Labourer receives settlement after long fight with insurer over TPD claim

Published 07 Sep 2016

Our client was a 30 year old labourer who suffered injury to his great toe and shoulders when some timber he was carrying broke off and landed on his foot.

Our client attempted to return to worker on lighter duties but this was not successful. His shoulder pain continued to increase due to the nature of the heavy lifting required in his job. Ultimately he had to stop work altogether despite doing his best to get well. This was a blow to his mental health and he subsequently developed depression in addition to his physical injuries.

Gerard Malouf and Partners assisted the client with a workers compensation claim in relation to the original injury. When it became apparent he would never be able to return to work because of his injuries we suggested lodging a TPD claim.

While our client’s insured benefit amount was relatively small we believed there were strong prospects success in the TPD claim due to the extent of his injuries and the physical nature of his work. Additionally, our client was illiterate, had not finished high school and did not have any experience in office work or sedentary jobs. He was therefore unable to return to work in an occupation that was within his “education, training and experience” as the TPD policy required.

Unfortunately, the superannuation fund and insurer delayed making a decision for over 6 months. After affording the insurer a reasonable amount of time to make a determination we advised our client to commence proceedings in the Supreme Court to sue the insurer for the disability benefits.

We continued to gather evidence and prepare our case against the insurer. We attempted to engage in settlement negotiations with the insurer on several occasions but were unsuccessful. We had a strong belief in the merits of our client’s case and believed that he had good prospects of success if the matter proceeded to a hearing.

As we came closer to having to attend the Hearing we again tried to resolve the matter with the insurer. While we were confident in the case we advised our client in relation to the risk of being unsuccessful at hearing and the certainty that comes with a negotiated settlement. Our expert TPD lawyers were able to negotiate a settlement of almost the entire benefit amount. Our client was very happy with this result and was glad we were able to resolve the matter without enduring the stress of a hearing.

If you have been injured and are no longer able to work – call us today for a free consultation. Our lawyers are experts in TPD claims and are ready to advise you on your rights and the obligations of insurers to deal with your claim for disability benefits fairly.

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