Helen Huang
Special Counsel
CTP Insurance, Insurance
The Dividing Line – When Are Renovations “Treatment & Care”?
5 May, 2025
In Brief
- Extensive renovations to a Claimant’s house are not an “attendant care service” because they are not an “everyday task“.
- Extensive renovations can, however, constitute “home and travel modification“, within the definition of “treatment and care” in s 1.4 of the Motor Accident Injuries Act 2017 (MAIA) provided the renovations assist the Claimant to address injuries sustained in their motor accident.
Facts
The Personal Injury Commission (PIC) published its decision in Ellis v AAI Limited t/as GIO [2025] NSWPIC 162 on 2 May 2025.
The Claimant sustained PTSD in a motor accident on 29 September 2023, causing her to become ostracised from friends and to suffer mobility issues due to weight loss and social isolation.
The Claimant requested the Insurer fund renovations to her home in the total sum of $150,217. The Claimant argued that she required the following renovations for the following reasons:
- Modifications to her existing bath and the placement of a walk-in shower because she feared falling out of the bath.
- Modification to the layout of her kitchen to enable easier movement and a safer cooking environment.
- Soundproofing one wall of the bedroom next to the apartment block lift because the sound of the lift triggered her misophonia.
The Insurer declined the request because the renovations were not considered an “everyday task” and were, therefore, not attendant care services.
The Member’s Determination
The Member agreed that the renovations to the bathroom, kitchen and soundproofing were not “everyday“, or common place tasks, and did not meet the definition of “attendant care services” under section 1.4 of the Act because:
- The renovations are substantial, would take 12 weeks to complete and would involve a substantial one-off expenditure.
- The renovations involved a total refurbishment of each room including the cost of fixtures and fittings.
- The renovations would require the Claimant to move out of her apartment whilst they were completed.
The Member determined, however, the renovations are a form of “treatment and care” because they do fall under “home and transport modifications“.
In doing so, the Member distinguished a prior PIC Decision of Warner v Insurance Australia Limited t/as NRMA Insurance (No 1) [2023] NSWPICMP 334. In that case a PIC Review Panel found that the completion of partly finished shed, paving and tiling were not “home modifications” because the works were not “for the injured person” in the sense that the works would alleviate or address limitations caused by the injuries sustained in the motor accident.
In this dispute, however, all the renovations sought by the Claimant were designed to help the Claimant cope with her accident-related injuries.
For these reasons, the PIC Member concluded that the renovations constituted “treatment and care” as contemplated by s 3.24 of MAIA. Whether the individual items were reasonable and necessary and related to the motor accident was a question for a separate medical assessment.
Why This Case is Important
The decision in Ellis confirms the previous decisions of BLI v Allianz Australia Insurance Limited [2024] NSWPIC 436 and Haddad v Lifetime Care and Support Authority [2024] NSWPIC 96 i.e. that the request for major renovations are not considered an “everyday task” and are, therefore not “attendant care services“.
It is important to understand, however, that the concept of “everyday task” is only relevant where the Claimant seeks a statutory benefit on the grounds that the payment relates to an “attendant care service“.
The decision in Ellis is also important because it confirms that renovations only constitute “home modifications” if the purpose of the renovations is to address the limitations caused by the motor accident. By contrast, if the renovations have nothing to do with the Claimant’s injuries then the cost cannot be recovered as a statutory benefit.
If you have a query relating to any of the information in this case note please don’t hesitate to get in touch with CTP Insurance Special Counsel Helen Huang today.
