Published 25 May 2015
Our client Mr N of the Central Coast is a former police officer for over twenty years. He was discharged from the police after developing Post-Traumatic Stress Disorder (PTSD) following a fatal shooting incident. Mr N was determined by the police panel to be unfit for his job as a result of his PTSD and was formally discharged. He then decidedd to claim on his TPD insurance as he was entitled.
The Police Blue Ribbon Insurance (PBRI) to which he was entitled had immediately made payment, but the additional TPD policy as held in his state employee superannuation account refused to pay. The insurer denying every aspect of the client’s claim from exaggeration to fraud.
The insurance company had subjected this former police officer to continuous investigations and surveillance, numerous interrogations and examinations, multiple demands of documents and evidence.
After a period of over 5 years the insurance company had still not made a determination of the case despite all possible evidence being made available. The insurer provided no reason and as part of the investigations process interrogated and pressured our client and many of his family, friends, and past colleagues. Mr N was greatly affected by the conduct of the insurer and sought the help of our firm, Gerard Malouf and Partners.
Our law firm immediately commenced action and proceeded with a claim against the superannuation fund Trustee and their insurance company at the Supreme Court of New South Wales. Evidence was gathered against the defendant and their investigators as to the investigations process. The defendant ultimately offered to settle the case after approximately 6 months of the matter being listed at court. With a Hearing pending the insurer and trustee agreed to pay our client the large majority of his TPD claim rather than have the issue run before the court.
Many insurance companies attempt to evade their duty to pay by refusing to make a decision and not rejecting a claim. This tactic does not prevent you from exercising your right to sue for the money that you have been paid had they made a decision. Gerard Malouf and Partners Superannuation Lawyers has experience in successfully conducting these cases. If you are facing difficulty with your TPD claim our firm can assist you.