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Injured Worker Turns to TPD Experts at Taylor & Scott When Claim Rejected

Injured Worker Turns turns to Taylor and Scott After Claim Rejected

Recently, Michelle Meigan, Senior Associate and expert in TPD claims here at Taylor & Scott, acted for a client who had attempted to make a TPD claim by himself without legal assistance. Michelle’s client had suffered a very serious injury to his back when he had worked in the construction industry. He had been required by his employer to carry very heavy loads up several flights of stairs on a building site when a crane that usually did the heavy lifts wasn’t available.

As a result of the injury to his back, our client spent years being treated by the medical profession. He underwent physiotherapy, epidural injections into his back and was prescribed very serious drugs to help him deal with his pain. Eventually, he came under the care of a Neurosurgeon who performed a spinal fusion on his back. At first, there was great hope that the unrelenting pain would resolve but as time went on, the pain in his lower back returned. As well as suffering the pain in his back, he suffers pins and needles in his leg. He is unable to sit or stand for any length of time. Lifting, carrying, playing with his children and helping his wife around the home are all too much for him to cope with. His days of working in the construction industry are well and truly over.

Having done everything he could to return to gainful employment, he eventually came to the conclusion that in all likelihood he will never be able to work again. Needless to say, this has devastated him psychologically and whilst his wife is very supportive and works part-time, the prospect of not having a pay packet every week has had a serious effect on him.

Faced with the prospect of financial ruin, he turned to his superannuation fund to see if he could claim under total and permanent disability (TPD). He believed he satisfied the definition of TPD. He completed the forms and asked his doctor to complete a medical report. He then submitted his claim to his superannuation fund. The fund sent his claim off to the insurer. Eventually, the insurer rejected the claim saying that although he had spent many years in construction, he had once worked in a club environment and was therefore capable of working as a club manager or supervisor. Being completely devastated by this response and knowing that the insurer was being totally unrealistic, he turned to Michelle Meigan here at Taylor & Scott for advice and assistance.

HOW TAYLOR & SCOTT HELPED WITH THE TPD CLAIM

Michelle met with her client on numerous occasions. She carefully prepared a very detailed work history. She obtained medical reports from all of her client’s treating doctors. She then qualified an eminent doctor specializing in Occupational Medicine to examine her client and provide an opinion. Following his examination, the doctor provided the medical report which concluded that Michelle’s client had a “failed back surgery syndrome”. He was in constant pain, could not tolerate prolonged sitting or standing, had sleep disturbance and at times his pain was unbearable.

Finally, the specialist concluded that having regard to his education, training and experience, Michelle’s client was not fit for any work for which he is reasonably fitted by his education, training and experience. The doctor also specifically turned his mind to Michelle’s client working as a club manager or in some other occupations suggested by the insurer. The specialist doctor opined that Michelle’s client did not have the capacity to perform the duties that had been suggested.

Having provided this further evidence to the insurer, surprisingly the insurer still rejected the claim. Michelle advised her client that he should issue proceedings in the Supreme Court of NSW seeking a declaration that he was totally and permanently disabled as defined in the insurance contract.

RESULT OF COURT ACTION

We are very pleased to report that the matter came to a settlement conference at which Michelle was able to secure a very satisfactory settlement of her client’s TPD claim ensuring that her client had the added financial security of the TPD payout.

TAYLOR & SCOTT’S OFFER TO YOU

If you have a TPD claim which you have submitted and which has been delayed or rejected by the insurer, you are welcome to contact Taylor & Scott’s expert team of TPD lawyers. Our TPD team will review your claim with you at a free case assessment. If we take your claim on, we will act on a no-win/no-pay basis, meaning you do not pay Taylor & Scott any costs whatsoever unless and until you win your claim.

Our TPD expert lawyers will do everything they can to ensure that the best evidence available is obtained on your behalf in the expectation that you will receive maximum compensation under your TPD insurance policy. Please phone us on 1800 600 664 or email us at info@tayscott.com.au.

At Taylor & Scott, We Care For You.