MetLife Insurance Limited v Sandstrom

[2021] NSWCA 123

NSW Court of Appeal

View on CaseLaw

Built by Barristers,
For Australian Law.

See how it works

Interrogate

Catchwords

1. Insurance
2. › Life insurance
3. › Group life insurance through superannuation
4. › Total and permanent disability claim
5. › Contractual obligation of insurer to assess claim in good faith and act fairly and reasonably
6. › Whether insurer breached contractual obligations in relying on ambiguous medical opinions
7. › Whether insurer took into account written submissions of claimant
8. › Whether cumulative effect demonstrated lack of overall fairness
1. Insurance
2. › Life insurance
3. › Total and permanent disability
4. › Construction of TPD definition
5. › Education training and experience clause
6. › Meaning of 'unlikely ever' to engage in gainful employment
1. Costs
2. › Party and party costs
3. › Exceptions to general rule
4. › Calderbank offers
5. › Whether rejection of offer was unreasonable
6. › Whether primary judge erred in refusing special costs order
7. › Supreme Court Act 1970 (NSW), s 101(2)(c)

Quick Take

Insurers relying on ambiguous medical opinions that do not address the specific policy question, without further inquiry, may breach the duty to act fairly and reasonably, and the cumulative effect of multiple deficiencies in reasoning will be assessed.