Case Examples    

The problem

A worker who did heavy labouring work all of his life suffered a back injury and was unable to work again in a labouring job. His claim was for a disability benefit was rejected because his treating doctor indicated that he was capable of working in an office.

The resolution

Slater & Gordon successfully challenged the decision to decline the claim on the basis that the alternative work was not suitable work within the worker’s education, training or experience.

The outcome

The claim was resolved in the worker’s favour for $250,000.

The problem

A man suffered severe depression following the death of a loved one and was permanently unable to work. His income protection claim was denied. The insurer alleged that he failed to disclose a pre-existing depressive condition on his application form and had they known about it, they would not have agreed to insure him.

The resolution

Extensive medical investigations by Slater & Gordon revealed that the man did not suffer from depression at the time of filling out his application form. Instead, he suffered temporary work-related stress that did not require disclosure.

The outcome

The claim was resolved in the man’s favour for $240,000.

The problem

A young man was diagnosed with a serious and progressive brain disorder which leads to great incapacity or death. He began experiencing significant loss of co-ordination causing him to sustain constant injuries at work. He was made redundant at work.

His superannuation fund and its insurer declined his disability benefit claim as they did not accept that he ceased work as a result of a disability, but rather as a result of his redundancy.

The resolution

Following extensive medical investigations by Slater & Gordon, supportive medical evidence was put to the fund as to the severity of the man’s condition at the time he was made redundant.

The outcome

The superannuation fund and insurer reviewed their decision to decline the claim based on the additional supportive medical evidence supplied by Slater & Gordon and approved the insured disability benefit in the sum of $65,000.

The problem

A woman was forced to give up work because of an injury to her neck with referred pain to her shoulder and arm. Her claim for the total and permanent disability benefit was declined even though the material before the fund and its insurer supported the application.

The resolution

Slater & Gordon successfully established that the decision to decline the claim was unreasonable and a result of the fund and its insurer misrepresenting the contents of the medical reports.

The outcome

The claim was resolved in the woman’s favour for $115,000.

The problem

A woman’s application for total and temporary disability benefits through her superannuation fund was declined on the basis that she was precluded from receiving superannuation disability benefits because of a previous WorkCover settlement.

The resolution

Slater & Gordon successfully argued the woman was not caught by the exclusion clause in the policy because she had received the WorkCover benefit well prior to the superannuation claim.

The outcome

The claim was resolved in the woman’s favour for $25,000 and ongoing total and temporary disability benefits.

The problem

A man’s income protection claim was denied on the basis that medical evidence demonstrated that, while he couldn’t do his usual job, he could do other suitable work that matched his education training or experience.

The resolution

Slater & Gordon successfully argued that the insurance policy required only that he prove that he could not do his usual job and did not extend to suitable employment.

The outcome