Our client was a construction worker who was installing an oven when he fell through a hole causing his shin to collide with a protruding bolt.
Whilst our client was able to manage working for a few days following the incident, his pain exacerbated, and he was forced to seek medical treatment. Our client underwent surgery in the hope of repairing his injuries, however he found this treatment to be ineffective. He continued to suffer physical restrictions and was unable to operate tools which he had previously operated during the course of his pre-injury employment.
Gerard Malouf and Partners supported the client with lodging a Total and Permanent Disablement claim. The claim was swiftly prepared and lodged with the fund along with various evidence in support of our client meeting all elements of the applicable TPD definition which were as follows:
- The Insured Person is unlikely to return to their usual occupation for three consecutive months;
- The Insured Person is unable to return to work due to injury or illness; and
- The Insure Person is unlikely to have the capacity to engage in any employment for which they are suited by way of education, training or experience in the future.
Under the Life Insurance Code of Practice, Insurers are provided a minimum six months within which to assess a claim. Due to the efforts of our Firm in promptly obtaining and supplying supportive evidence to the Insurer and responding to requests for further documents, the assessment of our client’s claim was carried out expeditiously. The Insurer advised within a short two and a half months after lodgement that the $62,000 claim had been approved. Our client was ecstatic with this outcome.
The Superfund does not necessary always assess a claim swiftly. For this reason, in instances where we suspect undue delay and a breach of client’s rights, a claim is pressed forward to help ensure assessment and a determination can be reached as soon as possible.
Have you sustained an injury or illness and are unable to return to your pre-injury work? Contact Gerard Malouf and Partners on 1800 004 878 for a free consultation with one of our superannuation solicitors to discuss your rights.