Folmer v VicSuper Pty Ltd

Folmer v VicSuper Pty Ltd involved a claim by the plaintiff, a member of a superannuation fund, against the trustee of the fund and the insurer of a group policy. The plaintiff sought benefits under a total and permanent disablement (TPD) insurance policy, arguing she was unable to work due to her disability. The trustee declined her claim, and the plaintiff challenged the decisions of both the trustee and the insurer.

The primary legal issues were whether the trustee breached its obligations in determining the claim for TPD benefits and if the insurer acted reasonably in denying the claim. The court had to consider the definition of total and permanent disablement in the insurance policy and whether the insurer acted with utmost good faith and fair dealing in its assessment.

The court found that the trustee did not breach its obligations in determining the claim, and the plaintiff's claim against the trustee was dismissed as she did not pursue it by the end of the hearing. Regarding the insurer, the court examined whether the insurer could reasonably have reached its conclusions based on the evidence available. The court held that the insurer's decision was open to it, given the material before it, and that the plaintiff was not totally and permanently disabled within the meaning of the policy.

The court did not make any orders against the trustee but dismissed the plaintiff's claim against the trustee. The court found that the insurer acted reasonably and fairly, upholding the denial of the TPD claim.