TAYLOR v ASTERON LIFE LIMITED [2020] NZCA 354

TAYLOR v ASTERON LIFE LIMITED [2020] NZCA 354

Court held the Policy implies an essential term that insureds must act honestly in making claims; dishonestly exaggerated claims disallow the entire fraudulent claim but do not void the policy retrospectively; Asteron was entitled to cancel under the CCLA for breach of that implied essential term and to recover...

Source-derived case information.

Citation
[2020] NZCA 354
Parties
Appellant: Peter James Taylor; Respondent: Asteron Life Limited
Court
Court of Appeal
Jurisdiction
New Zealand
Judgment Date
19 August 2020
Procedural Posture
Civil Appeal (insurance) / Court of Appeal Judgment
Outcome
Application to adduce further evidence on appeal declined; appeal allowed in part and High Court judgment on counterclaim modified by reducing recovery by NZD 51,835.64 and reducing costs award by NZD 1,600; otherwise appeal dismissed; appellant ordered to pay respondent's costs for a standard appeal on band A and...
Legal Topics
Fraudulent Claims Rule, Duty of Utmost Good Faith, Cancellation and Restitution, Interpretation of Insurance Policy, Interest on Judgments, Costs and Disbursements
Insurance Law Contract Law Civil Procedure Evidence Law Fraudulent Claims Rule Duty of Utmost Good Faith Cancellation and Restitution Interpretation of Insurance Policy +2 more

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Summary, issues, holding and outcome

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Parties

Peter James Taylor

Appellant

Asteron Life Limited

Respondent

Procedural Posture

Civil Appeal (insurance) / Court of Appeal Judgment

  1. 1 Was the insured Totally Disabled within the Policy definition?
  2. 2 How is Monthly Earned Income to be interpreted for a self‑employed insured?
  3. 3 Did the insured dishonestly misrepresent work and income in claim forms?

Ratio Decidendi

Court held the Policy implies an essential term that insureds must act honestly in making claims; dishonestly exaggerated claims disallow the entire fraudulent claim but do not void the policy retrospectively; Asteron was entitled to cancel under the CCLA for breach of that implied essential term and to recover payments made in periods where the insured was found to have dishonestly provided false information; Monthly Earned Income is the net earnings of the business for a self‑employed insured and abated any entitlement for the periods shown in the accurate accounts.

Court Disposition

Application to adduce further evidence on appeal declined; appeal allowed in part and High Court judgment on counterclaim modified by reducing recovery by NZD 51,835.64 and reducing costs award by NZD 1,600; otherwise appeal dismissed; appellant ordered to pay respondent's costs for a standard appeal on band A and...

Orders

  • Leave to adduce further evidence on appeal declined
  • Judgment on Asteron counterclaim reduced by NZD 51,835.64 (amount paid in respect of initial period)