Standley v Onepath Life Ltd [2020] NSWSC 848

Supreme Court New South Wales

Medium Neutral Citation: Standley v Onepath Life Ltd [2020] NSWSC 848 Hearing dates: 16 March 2020 Date of orders: 29 June 2020 Decision date: 12 June 2020 Jurisdiction: Equity Before: Rein J Decision: See [64] Catchwords: INSURANCE – Life insurance – Accident and sickness – Plaintiff sued defendant insurance company over its decision in 2017 to deny him cover under a total and permanent disability ("TPD") policy following a motor vehicle accident ("MVA") in 2015 – The policy provides cover to a life insured if, as a result of illness or injury, the life insured has been absent from and unable to engage in their "Own Occupation" for three consecutive months, and is disabled at the end of the period of three consecutive months to such an extent that they are unlikely ever again to be able to engage in their "Own Occupation" – The TPD policy defines "Own Occupation" as the most recent occupation in which the life insured was engaged prior to the date of disability – Plaintiff claimed to be physically and psychologically incapable of returning to his own occupation as a call centre manager following the MVA – Defendant refused cover on the basis that the plaintiff, whilst injured to some degree, was still physically capable of returning to his own occupation and that the plaintiff's claimed psychological problems arose after the relevant date of assessment (being three months after he stopped working); at trial, the defendant did not challenge the plaintiff's evidence as to his psychological condition, on the basis that it arose after the date of assessment and was therefore irrelevant – Held: the plaintiff exaggerated the physical requirements of his occupation as a call centre manager and was not physically incapable of returning to his own occupation for the whole of the three month period in question (February to May 2016) or thereafter. However, the Court accepted the plaintiff's unchallenged evidence that by September 2017 he was suffering from a psychological condition that rendered him unlikely ever to return to his own occupation. In so holding, the Court held that the three month period of absence from work (at the end of which the life insured's likelihood of returning to work is to be assessed) did not have to be the first three month period during which the life insured was absent from work; a later three month period of absence could be used for purposes of the assessment, provided the assessment was made as at the end of a three month period during which he was incapable of working. The plaintiff was therefore entitled to compensation for the defendant's breach of contract in refusing to cover him under the TPD policy. Legislation Cited: Nil Cases Cited: Hannover Life Re of Australasia Ltd v Jones [2017] NSWCA 233 Mason v Demasi [2009] NSWCA 227 TAL Life Ltd v Shuetrim [2016] NSWCA 68; (2016) 91 NSWLR 439 Wallaby Grip Ltd v QBE Insurance (Australia) Ltd [2010] HCA 9; (2010) 240 CLR 444 Texts Cited: Nil Category: Principal judgment Parties: Mr Aaron Standley (Plaintiff) Onepath Life Ltd (Defendant) Representation: Counsel: Mr R. de Meyrick (Plaintiff) Mr G. Watson SC (Defendant)