{"id":27100,"date":"2014-08-12T18:17:06","date_gmt":"2014-08-12T08:17:06","guid":{"rendered":"https:\/\/riskinfo.com.au\/news\/?p=27100"},"modified":"2025-09-02T11:34:37","modified_gmt":"2025-09-02T01:34:37","slug":"court-upholds-insurers-tpd-decision","status":"publish","type":"post","link":"https:\/\/riskinfo.com.au\/news\/2014\/08\/12\/court-upholds-insurers-tpd-decision\/","title":{"rendered":"Court Upholds Insurer&#8217;s TPD Decision"},"content":{"rendered":"<p>The New South Wales Supreme Court has upheld an insurer\u2019s decision to decline a TPD claim because the claimant was capable of working in an alternative occupation.<\/p>\n<p><!--more--><\/p>\n<figure id=\"attachment_27126\" aria-describedby=\"caption-attachment-27126\" style=\"width: 150px\" class=\"wp-caption alignright\"><a href=\"https:\/\/riskinfo.com.au\/news\/files\/2014\/08\/Ros-Wicks.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-27126\" src=\"https:\/\/riskinfo.com.au\/news\/files\/2014\/08\/Ros-Wicks.jpg\" alt=\"TurksLegal Senior Associate, Ros Wicks\" width=\"150\" height=\"180\" \/><\/a><figcaption id=\"caption-attachment-27126\" class=\"wp-caption-text\">TurksLegal Senior Associate, Ros Wicks<\/figcaption><\/figure>\n<p>In the case of <em>Birdsall v Motor Trades Association of Australia Superannuation Fund Pty Ltd and MetLife Insurance Limited<\/em>, the claimant sued the insurer and super fund after his claim for TPD was declined. The claimant, a motor vehicle mechanic, suffered an injury to his wrist while at work.<\/p>\n<p>The court ruled in favour of the insurer and fund, agreeing with their decision to decline the claim because there were specific areas of work that the claimant was \u2018reasonably capable of performing by reason of education, training or experience\u2019.<\/p>\n<blockquote><p>&#8230;the Court was required to consider &#8230; the actual likelihood of obtaining regular employment<\/p><\/blockquote>\n<p>During the court case, the claimant\u2019s lawyers argued that MetLife and the fund had failed to consider and analyse relevant material, being a number of unsuccessful job applications made by the claimant. The Judge agreed that the applications were relevant to the claims decision, saying that the Court was required to \u2018\u2026consider not just the theory that a person is physically fit to carry out particular work that was regarded as suitable, but also the actual likelihood of obtaining regular employment for reward other than casual work, or other work of an intermittent nature\u2019.<\/p>\n<p>\u201cHis Honour confirmed that the Court was required to consider not just the theory that a person is physically fit to carry out particular work that was regarded as suitable, but also the actual likelihood of obtaining regular employment for reward other than casual work, or other work of an intermittent nature,\u201d explained <strong>Ros Wicks<\/strong>, Senior Associate at <a href=\"http:\/\/www.turkslegal.com.au\/\" target=\"_blank\" rel=\"noopener\">TurksLegal<\/a>.<\/p>\n<p>However, despite agreeing with the claimant that the insurer and fund had failed to adequately assess all the evidence relevant to the claim, the Judge found in favour of the insurer, because the claimant\u2019s condition did not meet the policy definition of TPD.<\/p>\n<p>To view the case in detail, as summarised by <a href=\"http:\/\/www.turkslegal.com.au\/\" target=\"_blank\" rel=\"noopener\">TurksLegal<\/a>, <a href=\"https:\/\/riskinfo.com.au\/case-studies\/2014\/08\/12\/case-study-unsuccessful-job-applications-and-their-impact-on-tpd\/\">click here<\/a> to visit our Case Study library.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The New South Wales Supreme Court has upheld an insurer\u2019s decision to decline a TPD claim because the claimant was capable of working in an alternative occupation.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8294],"tags":[],"class_list":{"0":"post-27100","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-claims","7":"headers-new"},"_links":{"self":[{"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/posts\/27100","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/comments?post=27100"}],"version-history":[{"count":0,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/posts\/27100\/revisions"}],"wp:attachment":[{"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/media?parent=27100"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/categories?post=27100"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/riskinfo.com.au\/news\/wp-json\/wp\/v2\/tags?post=27100"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}