MetLife Insurance Ltd v FSS Trustee Corporation / FSS Trustee Corporation v Maund

[2014] NSWCA 281

NSW Court of Appeal

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Interrogate

Catchwords

1. Insurance
2. › Life insurance
3. › Group life insurance policy
4. › Total and permanent disablement benefit
5. › Calculation of Sum Insured
6. › Construction of 'time of the Insured Event giving rise to the claim'
7. › Whether referring to time illness contracted, time illness became incapacitating, or time six-month absence completed
1. Appeal
2. › Leave to appeal
3. › Supreme Court Act 1970 (NSW), s 101(2)(r)(i)
4. › Sum in dispute less than $100,000
5. › Whether leave should be granted where decision has potential to affect numerous other claims

Quick Take

In a group life insurance policy providing TPD benefits, the expression 'time of the Insured Event giving rise to the claim' in the definition of 'Sum Insured' refers to the time the bodily injury occurs or the illness is contracted or aggravated — not the time the illness becomes incapacitating, nor the time the insured member satisfies the definition of TPD. The 'Insured Event' is distinct from the insured risk or contingency. This construction applies to the calculation of salary-based benefits and may require review of past claims calculated on a different basis.