Published 10 Aug 2015
Mr M was formerly a Supermarket attendant and had a history of manual work in his forties. He has had a long term condition of his elbow following a boating accident. This condition was minor and he was able to work asymptomatic for many years. During 2012 our client underwent maintenance surgery on his elbow and due to the failure of that surgery our client suffered significant symptoms of his arm, shoulder, back and neck, along with significant psychological illness. He was likely to require significant medication and treatment in future to maintain his current symptoms. These new injuries made it impossible for Mr M to continue working.
Mr M approached GMP for advice regarding potential medical negligence claim. That claim was unable to proceed as it was found that our client was advised of the potential failure, the doctors had conducted themselves within procedure, and our client had made an informed decision to take the surgery. While it was unfortunate that Mr M could not claim medical negligence the solicitors at GMP identified that he was insured for TPD (“Total and Permanent Disability”) and IP (“Income Protection”) coverage in his closed Superannuation Fund.
GMP proceeded to gather evidence in support of Mr M’s case for TPD and IP, demonstrating the medical, financial, expert, and other supportive circumstantial evidence that points to Mr M being unable to work and unlikely to return. These documents was collated with a detailed Pre-filing statement and along with a letter of demand for payment was sent to the Insurer.
The insurer raised a number of issues to avoid payment but these were answer or rebuffed by GMP, depending on the reasonableness of the request. Following a period of three months a notice was sent to the Insurer noting litigation would commence due to their failure to pay. Upon this notice the Insurer realising the potential litigation against them made payment of the insurance in the region of 250,000.00 representing TPD benefit and unpaid IP, along with continuing income coverage. Mr M is very happy with these results and the work done by GMP.
Many Superannuation Funds have utilised our own money to purchase insurance in the event we become disabled. These policy are valid for when you become disabled, and could be valid even if they have ended, or the fund closed. These policy can be paid even if there was no negligence as they pay if it can be proven that you cannot work again because of illness or injury. At GMP our solicitors have conducted hundreds of cases in TPD and IP insurance. Please allow us to assist you in securing your benefit and contact us for a free consultation today.