An insurer under a group life contract who obtains medical reports that are severely adverse to a TPD claimant and that depart completely from the material submitted by the claimant must communicate those reports to the claimant and afford an opportunity to respond before declining the claim; failure to do so vitiates the insurer's opinion and the court will determine the question itself. A person who is not a party to a group life contract but whose interests are indirectly involved as a fund member has standing to challenge the insurer's opinion. The insurer's duty of good faith does not extend to imposing natural justice-type procedural requirements generally.
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