Court of Appeal
Supreme Court
New South Wales
- Summary available
- Amendment notes
Medium Neutral Citation: TAL Life Ltd v Shuetrim; MetLife Insurance Ltd v Shuetrim [2016] NSWCA 68 Hearing dates: 7, 8 March 2016 Decision date: 07 April 2016 Before: Beazley P at [1];
Leeming JA at [2];
Emmett AJA at [214]Decision: In 2015/150468 (TAL’s appeal):
1. Appeal allowed.
2. Set aside orders 1-9 made on 19 June 2015, and in lieu thereof dismiss the proceedings as against TAL.
In 2015/151747 (MetLife’s appeal):
1. Grant leave to Mr Shuetrim to rely upon the notice of contention dated 8 March 2016.
2. Appeal allowed with costs.
3. Set aside orders 1-9 made on 19 June 2015, and in lieu thereof dismiss the proceedings as against MetLife, with costs.Catchwords: APPEAL – new point on appeal – common ground at trial that court would determine whether “Total and Permanent Disablement” (TPD) clause satisfied if insurer found to have breached obligations to Insured Person – whether insurer should be permitted to depart on appeal from approach taken at trial – where potential unfairness to Insured Person
INSURANCE – life insurance – group policy taken out by trustee of superannuation fund – benefit for TPD payable if Insured Person provided proof to satisfaction of insurer that he or she was so incapacitated as to be “unlikely ever” to return to employment for which he or she was reasonably qualified by education, training or experience – proper construction of “unlikely ever” – whether obligation to accord procedural fairness waived – whether insurers breached obligations to Insured Person by rejecting claims – proper approach to construing letter declining cover – whether, if breach established, claim should be determined by court or remitted to insurer – whether Insured Person satisfied TPD definition
PRECEDENT – body of appellate authority consistent throughout Australia – doubts expressed in two appellate decisions – where matters raised by way of doubt had previously been addressed in authorities – whether court should depart from existing line of authority – McArthur v Mercantile Mutual Life Insurance Co Ltd [2002] 2 Qd R 197 and Birdsall v Motor Trades Association of Australia Superannuation Fund Pty Ltd [2015] NSWCA 104; 89 NSWLR 412, considered
TRUSTS – group insurance policy held by trustee – enforcement of rights under policy by member as opposed to trustee
WORDS AND PHRASES – “unlikely ever” – utility of dictionary definitions – Beverley v Tyndall Life Insurance Co Ltd [1999] WASCA 198; 21 WAR 327, followed – headnote in White v The Board of Trustees [1997] 2 Qd R 659 disapprovedLegislation Cited: Credit Act 1984 (NSW), s 86A
Insurance Contracts Act 1984 (Cth), ss 13, 48
Insurance Contracts Amendment Act 2013 (Cth)
Legal Profession Act 2004 (NSW), s 347
Marine Insurance Act 1906 (UK)
Matrimonial Causes Act 1929 (SA)
Trade Practices Act 1974 (Cth), s 45D
Uniform Civil Procedure Rules 2005 (NSW), r 36.16Cases Cited: 2 Elizabeth Bay Road Pty Ltd v The Owners -…
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- Case
- [2016] NSWCA 68
- Decision Date
CaseChat Overview and Summary
The Court of Appeal was required to determine several key legal issues. These included the proper construction of the phrase "unlikely ever" in the TPD definition, which stipulated that disablement was satisfied if the insured person was unlikely ever to return to employment for which they were reasonably qualified. The court also had to consider whether the insurers had breached their obligations to Mr Shuetrim by rejecting his claims, and if so, whether the court should determine the claim itself or remit it back to the insurer. Furthermore, the court examined whether the insured person had waived any obligation to accord procedural fairness and the proper approach to construing the letters issued by the insurers declining cover. Finally, the court considered whether it should depart from established appellate authority on the construction of TPD clauses.
The Court of Appeal, in its reasoning, followed the established body of appellate authority across Australia regarding the construction of TPD clauses, particularly the phrase "unlikely ever". The court applied the principles established in cases such as *Beverley v Tyndall Life Insurance Co Ltd*, finding that dictionary definitions were of limited utility in this context. The court also considered and distinguished the doubts expressed in *McArthur v Mercantile Mutual Life Insurance Co Ltd* and *Birdsall v Motor Trades Association of Australia Superannuation Fund Pty Ltd*, reaffirming the existing line of authority. The court found that the insurers had not breached their obligations to Mr Shuetrim and that the proceedings should be dismissed.
Consequently, the Court of Appeal allowed the appeals by TAL Life Ltd and MetLife Insurance Ltd. The orders made by the primary judge were set aside, and the proceedings against both insurers were dismissed.
Orders
Orders of the court
In 2015/150468 (TAL’s appeal):
1. Appeal allowed.
2. Set aside orders 1-9 made on 19 June 2015, and in lieu thereof dismiss the proceedings as against TAL.
In 2015/151747 (MetLife’s appeal):
1. Grant leave to Mr Shuetrim to rely upon the notice of contention dated 8 March 2016.
2. Appeal allowed with costs.
3. Set aside orders 1-9 made on 19 June 2015, and in lieu thereof dismiss the proceedings as against MetLife, with costs.
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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