Onepath Life Ltd v Standley [2020] NSWCA 321

Onepath Life Ltd v Standley [2020] NSWCA 321

The Own Occupation TPD definition was not confined to an assessment three months after Mr Standley first ceased employment. It required a three consecutive month period during which, as a result of illness or injury, he was absent from and unable to engage in his most recent occupation, followed by disability at the end of that period making him unlikely ever again to engage in that occupation. On the evidence and in circumstances where Onepath did not relevantly contest the September 2017 psychological condition below, the primary judge was entitled to find that Mr Standley satisfied the definition as at September 2017. The appeal therefore failed.

Jurisdiction
Australia
Judgment Date
10 December 2020
Procedural Posture
Appeal Concerning Claim Under Life and Disability Insurance Policy for Total and Permanent Disability Benefit / Appeal From Supreme Court of New South Wales, Equity Division, [2020] NSWSC 848
Outcome
Appeal dismissed with costs.
Legal Topics
['life and Disability Insurance' 'total and Permanent Disablement' 'construction of Insurance Policy' 'own Occupation TPD Definition' 'medical Evidence' 'new Arguments on Appeal']
['insurance Law' 'civil Procedure'] ['life and Disability Insurance' 'total and Permanent Disablement' 'construction of Insurance Policy' 'own Occupation TPD Definition' 'medical Evidence' 'new Arguments on Appeal']

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Procedural Posture

Appeal Concerning Claim Under Life and Disability Insurance Policy for Total and Permanent Disability Benefit / Appeal From Supreme Court of New South Wales, Equity Division, [2020] NSWSC 848

Legal Issues

  1. 1 ['Whether the primary judge erred in construing the policy so that the respondent could satisfy the Own Occupation TPD definition as at September 2017 rather than only at 2 May 2016, three months after he ceased working.' 'Whether the primary judge erred in finding that the medical evidence established that the respondent satisfied the TPD definition as at September 2017 by reason of his psychological condition.' 'Whether the appellant could rely on clause 3.2.1.3 of the policy on appeal although it was not relied on before the primary judge.']

Ratio Decidendi

The Own Occupation TPD definition was not confined to an assessment three months after Mr Standley first ceased employment. It required a three consecutive month period during which, as a result of illness or injury, he was absent from and unable to engage in his most recent occupation, followed by disability at the end of that period making him unlikely ever again to engage in that occupation. On the evidence and in circumstances where Onepath did not relevantly contest the September 2017 psychological condition below, the primary judge was entitled to find that Mr Standley satisfied the definition as at September 2017. The appeal therefore failed.

Court Disposition

Appeal dismissed with costs.

Orders

  • ['Appeal dismissed.' "Appellant pay respondent's costs."]