TPD Settlement of $100,000.00 in spite of surveillance evidence

Published 08 Jul 2015

Our client is a resident of Blacktown and was employed by a major Sydney hotel.  She was injured in 2010 by travelling to work in a significant motor vehicle accident which caused injuries to her back, neck and also resulting in psychological damage, including PTSD.  Our client as a result of this injury ceased all employment and began participating in rehabilitation under the Workers Compensation Scheme, this was prior to the changes in law that prevented journey claims.

Our client had initially retained Gerard Malouf & Partners for advice on her motor vehicle accident and workers compensation claim.  She was aware of a policy of TPD insurance held by her superannuation fund and she had personally without assistance attempted to apply for the claim.  This was subsequently rejected on the basis that she was not significantly ill and that she has not significantly recovered to be determined TPD.  Upon the rejection, she contacted Gerard Malouf & Partners to additionally act for her in relation to her TPD claim.

Upon being retained to act for our client, Gerard Malouf & Partners undertook an immediate review of the evidence and recognised that her claim was significantly vulnerable as there was surveillance footage that contradicted some of the restrictions she had indicated in her previous statements.  Gerard Malouf & Partners quickly underwent to acquire additional evidence which would answer those allegations and to suggest an alternative explanation as to her presentation in the footage and to illustrate the issues of total impairment disability.

As a result of significant alternate evidence the insurer agreed to participate in negotiations to resolve the claim.  The claim was ultimately resolved for approximately $100,000.00 which represented a significant percentage of the insured benefit.  The client had recognised the issues in her case and agreed to resolve the claim and she is greatly happy with the outcome.

In claims of private insurance, such as total and permanent disability and income protection, a significant part of the evidence comes down to the credibility of the person making the claim.  Unlike personal injury where the medical evidence maybe more significant, in a case of total and permanent disability, the question of whether a person can ever returned to work can only truly be answered by the claimant. The claim, very often rides, on whether a Judge can be convinced by the claimant.

Gerard Malouf & Partners has experience and expertise in conducting total and permanent disability and income protection insurance cases in various forms including the Supreme Court of New South Wales.  We would be happy to assist you should you have any enquiries about a total and permanent disablement claim or income protection claim.  Please do not hesitate to contact Gerard Malouf & Partners to speak to one of our solicitors so we may begin to build your case to secure for you an outcome.


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