Frederick Simpson successful at trial
In Djan v Metlife Europe DAC Recorder Halford found that the claimant Mr Djan did not meet the criteria for the ‘total permanent disablement’ cover of an accident insurance policy. In so finding, the court followed the approach to such policies set out in Napier v Unum Ltd [1996] 7 Med LR 349 (Tuckey J), in which it was held that (1) if there is a challenge to the insurer’s ‘vouching’ requirements (i.e. the evidence which the insurer requires the policyholder to provide in support of their claim), the question is whether those requirements were reasonable; but (2) if the challenge is to the insurer’s evaluation of the evidence, it is for the court to make its own assessment of whether or not the evidence shows that the policyholder satisfies the relevant policy criteria. The court is therefore not simply asking whether the insurer acted reasonably or in good faith in evaluating the evidence.
Frederick was instructed by Alaina Wadsworth and Kristyna Muhlfeitova at CMS Cameron McKenna Nabarro Olswang LLP.
