no time to walk the dogs now because his wife is busy with their children (at least one of which had not been born at the time of the accident) or she and the family are busy with all the other things they are doing for the claimant.
CONCLUSION
As I have found that dog walking services are a form of treatment and care, because it is a type of attendant care, it follows that Dr Forrest may have an entitlement to statutory benefits for the dog walking services that have been provided subject to any of the restrictions and limitations in the MAI Act including:
(a) the resolution of any medical assessment matter (were the services reasonable and necessary in the circumstances or related to the injuries caused by the accident), and
(b) the resolution of any merit review matter as to the reasonableness of the cost of the treatment.
As the claimant originally referred this dispute to the Commission as a medical assessment matter, the matter is returned to the Commission so that a medical assessment can be arranged.
The dispute to be determined by the Medical Assessor is whether the dog walking services the subject of the invoices from Mad Dogs and Englishmen dated 2 October and 4 November 2024 are reasonable and necessary in the circumstances and are related to the injuries caused by the accident.
Bearing in mind the value of the services claimed ($838.95) the parties are encouraged to try to resolve the matter before it proceeds to medical assessment.
In the report of the preliminary conference, I requested submissions from the parties as to costs. The claimant made no claim for costs in either the original submissions or the further submissions. The insurer has also not addressed the issue of costs. I do not propose to make any order for costs as a result.
If I had been asked to assess costs, I would have allowed the claimant his legal costs of this dispute. This Miscellaneous Claims Assessment matter was required because the insurer’s reply raised the issue about dog walking services not being a form of treatment and care and that is not a matter that a Medical Assessor can determine.
Schedule 1, Part 1, Cl (3)(g1) declares the current dispute to be a regulated Miscellaneous Claims Assessment matter which attracts the maximum of 16 monetary units currently the sum of $1,992.00.[27] Noting the amount of work done on the initial application and submissions as well as the time taken to attend the preliminary conference, I am of the view the sum of $1,000 would be appropriate to which GST may be added.[28] The total sum payable for costs therefore would have been $1,100.
[27] A monetary unit is currently worth $124.53, 16 monetary units therefore equals $1,992.48 which is rounded down in accordance with Schedule 3(3) of the Regulation.
[28] Clause 33 of the Regulation.
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