Kojic v NRMA [2026] NSWPIC 13: pedestrian fault and ongoing statutory benefits in NSW CTP claims
Kojic v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 13 is a useful decision for insurers and claimants dealing with pedestrian accidents where the insurer argues the injured person was wholly or mostly at fault. It is also notable because the Member followed Evic when approaching the statutory question.
This article is written in plain English for NSW CTP readers. It is general information only. If an insurer is trying to stop ongoing benefits on a wholly-or-mostly-at-fault allegation, the factual detail matters.
What happened in Kojic?
The claimant was a pedestrian crossing Victoria Road at Drummoyne near the intersection of Osgathorpe Road when he was hit by a vehicle. The insurer denied liability for ongoing statutory benefits under s 3.28, alleging he was wholly at fault.
The Member recorded that the insurer relied on a factual picture including crossing a major road in an unsafe place, being within less than 100 metres of traffic lights, using or being distracted by a mobile phone, and not keeping a proper lookout.
Why the case matters
This decision matters because pedestrian cases often generate sharp disputes about fault, lookout, road-crossing judgment, and whether an insurer is entitled to stop treatment and care benefits after the statutory cut-off point.
It also shows the continuing influence of AAI v Evic. The issue is not solved by a label alone. The decision-maker still has to evaluate the injured person’s contributory negligence in relation to the motor accident.
What the PIC focused on
- crossing a six-lane road at an unsafe place rather than using the nearby lights
- the claimant’s attention and lookout while crossing
- whether the driver was travelling lawfully and had realistic opportunity to avoid impact
- how contributory-negligence principles applied to the facts
In practical terms, Kojic is the kind of decision insurers may rely on when arguing that a pedestrian’s own conduct was the dominant cause of the accident for statutory benefits purposes.
If that allegation is affecting weekly benefits or treatment support, do not leave the file sitting in correspondence limbo. Preserve the issue through internal review, then move to the Personal Injury Commission if the dispute remains live.
Plain-English takeaway for claimants
If you are a pedestrian and the insurer says you were wholly or mostly at fault, do not assume the issue is hopeless — but do assume the facts will be examined closely. Road layout, lights, visibility, distraction, witness accounts, and the driver’s conduct can all matter.
The best response is evidence-led: reconstruct the scene carefully, challenge unsupported assumptions, and move quickly through internal review and PIC if benefits are being cut off.
Full decision source: Kojic v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 13.
Frequently asked questions
- What happened in Kojic v NRMA [2026] NSWPIC 13?
- The Personal Injury Commission held that the claimant pedestrian was wholly or mostly at fault for the motor accident for the purposes of s 3.28. The decision turned on unsafe road crossing, being close to lights, distraction, and failure to keep a proper lookout.
- Why is this case important?
- It shows how insurers and the PIC may analyse pedestrian conduct when deciding whether ongoing statutory benefits should stop. It also shows Evic continuing to influence how the “wholly or mostly at fault” question is approached.
- Does crossing away from lights automatically end a claim?
- Not automatically. Every case still turns on facts and evidence. But Kojic is a reminder that unsafe crossing conduct, distraction, and poor lookout evidence can heavily affect fault findings.
- What should a claimant do if the insurer says they were wholly or mostly at fault?
- Act quickly. Preserve the factual narrative, challenge weak assumptions, gather supporting evidence, and move through internal review and the correct PIC pathway without delay.