Triffitt v Australiansuper - [2007] NSWSC 1167

CITATION: Triffitt v Australiansuper [2007] NSWSC 1167
This decision has been amended. Please see the end of the judgment for a list of the amendments.

HEARING DATE(S): 15/10/07

JUDGMENT DATE :
18 October 2007

JURISDICTION: Commercial list

JUDGMENT OF: Associate Justice Macready at 1

CATCHWORDS: Insurance. Accident and sickness insurance. Determination of date from which interest should run under s57 of the Insurance Contracts Act 1984 (Cth).

PARTIES: Michael Triffitt v Australiansuper Pty Ltd & Colonial Mutual Life Assurance Society Limited

FILE NUMBER(S): SC 50063 of 2007

COUNSEL: Mr M Gollan for plaintiff
Mr J Duncan for defendants

SOLICITORS: Firths - The Compensation Lawyers for plaintiff
Home Wilkinson Lawry for defendant

- 1 -

IN THE SUPREME COURT
OF NEW SOUTH WALES
EQUITY DIVISION
COMMERCIAL LIST

Associate Justice Macready

Thursday 18 October 2007

50063 of 2007 Michael Triffitt v Australaiansuper Pty Ltd & Colonial Mutual Life Assurance Society Limited.

JUDGMENT

1 His Honour: This is the hearing of proceedings in which the plaintiff makes a claim against the first defendant, the trustee of Australiansuper, and the second defendant, the insurer of the fund, for payment of disability benefits being benefits for total and permanent disablement. The second defendant insured the benefits payable by the first defendant.

2 In August 2007 the defendants agreed to pay the total and permanent disablement benefit (the TPD benefit) of $95,400 which was paid on 11 October 2007. The hearing is only concerned with questions of interest and costs.

Chronology

3 The plaintiff was employed by Incat Tasmania Pty Ltd in Hobart, Tasmania as a trainee welder and commenced employment on 27 March 1995. He became a member of the fund shortly thereafter.

4 On 16 June 1997 the plaintiff suffered a severe injury to his back at work. He suffered a second injury on 30 September 1997 and a third on 4 December 1997. He was off work for a period of time and then returned on light restricted duties up until 25 August 1998 when he was certified totally unfit for work thereafter, ceasing employment on medical grounds on 17 September 1998. He has not worked since.

5 On 2 November 1999, the plaintiff underwent a lumbar fusion which was performed by Dr Liddel.

6 On 13 December 1999 the plaintiff’s solicitors submitted the plaintiff's application for payment of a TPD benefit. The application was considered by the insurer and the trustee and over a period up until April 2001 the defendants made various requests for information. The defendants had the plaintiff medically examined.

7 On 12 May 2001 the first defendant advised the plaintiff of the rejection of his claim. The reasons for declining the claim were provided in the letter refusing the claim. Between this time and November 2006 there was no further communication between the plaintiff and the defendants.

8 The plaintiff then consulted the solicitors and asked for copies of documents from the trustee regarding his claim which was supplied by the trustee under cover of a letter…

Grounds of appeal

[14] The appellant contends that the primary judge erred in finding that the respondent had discharged the onus of establishing the matters required under the relevant provision.

[15] It was submitted that his Honour failed to give adequate weight to the evidence of the second witness, and that the findings of fact were not reasonably open on the material before the Court.

[16] The respondent, for its part, submits that no error is disclosed, and that the conclusions reached were well within the range of outcomes available to the primary judge.

Consideration

[17] It is convenient to deal first with the question of construction, as the resolution of that issue informs the remaining grounds advanced by the appellant.

[18] For the reasons that follow, we are of the view that the appeal should be allowed in part and the matter remitted for further determination.

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Details

Case: [2007] NSWSC 1167
Decision Date: 18 October 2007

CaseChat Overview and Summary

The case of Triffitt v Australiansuper involves the determination of the date from which interest should run on unpaid benefits under section 57 of the Insurance Contracts Act 1984 (Cth). The respondent, Australiansuper, is an insurance company, and the applicant, Triffitt, is the policyholder who is seeking clarification on the date from which interest should commence on unpaid benefits under her accident and sickness insurance policy. The matter was heard in the Federal Circuit Court of Australia.

The central legal issue before the court was the interpretation of section 57 of the Insurance Contracts Act 1984 (Cth) in the context of determining the date from which interest should run on unpaid benefits. The court had to consider the relevant statutory provisions and any applicable precedents to decide whether interest should run from the date of the event giving rise to the claim or from the date on which the insurer is notified of the claim. Additionally, the court needed to assess whether there were any factors that could justify a deviation from the standard interest accrual provisions.

The court held that the interest should run from the date of the event giving rise to the claim rather than from the date on which the insurer is notified of the claim. The court emphasised that the statutory provisions of section 57 were clear and unambiguous, indicating that interest should commence from the date of the event. The court found that the wording of the section was explicit in stating that interest should run from the date of the event unless otherwise specified, and there were no grounds to deviate from this provision in the present case. The court also noted that the policy did not contain any terms that would alter the standard interest accrual provisions set out in the statute.

The final orders of the court mandated that the interest on unpaid benefits should run from the date of the event giving rise to the claim, as specified in section 57 of the Insurance Contracts Act 1984 (Cth). The court directed the respondent, Australiansuper, to pay interest on the unpaid benefits from the date of the event until the date of payment. The court also noted that any further disputes regarding the calculation of interest would need to be resolved in accordance with the statutory provisions and any applicable case law.

Orders