Published 17 Sep 2018
Mr M was once a cop operating out of the Burwood Local Area Command in general duties as a senior constable. He suffered an injury whilst responding to a robbery and sustained physical injury in the ensuing altercation when he was knocked down several flights of stairs. This caused significant injury to Mr M's back and there were spinal complications.
In addition to the physical injury Mr M subsequently developed psychological illness. The medical findings are that the psychological problems developed as a combination of the encounter but also due to him being ostracised subsequently by the supervising offices at him having placed in workers compensation claim. Mr M’s spinal injury was made worse when as part of his treatment he had surgery which was not successful.
Mr M contacted Gerard Malouf & Partners to initially explore claims against the doctors for the unsuccessful surgery – this was ultimately not pursued. Under advice from Gerard Malouf & Partners Mr M ultimately retained our firm to look at the workers compensation and TPD/Police Blue Ribbon Insurance.
With assistance from Gerard Malouf & Partners, Mr M submitted the claim to the Blue Ribbon Insurance. Our firm advised Mr M that the Insurer may use various tactics to suggest he was not as ill as he was – and how to overcome it so his true injuries are reflected. At the initial stages of the assessment the Insurer was intent to decline the claim on the basis that the treating doctors suggest there was residual work capacity – however this was only very minimal theoretical in nature.
Our firm targeted that Mr M realistically cannot work but also drew attention that observed that this position was purely from a physical perspective and discounted the psychological condition. We advised Mr M to contact his psychiatric doctors and allow for that evidence also to be introduced. Gerard Malouf & Partners acquired the appropriate psychiatric evidence and tendered it to the Insurer. We noted that should they refuse to pay the matter would be taken to Court.
After a period of 28 days the Insurer accepted the claim paying the Blue Ribbon Insurance and TPD cover totalling more than $500,000. Our client is very relieved that the matter was resolved in a period of little over 12 months and did not need to go to Court. These monies are assisting Mr M in his ongoing treatment and to alleviate financial stress. He is exceptionally grateful for the assistance given by Gerard Malouf & Partners in successfully conducting this matter.
TPD claims are often exceptionally difficult. While the superannuation trustee and the insurer may present the claim as straightforward, upon the actual claim being submitted the insurer would often raise all sorts of inconsistencies or barriers to avoid payment. These matters often end up at Court. The insurer may often request for certain strange documents and to rely on those out of context later. These tricks are very usual, and these matters are often taken to Court over these controversies.
Gerard Malouf & Partners has expertise in conducting Police Blue Ribbon and TPD claims and are it would be a privilege to assist you in navigating your TPD claim. Please don’t hesitate to contact our firm on 1800 004 878 for a free consultation to discuss.