Insurer backs down and approves TPD benefit after commencing litigation in the Supreme Court

Published 05 Oct 2016

Our client was a 50 year old woman employed as a Kitchen Hand and Shelf Stacker in a supermarket. While cleaning at home our client stood on a chair which gave out from underneath her. Our client fell backwards and sustained an injury to her back and right shoulder.

After almost a month in hospital and rehabilitation our client was discharged home, however she continued to have pain in her back and shoulder and had to wear a back brace for over 12 months. As a result of her fall she was left with a permanent disability.

In her previous positions as a Kitchen Hand and Shelf Stacker her duties predominantly involved lifting and carrying heavy objects as well as bending, twisting and remaining on her feet throughout her shifts. Due to her injuries and the constant pain she experienced our client was unable to return to work at all. It was unlikely that she would ever be able to return to work in any job within her training, education and experience.

Our client held Total and Permanent Disability (TPD) insurance through her superannuation account. She lodged a claim for the disability benefits herself which was declined by the insurer as they believed she could undergo further treatment and return to work.

Gerard Malouf and Partners are expert TPD Claim lawyers and our client approached us to see if there was any way to fight the decision of the insurer. We obtained a copy of our client’s file and upon review determined that she had an arguable case against the insurer.

We requested that the insurer review the claim and make a determination in favour of our client. In the meantime we began preparing our case to sue them. When the insurer did not make a further determination within a reasonable time period we commenced proceedings in the Supreme Court of NSW.

Shortly afterwards the insurer decided to approve payment of our client’s TPD benefit of $61,000.00 in full. We and the client were very pleased to be able to resolve her matter in such a timely manner, and without incurring the expense of running the case through the Court system all the way to Hearing.

TPD insurance claims are very complicated and you need the advice of expert lawyers to ensure you get the best outcome possible. At Gerard Malouf and Partners our superannuation lawyers are ready and willing to fight on behalf of those who have been treated unfairly by insurers.

If you have already lodged a claim or are unable to work and think you might be able to make a claim call us for a free consultation with one of our TPD Claim lawyers. We will be happy to advise you in relation to your rights and take on your case on a No Win, No Fee basis.

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