Insurance battle: ‘They won’t pay up because I have arms’
A FAR North commercial fisherman has claimed an insurer refused to pay out his life insurance policy because his arms were only seriously injured, not amputated, despite having lost the use of both of them in a work accident.
Michael Taifalos, 61, who worked alternate seasons as a diesel fitter and fisherman, tore both rotator cuffs in his shoulders attempting to lift a large block of ice onto a boat after catching 400kg of mackerel on a fishing trip in July 2015.
The self-employed grandfather-of-six said he took out a personal insurance policy with MLC Limited in 2004 and had been paying around $1000 a month.
But he and solicitor Adam Tayler, from Turner Freeman Lawyers, claimed the insurer has refused to pay out because Mr Taifalos still has his arms, even though he cannot use them.
"I've got these arms that just sort of hang beside me," he said.
"I can't even pick (my grandchildren) up.
"The pain really builds up at night.
"It's horrendous. It's relentless, it does not stop.
"I wake up in the morning and all I can think of is pain."
Mr Taifalos, who lives at Kurrimine Beach, has not been able to work since his injuries.
He has filed documents in the Cairns Supreme Court suing the insurer, accusing them of refusing to pay out the accidental injury claim, for more than $930,000, plus at least $40,000 in damages.
In an extract of the alleged policy in the documents, it said the insurer would pay out a maximum of $2 million for various injuries including the "loss of the use of both hands".
Solicitor Mr Tayler said many self-employed people took out life insurance.
"His arms are basically hanging from their sockets," he said.
"(We will allege) it goes against the spirit of the policy."
Mr Taifalos said he felt the insurer "promised the world and I was basically given the atlas".
An MLC Life Insurance spokesman said they could not comment on the matter as it was before court.
The insurer is yet to file any court documents and a court date is yet to be set.
THE STORY SO FAR
■ The former diesel fitter and fisherman tore both rotator cuffs in his shoulders attempting to lift a large block of ice onto a boat after catching 400kg of mackerel on a fishing trip in July 2015.
■ Took out a personal insurance policy with MLC Limited in 2004 and had been paying about $1000 a month.
■ Claims the insurer is refusing to payout.
■ Taking Cairns Supreme Court action and suing for more than $930,000.
Originally published as Insurance battle: 'They won't pay up because I have arms'