TPD Insurer admits claim after GMP commences court proceedings

Published 15 Dec 2015

Our client is a former rigger dogman residing around Kiama.  He has worked as a labourer for the majority of his career. 

On or around early 2010, he suffered an injury at work after being hit by construction material at the back.  This caused significant injury including disc bulge and nerve impingement around the thoracic and lumbar spine.

Our client had attended other solicitors to undertake his workers compensation claim and through that mechanism he attempted to return to work and sought treatment.  However, his deteriorating health condition and resulting depression caused him to cease all employment a year later in 2011.  As of date, our client’s workers compensation claim is still continuing being undertaken by his previous solicitors.                        

Our client had with the assistance of his previous solicitors commenced a TPD claim upon his superannuation fund and was subsequently declined. 

Our client contacted Gerard Malouf & Partners after seeing our advertisements on television for TPD case.  Upon receiving the instructions to proceed, Gerard Malouf & Partners quickly went and acquired all evidence in relation to the file.  The insurer had rejected the claim on the basis that our client was not sufficiently ill to be deemed total and permanently disabled retaining a residual work capacity. Gerard Malouf & Partners required expert medical evidence and also auxiliary supporting evidence to back up our client’s claim that these alternate capacity are not practically feasible. These were further submitted to the insurer and a demand made to them that should they fail, litigation will commence.

Subsequently, Gerard Malouf & Partners commenced litigation against the TPD insurer which immediately admitted the claim and requested that the matter be ended without costs.  Our client recognising that the claim has been paid agreed to let the insurer off the hook.  Our client has been greatly aided by this monies, financially, and is significantly pleased with the outcome of Gerard Malouf & Partners and is currently considering having our firm also undertake his workers compensation claim which is still continuing. 

Insurers will often attempt to deny claims on basis of residual work capacity and other captious issues.  There is a great risk in providing more information to the insurer as it might bight back rather than advance your case.  The courts have long held that these cases must be applied with a practical and reasonable view in mind. 

At Gerard Malouf & Partners our solicitors have experience in presenting cases of TPD insurance and other insurances to the courts.  Please contact Gerard Malouf & Partners to allow us to assist you to achieve an outcome in your insurance case.

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