Formerly a partner at Tauranga law firm Sharp Tudhope, Darryl Fletcher’s continued entitlement to insurance payments for ‘total disablement’ following a 2011 head injury are dependent upon his agreeing to further medical examination from specialists nominated by insurer Resolution Life, the High Court ruled. Mr Fletcher has resisted Resolution’s demands, arguing he cannot be forced to comply and reports from his own medical advisers are sufficient.
Resolution Life Australasia, formerly known as AMP Life, inherited Mr Fletcher’s case file after its 2017 buyout of National Mutual.
Staff questioned why Mr Fletcher was still receiving monthly disability payments for what was described in 2011 as a mild head injury suffered in a rugby game. The usual prognosis is that any issues would resolve within three to six months.
Statutory insurer Accident Compensation stopped compensation payments to Mr Fletcher one year after the accident.
Mr Fletcher’s ongoing payments from what is now Resolution Life arose from a group insurance policy benefitting Sharp Tudhope’s partners through its membership of the Lawlink national network of law firms.
In 2019, Resolution stopped its monthly payments to Mr Fletcher. This led to a High Court dispute over wording of Lawlink’s insurance cover.
Mr Fletcher argued Resolution’s contract was with Lawlink; he was merely the beneficiary of this contract.
Contract wording meant Lawlink had to provide all relevant information; this wording did not apply to him, he said.
Mr Fletcher claimed he was under no obligation to be assessed by head injury specialists nominated by Resolution. Ongoing evidence provided by his own specialist should suffice. This evidence indicated Mr Fletcher continues to suffer difficulties in concentrating for long periods of time.
Justice Johnstone ruled Lawlink’s provision of information necessarily required Mr Fletcher to assist by attending medical examinations. Provision of medical records and attendance for additional medical examinations are a ‘condition precedent’ for ongoing payment of monthly disability benefits, he said.
Resolution need not resume payments while Mr Fletcher refuses to attend medical appointments set by the insurer, Justice Johnstone ruled.
This ruling does not decide whether Mr Fletcher still qualifies for ongoing ‘total disability’ payments. That is an issue to be decided by medical assessors.
Fletcher v. Resolution Life Australasia Ltd – High Court (14.02.25)
25.066