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.

Can I still lodge review material if one specialist report is delayed?

Usually yes. Lodge within time with the strongest available chronology and objective records, then foreshadow supplementary evidence. Missing the deadline is usually more damaging than filing a properly explained interim brief.

PIC case note

Kojic: pedestrian fault and statutory benefits

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.

Kojic is a NSW Personal Injury Commission (PIC) example of how a pedestrian can lose ongoing statutory benefits where the evidence supports a wholly-or-mostly-at-fault finding. It is not an automatic rule against injured pedestrians. This article is general information only, and the outcome of any NSW CTP dispute still depends on the insurer notice, the road evidence, the statutory benefits pathway, and any internal review or PIC material filed on time.

Case note source and analysis

Case note at a glance

This note identifies the source decision before drawing practical lessons. It should be read with the full judgment or PIC decision and the current NSW CTP legislation, Guidelines and insurer/PIC pathway that apply to the individual claim.

Full case name: Kojic v Insurance Australia Limited t/as NRMA Insurance
Neutral citation: [2026] NSWPIC 13
Court or PIC division: Personal Injury Commission of NSW, Motor Accidents Division
Decision date: 13 January 2026
Decision-maker: Member Belinda Cassidy
Issue: Whether the pedestrian claimant was wholly or mostly at fault for statutory benefits purposes.
Authoritative decision: Kojic v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 13
Author / reviewer: Herman Chan; reviewed by Stephen Young Lawyers
Date last checked: 24 June 2026

Material facts

The claimant pedestrian was struck while crossing Victoria Road near an intersection and traffic lights.
The insurer relied on unsafe crossing, distraction, proximity to lights and lookout issues.
The Commission considered the claimant’s conduct through the statutory mostly-at-fault framework and the Evic reasoning.

Decision

The Commission accepted a wholly-or-mostly-at-fault conclusion on the facts of the pedestrian crossing incident.

Legal principle

Pedestrian statutory-benefit fault disputes require a concrete assessment of the claimant’s conduct, not simply a sympathy-based or outcome-based conclusion.

Limitations of the decision

The result is fact-specific. Crossing away from lights, phone use or lookout concerns do not automatically decide every pedestrian claim, and driver conduct still has to be assessed where relevant.

Practical significance

Pedestrian claimants should preserve scene photographs, traffic-light distance, line of sight, driver movement, contact point, witness material and a precise timeline before a 52-week benefits issue becomes urgent.

Summary

Kojic does not mean every injured pedestrian loses NSW CTP statutory benefits. It shows that a pedestrian can be found wholly or mostly at fault where the evidence supports unsafe crossing conduct, poor lookout, distraction, nearby safer crossing options, and little or no avoidable fault by the driver. A claimant response should therefore focus on objective scene evidence, the insurer notice, and the correct internal review or Personal Injury Commission (PIC) pathway.

Decision issue

Whether the pedestrian was wholly or mostly at fault for ongoing statutory benefits purposes under the NSW CTP scheme.

Evidence focus

Crossing location, traffic lights, visibility, mobile-phone distraction, driver opportunity to avoid impact, and contemporaneous records.

Practical response

Preserve the chronology, challenge assumptions, lodge review material on time, and use PIC if the insurer maintains the benefits decision.

Source-aware reading of the decision

Read this case note as a practical summary, not a substitute for the decision or tailored advice. The primary source is the PIC decision itself. The safer way to use Kojic is to compare the insurer notice with the actual findings in the case, then check whether your facts line up or differ in important ways.

Kojic v Insurance Australia Limited t/as NRMA Insurance [2026] NSWPIC 13: Primary decision source for the factual findings, s 3.28 issue and pedestrian fault reasoning discussed on this page.
SIRA motor accident injury claims: Scheme starting point for NSW CTP statutory benefits, insurer decisions and claimant pathway context.
Personal Injury Commission: Forum context for NSW motor accident disputes when an insurer decision remains disputed after review steps.

The key legal caution is that a case comparison is evidence-sensitive. Similar pedestrian conduct can still lead to a different outcome if the lighting, traffic phase, driver conduct, witness evidence, timing, visibility, or contemporaneous records are materially different.

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.

Response workflow if an insurer relies on Kojic

Read the insurer notice carefully. Check whether the decision is framed under s 3.28, a statutory-benefits cut-off, contributory negligence, or a broader liability allegation.
Reconstruct the crossing circumstances. Record the exact crossing point, traffic lights, lane position, speed environment, visibility, weather, and any mobile-phone or distraction allegation.
Test the reasoning against objective records. Compare the insurer’s assumptions with police, ambulance, hospital, witness, CCTV, dashcam, photographs, repair records, and contemporaneous statements.
Use the review pathway promptly. If benefits are being stopped, lodge internal review material within the applicable time frame and move to the PIC pathway if the decision remains disputed.

This workflow does not guarantee a result. It helps keep the dispute evidence-led and reduces the risk that an insurer’s fault conclusion becomes accepted because key scene evidence was never organised.

Practical evidence checklist before internal review/PIC

prepare a clean minute-by-minute chronology for the 10 minutes before and after impact
map crossing point, lane position, lights, and sight lines with photos or diagrams
separate proven facts from insurer assumptions in a two-column response table
attach objective records early (police extract, ambulance notes, hospital records, witness details, CCTV requests)
note any driver evidence about speed, braking, lookout, signal phase, and opportunity to avoid impact
file review material on time, then add supplementary evidence if pending reports arrive later

Evidence matrix for a pedestrian mostly-at-fault dispute

A useful response to a Kojic-style decision is not just a longer statement from the injured person. It is a structured comparison between what the insurer says and what the records actually prove. The table below is the kind of issue map that can help an internal review officer or Personal Injury Commission (PIC) decision-maker see where the real dispute sits.

Issue	Evidence to test	Why it matters
Crossing location	Photos, Google Street View, police sketch, traffic-light distance, lane count and median layout.	The fact that a safer crossing existed is relevant, but the exact distance, visibility and real-world crossing options still need proof.
Lookout and distraction	Witness accounts, phone-use allegation, hospital history, police notes and any inconsistent statements.	An allegation that the claimant was distracted should be separated from evidence that actually proves distraction at the critical moment.
Driver conduct	Speed estimate, braking, dashcam/CCTV, line of sight, traffic phase and avoidance opportunity.	Even where pedestrian conduct is poor, the insurer should still address whether the driver had any avoidable contribution to the accident.
Benefit consequence	The precise statutory benefits notice, s 3.28 wording, weekly payment decision and treatment decision.	The review should answer the actual decision being made, not a vague argument about blame after the accident.

This kind of matrix is also useful for AI and search discoverability because it states the practical answer plainly: Kojic is a pedestrian fault comparison case, not a rule that every injured pedestrian who crossed away from lights is automatically barred from ongoing NSW CTP statutory benefits.

How to use this case safely

Treat Kojic as a fact-comparison decision, not a shortcut rule. The useful question is not simply whether the injured person crossed away from lights. It is whether the full evidence proves that the pedestrian’s conduct was the whole or dominant cause of the accident when the driver’s conduct, road layout, timing, visibility, and available records are considered together.

If the insurer notice relies on Kojic, compare the notice with the actual records before accepting the conclusion. Look for unsupported assumptions about phone use, line of sight, vehicle speed, traffic-light distance, witness reliability, and whether the driver had a realistic chance to react.

For broader context, read this case with the site’s guides to contributory negligence, threshold injury disputes, and weekly payments being stopped. Those pages explain how fault, injury categorisation, and benefits decisions can interact in a live NSW CTP claim.

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.
Can I still lodge review material if one specialist report is delayed?: Usually yes. Lodge within time with the strongest available chronology and objective records, then foreshadow supplementary evidence. Missing the deadline is usually more damaging than filing a properly explained interim brief.