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NSW Life Insurance TPD Claim Concerns

Discussion in 'Insurance Law Forum' started by Joe1979, 11 March 2015.

  1. Joe1979

    Joe1979 Member

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    Hi, Have recently lodged a TPD claim on a no win no fee basis. Got a few things playing on the back of my mind and was wondering if i could get some clarification on them.

    Background: i was diagnosed with cardiomyopathy 1.5 years back, I went back to work not long after i was discharged from hospital but found it extremely difficult to carry out the work at hand due to my diagnosis and symptoms. After approx. 2.5 months of struggling with day to day duties, taking excessive sick days, turning up late and leaving early on a regular basis, i decided i couldnt do it anymore. It just so happened that the company i worked for was undergoing a restructure at the time and was offering volantary redundancies. Due to my health i felt i had no other option but to take up the offer for redundancy after 21 years service. Doctors have agreed that I can no longer carry out my old duties due to my condition

    At the time i had no idea that i may be entitled to income protection or a tpd claim, unfortunately i found this out later. If i had known i would have not gone the path i went but thats a different story.

    Now to my questions:

    1: The lawyers I engaged have taken nearly 8 months just to prepare and submit my claim! None of this delay was caused by documents i needed to provide from my end eg doctors reports specialist reports etc! Everything i needed to provide was done within 3 weeks! I kept phoning and emailing trying to get answers but always came back dissatisfied. Should i be concerned with this time frame? If it took that long just to prepare what about the remainder of the claim? Am i just a fill in case?

    2: I was advised that i would still be entitled to claim Income protection and the claim was submitted to include i.p. Even though the life insurance policy clearly states that as soon as employment ends so does the i.p. Insurance. Am i just being led astray with this advice? Not sure why they would do this but it seems awfully fishy to me.

    3: I have since read by many other tpd lawyers etc that the insurance company should make a decision within 3 to 4 months yet i have been advised it will take 6-12 months for a decision or longer? Surely its in the firms best interest to push for an outcome asap so that they get paid sooner. Why the difference in timeframes from firm to firm. Is this some type of plan to delay the outcome to incur further costs to me

    4: It has also been bought to my attention recently that some no win no fee firms, always push there clients to accept settlement offers that aren't reasonable due to the fact that this would still be classified as win. This forces the client into a position where if they accept or don't accept they are still liable for charges to the firm. Is there any truth to this?

    5: I have asked my firm on two occasions now, what is the strength of my case and how does it fair? Both times they have refused to give a clear straight forward answer. Rather they have basically just shun the question and given a very broad answer not at all specific to my case. Is this the norm??

    Thankyou for your time in advance.
     
  2. Ivy

    Ivy Well-Known Member

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    If you are concerned about the behaviour of your solicitor/s you can make a complaint to the NSW Office of the Legal Services Commissioner: http://www.olsc.nsw.gov.au/olsc/lsc_complaint/olsc_making_complaint.html

    The office recommends that you call them (contact details in the link) before making the formal complaint. Additionally, you could contact your solicitor again, state your concerns and the information you have found out and ask them for a formal written response because you are considering making a complaint to OLSC.
     
  3. Joe1979

    Joe1979 Member

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    Hi Ivy,

    Thanks for the informative response I will keep it in mind. However I'm not really sure if the above warrants a complaint or not. It may be just me over thinking things. Just trying to workout if the above is the way things roll within the legal industry or if I have drawn a short straw.

    regards
     
  4. TPD_Awareness Australia

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    Decision are made within 3-4 months and usually this is a decline of the claim on the basis you do not meet the criteria of TPD. This is when you need to argue the finer details of TPD which is detailed arguments around the last day worked, 6 months after the last day worked and medical evidence in this period. Also date of injury and pre exisiting injuries come into play.
     

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