The Commission Has No Power to Pre-Approve Treatment

In Brief

• The Personal Injury Commission does not have jurisdiction to assess claims for past treatment – including past travel – if the Claimant has not first sought Internal Review of the dispute.
• The Personal Injury Commission does not have jurisdiction to assess claims for future treatment, including claims for future travel.

Facts

The PIC published its decisions in Lieberman v Insurance Australia Limited t/as NRMA Insurance [2025] NSWPIC 310 on 11 July 2025.

The Claimant was injured in a motor accident on 9 August 2022.

She subsequently made a request, under section 3.24(1)(b) of the Motor Accident Injuries Act 2017 (MAIA), that the insurer pay her “ongoing transport assistance to and from treatment providers” by private car rather than by public transport.

The Insurer rejected the Claimant’s request and that decision was affirmed on Internal Review.

Whilst the Claimant had incurred some travel expenses to attend medical appointments in the past, she had not formally sought any recovery of those expenses and any claim for past travel had not yet proceeded to Internal Review.

The Claimant referred the dispute to the Personal Injury Commission. The dispute was initially referred to a Member, by way of Miscellaneous Assessment, to determine whether the Commission had jurisdiction to resolve the dispute.

The Member’s Decision

The Member determined that the Commission had no jurisdiction to assess a dispute for future travel for the following reasons:

• There is no specific or explicit power in MAIA which gives Merit Reviewers or Medical Assessors power to determine disputes under s 3.24(1)(b).
• A dispute about an Insurer’s liability to pay benefits in a statutory benefits claim can, however, be referred to a Member pursuant to Schedule 2(3)(n), which declares the following to be a Miscellaneous Assessment Matter:
  “Any issue of liability for a claim, or part of a claim for statutory benefits not otherwise specified in this Schedule.”
• The Commission did not have any jurisdiction, however, to assess disputes about past treatment – including past travel – until a formal claim had been made for those expenses and, if necessary, any dispute had proceeded to Internal Review.
• The Commission does not have jurisdiction to assess claims for future treatment, including future travel. It can only assess expenses which have been “incurred“.
• The Claimant can lodge a dispute in the Commission, in the future, if a claim for travel is declined and that decision is affirmed on Internal Review.

Why This Case is Important 

The decision in Lieberman confirms that the Commission has no power to, effectively, provide pre-approval for a future treatment regime. Section 3.24(1) makes it clear that the Claimant can only recover the cost of treatment and care which has been “incurred“.

The practical outcome is that a Claimant can only refer a dispute to the Commission for assessment when a claim for past treatment has been rejected and that rejection has been affirmed on Internal Review (or if the Insurer has declined to conduct an Internal Review).

If you would like to discuss this case note, please don’t hesitate to get in touch with CTP Insurance Principal Peter Hunt today.

Additional McCabes Resources

• MC PIC Decision of the Week
• MC MAIA Toolkit
• The Proper Lookout Podcast
• MC Ready Reckoner