MetLife Insurance Limited v Sandstrom [2021] NSWCA 123

MetLife Insurance Limited v Sandstrom [2021] NSWCA 123

The majority found MetLife breached its contractual duty to assess Ms Sandstrom's TPD claim fairly and reasonably by unfairly relying on ambivalent medical opinions, not adequately considering solicitor submissions, and failing to provide overall fairness in its assessment process. The appeal was dismissed, orders against MetLife were affirmed, and the cross-appeal regarding costs was also dismissed.

Jurisdiction
Australia
Judgment Date
09 June 2021
Procedural Posture
Appeal / Final Judgment
Outcome
Appeal dismissed (majority), cross-appeal dismissed.
Legal Topics
['total and Permanent Disability (tpd) Insurance' 'good Faith and Fair Dealing' 'costs Orders' 'contractual Obligations of Insurers']
['insurance' 'civil Procedure'] ['total and Permanent Disability (tpd) Insurance' 'good Faith and Fair Dealing' 'costs Orders' 'contractual Obligations of Insurers']

Case Brief

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Procedural Posture

Appeal / Final Judgment

Legal Issues

  1. 1 ["Whether MetLife breached its contractual duty to assess Ms Sandstrom's TPD claim in good faith and act fairly and reasonably" 'Whether MetLife was reasonable in relying on certain medical reports to decline the claim' "Whether written submissions by Ms Sandstrom's solicitors were properly considered" 'Whether refusal to make a special costs order was erroneous']

Ratio Decidendi

The majority found MetLife breached its contractual duty to assess Ms Sandstrom's TPD claim fairly and reasonably by unfairly relying on ambivalent medical opinions, not adequately considering solicitor submissions, and failing to provide overall fairness in its assessment process. The appeal was dismissed, orders against MetLife were affirmed, and the cross-appeal regarding costs was also dismissed.

Court Disposition

Appeal dismissed (majority), cross-appeal dismissed.

Orders

  • ['Dismiss the appeal from the judgment in the Equity Division of 9 March 2020 and the orders entered on 10 March 2020.' "Order that the appellant pay the respondent's costs of the appeal." 'Grant leave to Ms Sandstrom to cross-appeal from the refusal of her application for an indemnity costs order by the judgment in...