Insured Benefit of $1.8 Million Paid 5 days after GMP on the Scene
Published 15 Aug 2018
Author: Jesicca Yousif
Our client, Ms H of Wagga Wagga, was previously employed as a high level, white collar employee in the Banking and Finance Industry.
Following incidents of workplace bullying and harassment in 2012, Ms H sustained psychological injury and subsequently ceased work. Ms H attempted to return to work with alternative employers however these attempts were unsuccessful. Ms H was later diagnosed as suffering from depression and anxiety stemming from the psychological injuries of 2012.
After lodging an application for income protection in 2013, Ms H decided to lodge a claim for Total and Permanent Disablement and did so in January 2016.
In assessing the claim, the insurer requested Ms H to submit extensive documentation, complete monthly reports and attend various medical examinations. The assessment process was dragged on with no clear end in sight. Despite assurances from the insurer that a determination would be made shortly, Ms H continued to wait.
Over a year and half later, no decision was made.
Ms H, fed up and distressed at the lack of a substantial response, decided to retain the services of Gerard Malouf & Partners. Our expert solicitors determined the claim was viable and wasted no time in contacting the Fund and its Insurer, issuing correspondence and letters of demand with a view of commencing litigation.
Less than 5 days later, the claim was admitted for the full insured benefit of $1.8 Million.
Ms H was extremely grateful and relieved that the matter had finally come to a successful resolution.
The superannuation fund trustee and insurer have a duty to act in good faith and assess a claim in a reasonable and timely manner. Failure to do so constitutes breach of such a duty and could give reasonable ground for proceedings to be commenced against a fund and its insurer.
If you believe you may have a claim for TPD or have attempted to lodge a claim with no response from the fund and/or its insurer, our expert solicitors can assist. Contact Gerard Malouf and Partners on 1800 004 878 for a free consultation to determinate your legal rights and provide you with expert advice.