The claimant appealed refusal of his claim under a Personal Retirement Policy. The issue was as to his right to a waiver of contributions benefit from inception or at all. He had been a dentist, but suffered an injury which became progressively more disabling. The judge found this to be a congenital condition combining with his work to produce the disablment.
Held: The clause was ambiguous. ‘it should be construed, so far as necessary, against the respondent as proferens and in favour of the policy holder. It follows that the judge was wrong to hold that the TOS could not be a condition within the meaning of the definition. ‘
Judges:
The President (Dame Elizabeth Butler-Sloss) Lord Justice Clarke Lord Justice Sedley
Citations:
[2004] EWCA Civ 192
Links:
Jurisdiction:
England and Wales
Citing:
Cited – Hayward v Norwich Union Insurance CA 22-Feb-2001
An insurance policy which exempted the company from liability when a car was stolen was phrased to apply ‘while the keys had been left in the car’ The claimant had been subject to a robbery whilst in the car, and been obliged to get out. The car was . .
Cited – Investors Compensation Scheme Ltd v West Bromwich Building Society HL 19-Jun-1997
Account taken of circumstances wihout ambiguity
The respondent gave advice on home income plans. The individual claimants had assigned their initial claims to the scheme, but later sought also to have their mortgages in favour of the respondent set aside.
Held: Investors having once . .
Cited – Cook (A P ) v Financial Insurance Company Limited HL 18-Jun-1998
The claimant sought payment under his insurance policy for a disability. The insurance company declined to pay, saying the injury predated the policy. He was a runner, but had had episodes of breathlessness and angina.
Held: He had visited his . .
Cited by:
See Also – Malekout v Secretary of State for Health Admn 10-Dec-2004
The claimant had been a dentist. He was eligible for a health service injury allowance, having ceased to be employed because of an injury. He appealed a finding that he was entitled to benefit calculated only on the average of his emoluments . .
Lists of cited by and citing cases may be incomplete.
Insurance
Updated: 10 June 2022; Ref: scu.194135