MetLife Insurance Limited v MX [2019] NSWCA 228

Court of Appeal Supreme Court New South Wales Medium Neutral Citation: MetLife Insurance Limited v MX [2019] NSWCA 228 Hearing dates: 8 March 2019 Date of orders: 16 September 2019 Decision date: 16 September 2019 Before: Meagher JA at [1]; Gleeson JA at [2]; Payne JA at [165]. Decision: (1) Grant leave to appeal.

(2) Direct the appellant to file a notice of appeal in the form of the draft in the White Book within 7 days.

(3) Appeal dismissed.

(4) Appellant to pay the first respondent's costs in this Court.

(5) Order that in relation to these proceedings, the first respondent be referred to only by the pseudonym "MX".

(6) Pursuant to Court Suppression and Non-publication Orders Act 2010 (NSW), s 7, and on the ground specified in s 8(1)(c), prohibit for a period of 50 years the disclosure of the identity of the first respondent, or any information tending to reveal his identity, by publication or otherwise in Australia. Catchwords: SUPERANNUATION – accident and sickness insurance – benefits for disablement – where benefits insured under group life policy – benefit for "total and permanent disability" – where insurer declined claim twice – where the insurer's second decision took into account its first decision – whether insurer took into account irrelevant consideration – whether insurer in breach of its contractual duty – whether insurer acted reasonably and fairly in its consideration of the claim Legislation Cited: Court Suppression and Non-publication Orders Act 2010 (NSW), ss 7, 8(1)(c), 11 Supreme Court Act 1970 (NSW), s 103 Cases Cited: Chammas v Harwood Nominees Pty Ltd (1993) 7 ANZ Ins Cas 61-175 Edwards v The Hunter Valley Co-op Dairy Co Ltd (1992) 7 ANZ Ins Cas 61-113 Halloran v Harwood Nominees Pty Ltd [2007] NSWSC 913 Hannover Life Re of Australasia Ltd v Jones [2017] NSWCA 233 Hannover Life Re of Australasia Ltd v Sayseng [2005] NSWCA 214; (2005) 13 ANZ Ins Cas 90-123 Kuru v State of New South Wales (2008) 236 CLR 1; [2008] HCA 26 MetLife Insurance Ltd v Hellessey [2018] NSWCA 307 Metlife Insurance Ltd v RGA Reinsurance Company of Australia Ltd [2016] NSWSC 980 Metlife Insurance Ltd v RGA Reinsurance Company of Australia Ltd [2017] NSWCA 56 Newling v Metlife Insurance Limited [2019] NSWCA 149 Nile v Club Plus Superannuation Pty Ltd [2005] NSWSC 55 Rapa v Patience (Supreme Court (NSW), McLelland J, 4 April 1985, BC850088, unrep) TAL Life Ltd v Shuetrim; MetLife Insurance Ltd v Shuetrim (2016) 91 NSWLR 439; [2016] NSWCA 68 Ziogos v FSS Trustee Corporation as Trustee of the First State Superannuation Scheme [2015] NSWSC 1385 Category: Principal judgment Parties: MetLife Insurance Limited (Appellant) MX (First Respondent) FSS Trustee Corporation as Trustee of the First State Superannuation Scheme (Second Respondent) Representation: Counsel: Mr J E Sexton SC / Mr S J Walsh (Appellant) Mr R A Cavanagh SC / Mr M Best (First Respondent) Mr S Drummond (Solicitor) (Second Respondent)