The proper understanding of “chosen profession” in income protection

Published 23 Sep 2014

This is an income protection claim where the plaintiff was a naturopath. She operated a business out of her home. In 2009, she had a new gates placed in her garage. The gates failed for and fell upon her head. As a consequence she suffered injury to her cervical spine consistent with a heavy impact upon her head.

The club was successful in her claim against the contractors who installed the carrots gate. She received a significant amount of compensation which verified that she had suffered a serious injury.

As a consequence of the accident she was unable to continue her business as a naturopath because her treatment of her patients required hands on attendance. She required the strength of her neck and arms to manipulate her patients before she provided diagnosis and then a prescription for Naturopathic products.

A claim for income protection was submitted and she was paid protection on a weekly basis for proximally to use. In or about 2011 payments ceased on the basis that the insurer was of the opinion that she was capable of returning to be a naturopath.

A dispute arose and the claim was filed in the Supreme Court of New South Wales. Between 2011 and 2014 the plaintiff continued to maintain that she was unable to return to the business of being an accurate. The amount being claimed in the Supreme Court amounted to approximately $500,000. The matter was listed for hearing and parties agreed to attempt settlement of this matter amicably by way of an informal summit conference.

At the informal summit conference the defendant inquired about 2 businesses. One being a naturopathic product supplier. The other being an Internet naturopath sales website which also offers online diagnosis. Prior to the informal some conference we would not informed of any of our client’s relationship with these businesses. The plaintiff confirmed that she had attended numerous conferences with the knacker paddock supply. She had also confirmed that she was an active participant during those conferences. The defendant had in the possession of a written explanation to the plaintiff’s question which included technical medical information.

Our client also confirmed that she was the owner/operator of the Internet website that sold naturopathic products. The defendant informed us that they were in possession of many of the products because they had made ranges for an agent to be a purchaser.

As a consequence of the investigations that the insurer had conducted, the claim to which we had assessed to be in excess of $500,000 was obviously significantly reduced leaving the plaintiff with no benefits from the income protection claim.

The plaintiff had an incorrect understanding that the policy was to return her back to her chosen profession in the manner to which she ran her business. The proper interpretation of a policy ought to have been whether she could return to being a naturopath in its generic sense.

  • NSW Offices
  • North Parramatta
  • Ballina
  • Baulkham Hills
  • Blacktown
  • Bondi Junction
  • Campbelltown
  • Chatswood
  • Erina
  • Rockdale
  • Liverpool
  • Miranda
  • Newcastle
  • Penrith
  • Ryde
  • Sydney
  • Tamworth
  • Wagga Wagga
  • Wollongong
  • Mudgee
  • Tweed Heads
  • VIC Offices
  • Melbourne
  • QLD Offices
  • Brisbane
  • Bundall
  • ACT Offices
  • Canberra City
Phone 1800 004 878 to book a free appointment