Published 22 Aug 2018
Author: Jesicca Yousif
Our client, Ms D of Aberglasslyn, was previously employed as a telemarketer where her usual duties included working with computers and engaging in telephone communication to make sales.
In 2013, Ms D began suffering from micro-strokes due to Short-Distance Claudication and Occasional Rest Pain giving rise to the need for surgery. After complications from surgery Ms D became unfit to return to work. Her ongoing injuries and disabilities included infrarenal aorta occlusion, chronic severe pain, claudication/peripheral vascular insufficiency and thrombophilia.
It was on this basis that Ms D sought the help of Gerard Malouf and Partners to investigate the possibility of a claim for Total and Permanent Disablement. Our expert Solicitors were able to quickly assess the viability of the claim and begin the process of preparing and lodging the claim to be assessed.
Once the claim was lodged for assessment, the Insurer continued to request further information. Our Solicitors reviewed each request and determined whether or not each request was reasonable in the assessment of the claim.
Assessing the appropriateness of a request is important in ensuring that the assessment is not being unreasonably delayed and that the duties owed by the Super Fund and Insurer to the insured, in this case Ms D, are not breached.
Within 3 months of lodging the claim, the claim was approved for the full insured benefit of approximately $150, 000. Ms D was greatly relieved at the successful outcome of her claim.
In order to ensure the swift assessment of a claim, it is important to provide the Fund and/or its Trustee with all relevant documentation to place them in a position where they can assess and determine the claim. This can include, but is not limited to, claims forms, medical reports, clinical records, certified ID, employment documentation, tax records and centrelink files where relevant.
In the event that sufficient information has been supplied and the Insurer fails to assess the claim and/or continues to request information that has already been supplied and/or is not necessary to determine the claim then you may be in a position to commence court proceedings where the failure to assess is unreasonable.
Our expert Solicitors can assist in ensuring your claim is handled efficiently and that your rights are protected. It is important to understand your rights as well as the duties owed to you by the Fund and its Trustee in assessing your claim including the duty to act in good faith and assess a claim in a reasonable and timely manner.
Contact Gerard Malouf and Partners on 1800 004 878 for a free consultation to determinate your legal rights and provide you with expert advice.