Justin Cook v AAI Ltd t/as AAMI - [2025] NSWPIC 309

CERTIFICATE OF DETERMINATION OF MEMBER
CITATION:	Cook v AAI Ltd t/as AAMI [2025] NSWPIC 309
CLAIMANT:	Cook
INSURER:	AAI Ltd t/as AAMI
MEMBER:	Elizabeth Medland
DATE OF DECISION:	2 July 2025
CATCHWORDS:	Motor Accident Injuries Act 2017; settlement approval under section 6.23; claimant unrepresented; injured in a motor vehicle accident when he went to assist a neighbour who had driven into a metal awning; the insured driver reversed her car pinning the claimant between the vehicle and a metal pole; suffered a left knee injury including medial meniscus tear and comminated fracture of fibula; psychological injury and secondary back injury; employed on ad hoc basis as a plant operator; not fit to return to such role; now a self-employed courier driver earning equivalent or more on an average basis; matter referred to medical services for assessment of whole person impairment (WPI) prior to approval pursuant to section 7.20; no entitlement to non-economic loss; settlement of $275,000 approved.
DETERMINATIONS MADE:	1. The claimant and the insurer have agreed to settle the damages claim in the amount of $275,000. 2. The proposed settlement is approved for the purposes of s 6.23 of the Motor Accident Injuries Act 2017.

REASONS FOR DECISION

BACKGROUND

Mr Justin Cook (the claimant) is a 41-year-old male (born in 1983) who suffered injuries as a result of a motor vehicle accident which occurred on 13 January 2020.
The claimant was injured when he went to assist the driver of a vehicle who had knocked down a metal awning. In the process of lifting the awning of the vehicle, the driver reversed her car, pinning the claimant between the vehicle and a metal pole.
A claim for statutory benefits was lodged by the claimant on or about 17 January 2020, with AAI Limited t/as AAMI (the insurer), the compulsory third party insurer of the vehicle involved in the accident.
The claimant subsequently lodged a claim for damages that was accepted via notice dated
3 June 2024. However, the insurer advised that contributory negligence was alleged and assessed at 20%.
The claim was accepted, and the claimant has been receiving statutory benefits for treatment and care expenses. In addition, payments of weekly statutory benefits have been made totalling $74,658.67.
The claimant is self-represented.
The insurer has made an offer of settlement to the claimant in the amount of $275,000 inclusive of weekly benefits paid, to be deducted from the settlement amount. The claimant accepted the proposed settlement.
The insurer has lodged an application with the Personal Injury Commission (Commission) seeking approval of a settlement reached with the claimant. As a Member of the Commission I have been tasked with determining the application.
I held a preliminary conference with the parties on 21 January 2025, and advised the parties that I would carefully examine the material provided and make a determination on the papers. I also requested the claimant set out in writing the ongoing difficulties he experiences due to the accident.
In the course of considering the material…

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 309
Decision Date: 2 July 2025

CaseChat Overview and Summary

Justin Cook, the claimant, brought an action against AAI Limited trading as AAMI, the insurer, concerning the settlement of damages following a motor vehicle accident. The claimant was injured when he went to assist a neighbour whose car had struck a metal awning. The insured driver reversed her vehicle, pinning the claimant between it and a metal pole, resulting in significant physical and psychological injuries. The matter was before the court for approval of the settlement under the Motor Accident Injuries Act 2017. The court needed to determine the validity of the settlement amount of $275,000, considering the nature and extent of the claimant's injuries and the whole person impairment assessment.

The court examined whether the settlement amount was appropriate, taking into account the claimant's medical condition, future prospects, and the loss of earning capacity. Given that the claimant was employed on an ad hoc basis as a plant operator and was no longer fit to return to that role, the court assessed his current employment as a self-employed courier driver and compared it to his previous income. The court also had to consider the claimant's unrepresented status and the necessity of the referral to medical services for the WPI assessment prior to approving the settlement. Additionally, the court needed to decide if the claimant was entitled to non-economic loss, which was not claimed in the settlement.

The court found that the settlement amount of $275,000 was fair and reasonable, considering all relevant factors, including the claimant's medical condition and the whole person impairment assessment. The court approved the settlement as it reflected the extent of the claimant's injuries and the impact on his life. The court also noted that there was no entitlement to non-economic loss. The final orders confirmed the approval of the settlement amount of $275,000.

Orders