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      What are some recent court decisions relevant to my claim?

      Quick answer

      In the recent years, courts have found in favour of insurance companies on many occasions, including upholding an insurer’s right to their own medical tests, as well as making it more difficult to dispute a rejected claim.

      Overall, these decisions have made it increasingly difficult for unrepresented claimants to run successful TPD claims.

      In depth answer

      Sargeant v FSS Trustee Corporation and Metlife Insurance Ltd v Hellessey

      The court ruled that an insurance company does not have to accept your doctor’s opinions about your medical condition. Your insurer has the right to challenge your medical reports and obtain their own medical evidence that favours them.

      Newling v FSS Trustee Corporation and TAL Life Limited v Shuetrim

      The court determined that it’s up to you to prove your disablement and raised the bar for what is required. It is no longer enough to simply provide existing medical records: you need to submit detailed and persuasive medical evidence to prove disablement.

      Newling v FSS Trustee Corporation

      The court determined that you can only challenge an unfavourable decision if you prove that the insurer acted unreasonably. This means it’s important to get it right the first time.

      Carrol v United Super Pty Ltd and Board of Trustees v Gomez

      Your insurance company can decline your claim if they show you could retrain for a new job – even if this job is completely unrelated to your previous occupation. If we think there is a risk of the insurer declining your claim on this basis, we get in ahead by obtaining specific medical evidence to address this issue.

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