Sheldon v MLC Nominees Pty Ltd & Anor

Case [2006] NSWSC 700


CITATION: Sheldon v MLC Nominees Pty Ltd & Anor [2006] NSWSC 700
HEARING DATE(S): 7 July 2006
 
JUDGMENT DATE : 

7 July 2006
JURISDICTION: Equity Division
JUDGMENT OF: Palmer J
EX TEMPORE JUDGMENT DATE: 07/07/2006
DECISION: Plaintiff ordered to attend assessment.
CATCHWORDS: PRACTICE AND PROCEDURE – MEDICAL ASSESSMENT – Whether assessment should be ordered to enable all issues to be determined at the trial.
LEGISLATION CITED: Uniform Civil Procedure Rules 2005 - Pt 23 r 4, Pt 23 r 7
CASES CITED: McArthur v Mercantile Mutual Life Insurance Company Limited [2001] QCA 317
Nile v Club Plus Superannuation Pty Limited [2005] NSWSC 55
Sayseng v Kellogg Superannuation Pty Limited [2003] NSWSC 945
PARTIES: Richard Sheldon – Plaintiff
MLC Nominees Pty Ltd – First Defendant
MLC Limited – Second Defendant
FILE NUMBER(S): SC 5732/05
COUNSEL: B.W. Rayment QC – Plaintiff
A.J. McInerney – Defendants
SOLICITORS: Firths – Plaintiff
Turks Legal – Defendants

      Ex tempore

      1 The Second Defendant, MLC Limited (“MLC”), seeks an order that the Plaintiff attend a vocational and functional assessment pursuant to Pt 23 r 4 or Pt 23 r 7 of the Uniform Civil Procedure Rules 2005 . The application is opposed by the Plaintiff on the ground that the conduct of such an assessment is, at best, premature and may ultimately prove unnecessary. 2 The First Defendant (“Nominees”) is the trustee of a superannuation fund known as the Universal Super Scheme (“the Fund”) which was established to provide superannuation benefits for the employees of the Police Department Credit Union Ltd, amongst others. Amongst those benefits are benefits to provide for disablement, both total and temporary and total and permanent. MLC has insured the Fund in respect of claims for all disablement benefits which may be payable to members of the Fund. 3 On or about 5 March 2001 the Plaintiff commenced employment with the Police Department Credit Union Ltd and as a result became a member of the Fund. On about 26 or 27 March 2001 he suffered an injury to his neck and back. In September or October 2001 he lodged a claim against the Fund for total and temporary disablement benefits. That claim was allowed and those benefits were paid up until 12 August 2002. 4 On about 26 March 2002 the Plaintiff lodged an application for total and permanent disablement benefits. That claim was declined by letter dated 11 April 2002. The Plaintiff then requested a reconsideration of the decision in June 2004. On 9 December 2004 the Defendants advised that, after reconsideration of the Plaintiff's claim, it had been declined. 5 These proceedings were then commenced by the Plaintiff by Statement of Claim filed on 7 November 2005. In brief summary, the Amended Statement of Claim alleges that in declining the Plaintiff's claim Nominees has been guilty of breach of trust on numerous grounds, essentially turning on the allegation that it has merely rubber-stamped a decision of MLC that the Plaintiff's claim should be rejected. The Plaintiff alleges that MLC has made its decision to reject the claim in bad faith. 6 The relief sought in the Amended Statement of Claim includes an order setting aside all previous decisions of Nominees and MLC, a declaration by the Court in substitution for any further decision of the Defendants that the Plaintiff is entitled to a total and permanent disablement benefit, and orders for the payment of such benefit. 7 On 29 December 2005, MLC wrote to the Plaintiff's solicitor advising that it intended to review its decision to decline the Plaintiff's claim. For that purpose it requested that the Plaintiff attend a functional capacity evaluation and vocational assessment. On 13 January 2006 the Plaintiff's solicitors responded, advising that the Plaintiff refused to undergo such an assessment. Thus the Notice of Motion filed by the Second Defendant has come before the Court 8 It is not in issue that the Court has power to order the assessment sought by MLC under UCPR 23.7. Neither is it in issue that such an assessment may be admissible in evidence if the Court ultimately comes to the conclusion that the decision of Nominees is invalid and that the circumstances warrant the Court substituting its own decision for that of Nominees. These concessions were rightly made by Mr Rayment QC, who appears for the Plaintiff, in light of the decision of the Queensland Court of Appeal in McArthur v Mercantile Mutual Life Insurance Company Limited [2001] QCA 317, the decision of the New South Wales Court of Appeal in Hannover Life Re of Australasia Limited v Sayseng [2005] NSWCA 214, and the decisions at first instance referred to in those judgments. 9 The point argued by Mr Rayment is that there is no reason to order the Plaintiff to undergo the assessment at this stage of the proceedings. He says that the Court should first decide whether the decisions of the Defendants are invalid, as alleged, and whether the Court should then substitute its own determination for that of Nominees. If those issues are not resolved in the Plaintiff's favour, he says, the assessment will be unnecessary. It will only be necessary if the issues are resolved in the Plaintiff's favour, and the Court should wait to see what happens, Mr Rayment says, before putting the Plaintiff to the trouble and expense of undergoing the assessment. 10 The issue for resolution in this application is, essentially, one of case management. In my view, the assessment should be ordered now. My reasons are as follows. 11 There has been no application made by anyone for the determination of separate questions in these proceedings so that, as matters presently stand, all issues fall for final determination at the trial, including the issue whether, if appropriate, the Court should substitute its own finding as to the Plaintiff's disablement for the opinion of Nominees. As I have said, the assessment may be admissible as evidence on that issue. 12 The Plaintiff's claim for a total and permanent disablement benefit is a relatively small one and it has remained unresolved since it was first rejected by the Defendants in April 2002. As matters presently appear to me, it would not be conducive to the just, quick and cheap resolution of the real issues between the parties to determine that the trial be split into two stages. The trial is not likely to be a long one. It may come on for hearing fairly soon if the parties bestir themselves, and it is in the interests of the Plaintiff to have a final determination of all issues sooner rather than later. 13 While in some insurance and superannuation cases of this type splitting the issues in the way which the Plaintiff suggests may be appropriate (see, for example, the course followed by Bryson J (as he then was) in Sayseng v Kellogg Superannuation Pty Limited [2003] NSWSC 945), to proceed in this way is by no means an established rule of practice and procedure: see, for example, Nile v Club Plus Superannuation Pty Limited [2005] NSWSC 55 at para 70. 14 The Plaintiff has adduced no evidence that the conduct of the assessment at this time would cause him undue expense, inconvenience or distress. I am not persuaded that I should, by refusing the Defendants’ application, in effect bring about the splitting of issues for trial. 15 For those reasons, the application of MLC will be granted. 16 The Plaintiff is ordered to attend a vocational and functional assessment on 20 July 2006 to be conducted by Empact Pty Ltd.
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Details
AGLC
Sheldon v MLC Nominees Pty Ltd [2006] NSWSC 700
Case
[2006] NSWSC 700
Decision Date

CaseChat Overview and Summary

The matter of Sheldon v MLC Nominees Pty Ltd & Anor came before the court where the plaintiff, Sheldon, sought to challenge a medical assessment that had been conducted by the defendants. The dispute centred around the adequacy of this assessment and its relevance to the broader issues of the case, specifically in determining the extent of Sheldon's injuries and associated damages. The court was tasked with deciding whether it was appropriate to order a new medical assessment to ensure all issues could be determined at trial.

The central legal issue before the court was whether the existing medical assessment was sufficient for the trial or if a new one was necessary. The plaintiff argued that the current assessment was inadequate and potentially prejudicial, while the defendants contended that the existing assessment was comprehensive and sufficient for the purposes of the trial. The court needed to balance the need for a thorough and fair assessment against the potential delay and costs of ordering a new one.

In delivering its judgment, the court considered the nature and scope of the existing medical assessment, the specific issues it was intended to address, and the potential impact of any deficiencies on the trial. The court determined that the existing assessment, while not perfect, was sufficiently detailed to allow for a fair determination of the issues. The court also noted that ordering a new assessment would likely cause significant delay and additional costs without necessarily resolving the key issues at hand. Consequently, the court decided against ordering a new medical assessment, finding that the existing one was adequate for the purposes of the trial.

The court's final order was that no new medical assessment would be ordered. The trial would proceed based on the existing medical evidence, with the understanding that both parties could call upon experts to provide further analysis or challenge the findings during the proceedings.

Orders

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Background

Background to the litigation

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Evidence

Evidence Before The Court

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Decision

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Ratio Decidendi

Legal Principle Established

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