Hannover Life Re of Australasia Ltd v Jones [2017] NSWCA 233

Court of Appeal Supreme Court New South Wales Medium Neutral Citation: Hannover Life Re of Australasia Ltd v Jones [2017] NSWCA 233 Hearing dates: 23 June 2017 Decision date: 14 September 2017 Before: Macfarlan JA at [1] Meagher JA at [4] Gleeson JA at [11] Decision: (1) Appeal dismissed. (2) Appellant to pay the costs of the first respondent. Catchwords: INSURANCE – accident and sickness insurance – where policy taken out by trustee of superannuation fund with insurer for benefit of its members – respondent claimed benefit for "total and permanent disablement" after suffering back injury while working as a roofing supervisor – insurer's liability contingent on it forming a favourable opinion that claimant meets definition of total and permanent disablement (TPD) – where insurer formed unfavourable opinion that claimant did not satisfy definition of TPD – standard of review adopted by Court – whether unreasonableness in the Wednesbury sense – whether Court undertakes "merits review" of insurer's opinion on entirely objective basis – whether opinion open to insurer acting reasonably and fairly on the material before it.

INSURANCE – accident and sickness insurance –construction of phrase "reasonably fitted by education, training or experience" (ETE clause) – where respondent has discrete transferable skills relevant to non-labouring customer service roles but no vocational history in such roles – whether ETE clause requires a connection between suggested future work and the claimant's education, training and experience. Legislation Cited: Trade Practices Act 1974 (Cth), s 82 Uniform Civil Procedure Rules 2005, r 42.1 Cases Cited: Associated Provincial Picture Houses Ltd v Wednesbury Corporation [1948] 1 KB 223 Bartlett v Australia & New Zealand Banking Group Ltd (2016) 92 NSWLR 639; [2016] NSWCA 30 Beverley v Tyndall Life Insurance Co Ltd (1999) 21 WAR 327; (1999) WASCA 198 BP Refinery (Westernport) Pty Ltd V Shire of Hastings (1977) 180 CLR 266 Braganza v BP Shipping Ltd & Anor [2015] 4 All ER 639; [2015] UKSC 17 Buck v Bavone (1976) 135 CLR 110 Byrne v Australian Airlines Ltd (1995) 185 CLR 410 Chammas v Harwood Nominees Pty Ltd (1993) 7 ANZ Ins Cas 61-175 Chapman v United Super Pty Ltd [2013] NSWSC 592 Cromwell Property Securities Ltd v Financial Services Ombudsman Service Ltd and Ors (2014) 288 FLR 374; [2014] VSCA 179 Doyle v City of Glasgow Life Insurance Co (1884) 53 LJ Ch 527 Duncan v Independent Commission Against Corruption [2016] NSWCA 143 Edwards v The Hunter Valley Coop Dairy Co Ltd (1992) 7 ANZ Ins Cas 61-113 Finch v Telstra Super Pty Ltd [2010] 242 CLR 254; [2010] HCA 36 Halloran v Harwood Nominees Pty Ltd (2007) 16 ANZ Ins Cas 90-142; [2007] NSWSC 913 Hannover Life Re of Australasia Ltd v Dargan (2013) 83 NSWLR 246; [2013] NSWCA 57 Hannover Life Re of Australasia Ltd v Colella (2014) 47 VR 1; [2014] VSCA 205 Hannover Life Re of Australasia Ltd v Sayseng (2005) 13 ANZ Ins Cas 90-123; [2005] NSWCA 214 Heitman v Guardian Assurance Co Ltd & Anor (1992) 7 ANZ Ins Cas 61-107 Jones v United Super Pty Ltd [2016] NSWSC 1551 McArthur v Mercantile Mutual Life Insurance Co Ltd [2000] 2 Qd R 197 Legal and General Life of Australia Ltd v A Hudson Pty Ltd (1985) 1 NSWLR 314 McCann v Switzerland Insurance Australia Ltd (2000) 203 CLR 579; [2000] HCA 65 Minister for Immigration and Border Protection v Stretton (2016) 237 FCR 1; [2016] FCAFC 11 Minister of Immigration and Citizenship v Li (2013) 249 CLR 332; [2013] HCA 18 Nile v Club Plus Superannuation Pty Ltd [2005] NSWSC 55 Repatriation Commission v Hill (2005) 142 FCR 88; [2005] FCAFC 7 Riley v National Mutual Life Association of Australasia Ltd (1985) 4 ANZ Ins Cas 74,061 TAL Life Limited v Shuetrim; Metlife Insurance Ltd v Shuetrim (2016) 91 NSWLR 439; [2016] NSWCA 68 Tonkin v Western Mining Ltd (1998) 10 ANZ Ins Cas 61-397; [1998] WASCA 101 Wardley Australia Ltd v The State of Western Australia (1992) 175 CLR 514 Wells v Australian Aviation Underwriting Pool [2004] QCA 43 Wheeler v FSS Trustee Corporation ATF First State Superannuation Scheme [2016] NSWSC 534 Ziogos v FSS Trustee Corporation as trustee of the First State Superannuation Scheme [2015] NSWSC 1385 Texts Cited: Enright & Merkin, Sutton on Insurance Law (4th ed), Vol 2 Category: Principal judgment Parties: Hannover Life Re of Australasia Limited (Appellant) Clinton Keith Robert Jones (First Respondent) United Super Pty Ltd (Second Respondent) Representation: Counsel: Mr J Sexton SC / Ms B Nolan (Appellant) Mr M Rayment QC / Mr M Gollan & Mr A Coombes (First Respondent)