Published 17 Aug 2016
Mr J is a resident of Richmond New South Wales who suffered a motor vehicle accident and severely injured his left non-dominant hand. The injury caused him loss of any grip in his left hand and most of its motor functions. In addition he was required to take long-term medication for the pain. He had for the 10 years of his working life been employed in labour-intensive construction roles and subsequent to his injury has ceased all work due to his restrictions.
Mr J had initially approached Gerard Malouf and Partners for conduct of his motor vehicle accident claim which was successfully resolved. Our client also had a policy of TPD insurance held in his Superannuation Fund, which he had initially decided to run himself. He had been informed by the insurer that that the application would likely be uncontested and payable imminently. After the entire duration of the motor vehicle accident claim, Mr J’s TPD application was rejected by the insurer on the basis that he did not satisfy the definitions of the policy.
At that time Mr J contacted Gerard Malouf and Partners to take conduct of the TPD claim. The solicitors of Gerard Malouf and Partners immediately engaged into action and identified key errors in the decision making of the insurance company. Their particular focus was on surveillance of trivial event where Mr J had certain “good days” with no consideration of the context of the overall restrictions. Our solicitors commenced proceedings against the insurance company at the Supreme Court of New South Wales.
As a result of the commencement proceedings the insurance company quickly retained their own solicitors who engaged in negotiations with us for resolution of the claim. The matter was subsequently resolved for an amount of $150,000.00 which represented a significant percentage of the insured benefit in order to resolve the dispute within a period of six months. Mr J is greatly satisfied with the result and the conduct of the matter by Gerard Malouf and Partners.
Unlike in an injury claim which is based on liability and compensation, a TPD claim is contractual is determined on the exact meaning and wording of the policy - this often boils down to very technical disputes. Insurance companies have increasing used narrow and absurd interpretations of the policies to avoid payment – this has resulted in an increasing number of disputes in the Supreme Court for TPD claims.
Gerard Malouf and Partners have experience and a record of success in conducting TPD claims against insurer companies. Our firm that often takes these matters to the Supreme Court of New South Wales to get a proper remedy for our clients. If you are having difficulty in your total and permanent disablement claim please do not hesitate to contact our solicitors for a free consultation to discuss potential strategies to achieve a successful outcome.