MLC LIMITED v O'NEILL [2001] NSWCA 161

New South Wales Court of Appeal

CITATION : MLC LIMITED v O'NEILL [2001] NSWCA 161 FILE NUMBER(S) : CA 40564/00 HEARING DATE(S) : 22 May 2001 JUDGMENT DATE : 22 May 2001

PARTIES : MLC LIMITED v Elizabeth O'NEILL JUDGMENT OF : Mason P at 1; Handley JA at 25; Hodgson JA at 26

LOWER COURT JURISDICTION : District Court LOWER COURT DC 3454/99 FILE NUMBER(S) : LOWER COURT McGuire DCJ JUDICIAL OFFICER :

COUNSEL : Appellant: D Jackson QC/ J Downing Respondent: B Coles QC/ J Jobson SOLICITORS : Appellant: P W Turk & Associates Respondent: Anthony Ziade & Associates CATCHWORDS : Contract - Life Insurance Policy - definition of "Heart Attack" - myocardial infarction - diagnosis required to be based on electrocardiogram and biochemical assessment.ND DECISION : Appeal allowed.

THE SUPREME COURT OF NEW SOUTH WALES COURT OF APPEAL CA 40564/00 MASON P HANDLEY JA HODGSON JA

Tuesday 22 May 2001 MLC LIMITED v Elizabeth O'NEILL

JUDGMENT

1 MASON P: This appeal challenges a verdict that upheld the respondent's claim under a policy of insurance. The life insured was the respondent's husband, Anthony O'Neill. The primary judge found that Mr O'Neill had suffered a "Heart Atack" within the meaning of the policy. Judgment was entered for the relevant sum specified in the schedule to the policy plus interest totalling a verdict of $258,146. 2 The relevant terms of the policy were as follows: MLC Life Limited (MLC) will pay to the policy owner or the policy owner's executors administrators assigns or other successors in title the benefits set out on the schedule subject to the conditions of the Policy….

2. Payment of Benefits. When MLC is satisfied that it has proof of the life insured's age or proof of any other matter it requires and that an event giving rise to a claim has happened it will pay the benefits...MLC will not consider a Vital Health Condition which has not been diagnosed by a Medical Practitioner....