Tag Archives | Claims

Case Study – Binding Death Benefit Nominations and Avoiding a Family Feud

This case study highlights the value of Binding Death Benefit Nominations and what can happen if they are not implemented… (more…)

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Case Study – Unsuccessful Job Applications and their Impact on TPD

In the case of Birdsall v Motor Trades Association of Australia Superannuation Fund Pty Ltd and MetLife Insurance Limited, the Supreme Court of New South Wales delivered a judgment which considered, among other things, whether an insured’s unsuccessful job applications demonstrated Total and Permanent Disablement (TPD) under a group life insurance policy. TurksLegal Senior Associate, […]

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Case Study – Ward v MetLife

In this legal case, the plaintiff sued his insurer after his group salary continuance claim was discontinued because he was deemed to be no longer disabled. The case highlights the difficulties insurers and the courts can experience when dealing with mental health claims. At a Glance Source: Judges’ decision notes, with commentary by Terry Ward, claimant Topics covered: mental […]

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Case Study – FOS Determination – Income Protection Offset

This case looks at a dispute between a claimant and their insurer, which was resolved by the Financial Ombudsman Service in June 2014. The insurer applied an offset clause to the claimant’s income protection benefit, reducing the payments. FOS overruled the insurer, ordering them to pay compensation. The case has implications for advisers recommending key […]

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Case Study – Preston v AIA Australia

In this legal case, a carpenter who took out a life insurance policy with AIA Australia, took the insurer to court for refusing to pay his TPD claim. The original judgement found in favour of the insurer, because the insured’s injury did not meet the policy definition of ‘accidental injury’. This decision was upheld by […]

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Case Study – CFP v Couper

This legal case study deals with a client who switched his life insurance cover from one company to another, on the advice of his adviser. He was left uninsured when the new insurer voided the contract due to non-disclosure issues. The court concluded that the adviser was negligent and engaged in misleading or deceptive conduct, in […]

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Case Study – Insurance For Miners

This case study, provided by AMP, looks at some of the issues insurers need to address when considering the insurance cases of mining employees.   At a glance Submitted by: AMP Client name: Tony Client occupation: Mining engineer Cover applied for: AMP Elevate income insurance benefit of $11,250 per month In detail The client Tony* […]

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Case Study – Why I Became An Adviser

Risk Management, Estate Planning & Business Succession Specialist, Mark Everingham, watched his family struggle financially after his father suffered a heart attack. The experience would have a significant impact on Mark’s future career path, as he shares here…

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Case Study – Ravesi vs National Australia Bank

In this legal case study, the client, Paul Ravesi, successfully argued that he was entitled to damages because his adviser, Peter Moore, an employee of the National Australia Bank (NAB), failed to take out the correct insurance policies on his behalf. Mr Ravesi suffered a serious accident, for which he was entitled to claim on […]

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Case Study – Powerful Client Letter

This letter was sent to the adviser by the mother of a 27 year old man, diagnosed with cancer. It demonstrates the value that advisers deliver every day to individuals faced with genuine hardship. As the adviser points out, successful client relationships and client outcomes are at the centre of what advisers do, and technical […]

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