Settlement in TPD claim for client with arthritis

Published 20 Jul 2016

Our client is Mr Z of Bathurst who decided to conduct a total and permanent disablement (TPD) claim on the basis that he is no longer able to work as a result of arthritis.  At the onset of his condition he was working and aged in his fifties, and subsequently stopped work as a result.  Seeing that he has a policy of TPD held by his superannuation fund he decided to make a claim upon this policy of insurance.  

This claim was rejected by the insurer on the basis that the condition was not so severe that prevents it Mr Z from all work.  He had decided to commence proceedings against the insurance company for a declaration that he is entitled to those benefits.  The matter had progressed to the stage of Hearing when it became evident that this was significant material to demonstrate he was able to conduct employment.  Footage and records of him conducting in extensive roles for voluntary organisations, and strongly indicative of Mr Z's ability to work.  

Mr Z contacted Gerard Malouf and Partners to conduct his case.  Our solicitors drew attention to the debilitating nature of his condition and put forward arguments that the disability was alleviated by the non- demanding nature of the volunteering which were therapeutic to him.  The risks however were still high in this case should it have gone to Hearing, but these arguments persuaded the insurance company to settle for a decent percentage of the insured benefit.

Our client is satisfied with the resolution of his claim and received a settlement sum.  Our client is satisfied that he was able to retain Gerard Malouf and Partners for the conduct of his litigation which had it gone on without our solicitor’s assistance, may have resulted in an adverse finding and significant cost orders.

TPD policies and other insurance policies held in superannuation funds or otherwise often advertise themselves to be easy and simple claims.  On many occasions this is far from reality and insurance companies would utilise every method to prolong the process to finally reject the claim.  Should the matter be commenced at a Court, fight it vigorously.  The increasing number of TPD matters before the Court which have been reported in recent years is indicative of the resistance in paying claims.

Gerard Malouf and Partners have experience in conducting TPD and other insurance claims at the New South Wales Supreme Court in other forums.  We have conducted successfully TPD claims against the largest insurers.  Should you have any enquiries in relation to TPD or are having issues in your claim, please do not hesitate to contact our solicitors for a free consultation and let us assist you in achieving a successful outcome.

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