The Challenge

A small business owner in his mid-50s suffered catastrophic injuries when a vehicle crashed into his workplace.

The accident left him facing life-changing consequences and navigating a complex insurance claim process.

Key challenges included:

• • Severe injuries including a shattered pelvis, spinal fractures and broken ribs

• • Multiple surgeries and ongoing physical limitations

• • Significant psychological trauma following the accident

• • The forced sale of his long-running business

• • A TPD claim lodged through his superannuation that was being questioned by the insurer

Despite extensive medical evidence already available, the insurer focused primarily on a single medical assessment of whether the client retained physical ability, requesting further medical assessments rather than fully considering the broader impact the accident had on his life, family and ability to work.

The Solution

Recognising the claim had become highly focused on specific medical assessments, the Steadfast Life team worked closely with the client’s solicitor and barrister to step back and reassess how the case was being evaluated.

Drawing on deep claims experience and a shared commitment to advocating for the client, the Steadfast Life team collaborated to present a clearer and more complete picture of the client’s circumstances.

This included:

• • Working with the client’s legal team to align on a clear and consistent strategy to strengthen the claim submission

• • Bringing together the medical evidence and preparing a comprehensive submission that addressed the insurer’s concerns while highlighting the broader reality of the client’s situation

Importantly, the matter was escalated by Steadfast Life leadership through the insurer’s internal review processes, resulting in the case being referred for a follow-up review by the insurer’s Chief Medical Officer.

The Outcome

Following the review, the insurer reassessed the claim and approved a $500,000 Total and Permanent Disability payment.

For the client, the outcome provided vital financial stability after the loss of his business and the significant life changes caused by the accident.

More importantly, it ensured his circumstances were recognised in full and not reduced to a single medical test.

When life didn’t go to plan, having the right advocacy helped keep things on track.

 

This case study is provided for general information purposes only and does not take into account your objectives, financial situation or needs. The outcome described is specific to the client’s individual circumstances and should not be taken as an indication of future outcomes. Policy terms, conditions and eligibility criteria apply.