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Case Reports - Civil Law Disclosures and insurance policies We recently acted for a former self-employed plumber M, who injured his left ring finger in 1990. AMP paid M under his disability insurance policy for three months before it cancelled his policy on the basis of alleged non-disclosure of his medical history and misrepresentations regarding his pre-accident income. A private firm took the case to the District Court, seeking payment of the full benefit for two years, and after that time, a benefit for the difference between his old and new incomes. The matter eventually became too difficult for the private firm which dumped M, who then approached us at Parramatta office. AMP was represented by Mallesons. M claimed that when he was completing the application for the AMP agent told him to disclose only his “serious injuries such as fractures". He admitted to having had a broken leg but left out the little things such as a sore shoulder, strained neck muscles, twisted left knee, sinusitis and rubella infection. AMP relied on his “non-disclosure” to deny liability. His Honour, Judge McGuire, sitting in the Sydney District Court, found M's version to be more reliable than the AMP agent's. He found that it was "arrant nonsense that any experienced insurance representative would not have been completely aware" that M, a 32 year old self employed tradesman at the time, would have failed to state all of his injuries. His Honour also said that "any modestly intelligent underwriter or AMP doctor would have been fully aware that M had not revealed every illness etc." In relation to AMP's chief medical officer, His Honour found that "he had rarely heard such an unimpressive witness and I simply do not accept what he told me." His Honour awarded M $22,000 contract damages plus $21,000 interest, for a verdict of $43,000. The party/party costs bill is $62,000. Back to full list of case reports |
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