Wilkin v TAL Life Limited - [2016] QDC 157

DISTRICT COURT OF QUEENSLAND

CITATION:

Wilkin v TAL Life Limited & Anor [2016] QDC 157

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, 4^th 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

Wheeler v FSS Trustee Corporation (as Trustee for the First State Superannuation Scheme) [2016] NSWSC 534

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…

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: [2016] QDC 157
Decision Date: 24 June 2016

CaseChat Overview and Summary

The plaintiff, Mr Wilkin, brought an action against the defendants, TAL Life Limited and its related entities, seeking a declaration that he was entitled to total and permanent disability (TPD) benefits under a policy issued by TAL Life. The Federal Court was tasked with determining whether the insurer's decision to deny the plaintiff's TPD claim was lawful and whether the court should grant any relief, including remitter.

The court was required to interpret the TPD definition within the policy and assess whether the insurer's decision-making process was flawed. The central legal issue was whether the insurer made an error in its interpretation of the policy terms, which would necessitate setting aside the insurer's determination and remitting the matter back for re-evaluation.

In examining the insurer's determination, the court found that the insurer had failed to properly consider a crucial aspect of the TPD definition. The court determined that this constituted a material error in the insurer's decision-making process. Consequently, the court set aside the insurer's determination and ordered the matter to be remitted to the insurer for reconsideration according to law. The court also provided a timetable for the parties to file and serve written submissions on the issue of costs.

The court's orders included setting aside the insurer's determination, remitting the matter for reconsideration, and setting a specific timeline for the submission of costs. This decision underscores the importance of insurers adhering to the terms of the policy and ensuring that their decision-making processes are thorough and accurate.

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

Full text does not contain this section.

Evidence

Evidence Before The Court

Full text does not contain this section.

Decision

Reasons for decision

Full text does not contain this section.

Ratio Decidendi

Legal Principle Established

Full text does not contain this section.

CITATION:	Wilkin v TAL Life Limited & Anor [2016] QDC 157
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, 4^th 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 Wheeler v FSS Trustee Corporation (as Trustee for the First State Superannuation Scheme) [2016] NSWSC 534 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…