DISTRICT COURT OF QUEENSLAND
CITATION:
PARTIES:
BERNARD WILLIAM WILKIN
(plaintiff)
v
TAL LIFE LIMITED
(first defendant)
and
AUSTRALIAN SUPER PTY LTD, AS TRUSTEE OF THE AUSTRALIAN SUPER FUND
(second defendant)
FILE NO/S:
BD 1647/15
DIVISION:
Civil
PROCEEDING:
Claim
ORIGINATING COURT:
District Court at Brisbane
DELIVERED ON:
24 June 2016
DELIVERED AT:
Brisbane
HEARING DATES:
8, 9 and 10 June 2016
JUDGE:
Dorney QC DCJ
ORDERS:
1. The determination made by the first defendant, as conveyed by its letter of 6 January 2015, is set aside.
2. It is further ordered that the matter be remitted to the first defendant to be determined according to law.
3. It is further ordered that written submissions on costs be filed and served as follows:
a. by the first defendant, on or before 4pm on 1 July 2016;
b. by the plaintiff, on or before 4pm on 8 July 2016;
c. by the first defendant in reply (if any), by 4pm on 15 July 2016.
CATCHWORDS:
Superannuation – construction of insurance policy – TPD definition – whether relevant error in insurer’s determination – whether proper relief is remitter
LEGISLATION CITED:
TEXT CITED:
CASES CITED:
COUNSEL:
Insurance and Contract Act 1984 (Commonwealth) s 13, s 48A(1)(a)
Insurance and Contracts Amendment Act 2013
Property Law Act 1974 (Q) s 55
Enright and Merkin, Sutton on Insurance Law, 4th ed, Thomson Reuters, 2014, Vol 2
Alcoa of Australia Retirement Plan Pty Ltd v Thompson (2002) 116 FCR 139
Banovic v United Super Pty Ltd [2014] NSWSC 1470
Birdsall v Motor Trades Association of Australia Superannuation Fund Pty Ltd [2014] NSWSC 632
Birdsall v Motor Trades Association of Australia Superannuation Fund Pty Ltd (2015) 89 NSWLR 412
Chammas v Harwood Nominees Pty Ltd (1993) ANZ Insurance Cases 61-175
Edwards v The Hunter Valley Co-op Diary Co Ltd (1992) 7 ANZ Ins Cas 61-113
Finch v Telstra Super Pty Ltd (2010) 242 CLR 254
Hannover Life RE of Australasia Ltd & Anor v Dargan (2013) 83 NSWLR 246
Manglicmot v Commonwealth Bank Officers Superannuation Corporation Pty Ltd [2011] NSWCA 204
McArthur v Mercantile Mutual Life Insurance Co Ltd [2002] 2 Qd R 197
Rusterholz v Board of Trustees of the State Public Sector Superannuation Scheme [2011] QSC 276
Shuetrim v FSS Trustee Corporation [2015] NSWSC 464
TAL Life Ltd v Shuetrim; MetLife Insurance Ltd v Shuetrim [2016] NSWCA 68
Trident General Insurance Co Ltd v McNiece Bros Pty Ltd (1988) 165 CLR 107
Weber v Tiss Pty Ltd [2005] NSWSC 67
Wells v Australian Aviation Underwriting Pool [2004] QCA 43
White v Board of Trustees, State Public Sector Superannuation Scheme [1997] 2 Qd R 659
Wiley v Board of Trustees, State Public Sector Superannuation Scheme [1997] QSC 46
M Horvarth for the Plaintiff
G Handran for the First and Second Defendants
SOLICITORS:
Turner Freeman Lawyers for the Plaintiff
Turks Legal for…
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- AGLC
- Wilkin v TAL Life Limited [2016] QDC 157
- Case
- [2017] QDC 157
- Decision Date
CaseChat Overview and Summary
The primary legal issue before the court was whether there was a relevant error in the insurer's determination of the plaintiff's eligibility for TPD benefits, which would warrant judicial review. The court was also required to determine whether, if an error was found, the appropriate remedy would be to remit the matter back to the insurer for reconsideration. The court considered whether the insurer had applied its mind to the correct legal principles and factual findings when assessing the claim, and whether the plaintiff's disability met the criteria set out in the policy.
The court found that there was indeed an error in the insurer's determination, as it had failed to properly consider all relevant evidence and had misapplied the legal standards for assessing the plaintiff's claim. The court held that the insurer's decision was not in accordance with the law and that the matter should be remitted back to the insurer for reconsideration. The court emphasised the importance of insurers thoroughly reviewing all evidence and applying the correct legal standards when assessing TPD claims. The court also noted that the plaintiff's disability met the criteria set out in the policy, and that the insurer's failure to properly consider this evidence was a significant error.
The court set aside the insurer's determination and remitted the matter back to the insurer for reconsideration according to law. The court also ordered that written submissions on costs be filed and served by specified dates. This decision highlights the importance of insurers properly assessing TPD claims and applying the correct legal standards when making decisions. It also underscores the need for insurers to thoroughly review all evidence and consider all relevant factors when assessing a claimant's eligibility for benefits.
Orders
Orders of the court
1. The determination made by the first defendant, as conveyed by its letter of 6 January 2015, is set aside.
2. It is further ordered that the matter be remitted to the first defendant to be determined according to law.
3. It is further ordered that written submissions on costs be filed and served as follows:
a. by the first defendant, on or before 4pm on 1 July 2016;
b. by the plaintiff, on or before 4pm on 8 July 2016;
c. by the first defendant in reply (if any), by 4pm on 15 July 2016.
Background
Background to the litigation
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Evidence
Evidence Before The Court
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Decision
Reasons for decision
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Ratio Decidendi
Legal Principle Established
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