Police PTSD disability insurance claim of over $600,000

Published 01 Jun 2015

The client in this case is a former police officer, Ms P of Campbelltown.  She developed Post-Traumatic Stress Disorder (PTSD) as a result of her job with the police which included personally witnessing a fatality. She was formally discharged after being determined by the police panel to be unfit for duty as a result of PTSD.

Subsequently she attempted to claim on her TPD insurance which was part of her First State Super (FSS) entitlements. The Police Blue Ribbon (PBRI) responded quickly and she received part of the money she was entitled. However the insurance company of her superannuation which was MetLife, refused to pay any benefit. Our client had in good faith attempted to comply with all requests, yet the insurer challenged every aspect of her TPD claim and subjected this former officer to years of continuous investigations.

Her case continued for over 7 years and the insurance company continued to barrage our client with their investigative demands while not getting any close to making a determination and no explanation was offered. Even Ms P's family, friends and past colleagues were subjected to interrogation and pressure. She was hurt by this conduct and was at the end of her tether as she was unable to understand why the insurer doubted her. Finally legal assistance was sort from Gerard Malouf and Partners.

Our superanniuation lawyers quickly commenced Supreme Court proceedings. We began preparing a case which questioned the legitimacy of the insurer’s investigative procedures, including court orders to examine their case managers and investigators. The insurer and Trustee ultimately offered to settle the case after approximately 8 months of the matter being listed for appearance at court. With a hearing pending the defendants agreed to pay our client the large majority of her TPD claim in the amount of over $600,000.00.

Many insurance companues employ the tactic of refusing to make a decision and not rejecting a claim, as well as making continuous demands for information and examination for many years. It is the law that such demands may not be unreasonable and you are entitled to to sue for the money that you should have been paid had they made a reasonable decision.

The superannuation lawyers at Gerard Malouf and Partners have vast experience in successfully managing these types of cases so contact us on 1800 004 878.

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