Published 27 Dec 2017
Our client, Mr Smith of Potts Point, was formerly a public servant with the Treasury NSW. He became unable to work because of leg and back pain in 1997, ceasing all work since that time. As he became ill and was not injured Mr Smith did not receive workers compensation.
Mr Smith was a member to a NSW state Superannuation Scheme under a Disability Entitlement which was self-insured by the scheme, and he was insured to a benefit of $150,000.00. Mr Smith had personally, and subsequently with assistance by his Union appointed lawyers, attempted to claim on this benefit in 1997. The claim was declined by the Fund on the basis Mr Smith should be able to work in other capacity. The claim was not further pressed.
In 2008 Mr Smith was diagnosed with arthritis and has been in receipt of Disability Support Pension since.
Mr Smith first retained our firm as a result of a Slip and Fall injury in 2015 which worsened his problems, and as part of conducting that claim our lawyers observed the Superannuation entitlement in 1997. Our firm advised that the Trustee was under a constant obligation to assess information, and the 2008 diagnosis goes a long way to explain the difficulties Mr Smith was experiencing in 1997.
Our client gave us instruction revive the claim. Our firm firstly tendered the later documents to the Trustee of the Fund requesting a reassessment, and when refused our firm commenced the case at the Supreme Court of New South Wales. Within 3 months of commencing proceedings the Fund hired a major leading Sydney Law Firm to run their case.
This firm contacted us and offering to resolve this claim for 80% of the entitlement. Our client was very satisfied with this offer, and gave instructions to accept. This settlement gave him closure on the matter and the settlement monies greatly assists his current financial needs, and he is very happy with the services provided by GMP.
The limitation period for an insurance or trustee claim in NSW is 6 years from a breach or decline (rejection). However there is continual obligation of the trustee or insurer to consider new information when presented. Often times a case is not clear, diagnosis not available, until years down the track, and an insurer is required to revisit their previous decision should new information be available.
At Gerard Malouf and Partners, our firm has expertise in insurance and trust disputes, and should intend to make a claim or have been declined a claim our firm may be able to assist and please contact us for a free consultation.