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Dunedin insurance broker ordered to pay Asteron $371K

A Dunedin insurance broker who claimed he was too sick to work - while splashing out on luxury cars, a new home and overseas trips - has been ordered to repay more than $370,000 in income insurance payouts.

Wednesday, May 15th 2019, 6:58PM

Peter Taylor had lodged a High Court claim against his insurer, Asteron Life, after the company stopped making payments amid unanswered questions about his finances.

Asteron then lodged a counter-claim, seeking reimbursement for payments made to Taylor over four years.

In findings favouring the insurance company, Justice Cooke outlined how Taylor had spent significant sums on a new holiday house at Karitane, two Mercedes Benz coupes and trips to the Pacific, all while relying on insurance payments from Asteron.

His spending included a ''well over'' $700,000 new holiday house at Karitane, which Taylor argued was necessary because his illness meant he could no longer travel regularly to another home in Wanaka.

The purchase of two luxury vehicles - a new 2010 Mercedes Benz SL400 Coupe and a used 2012 Mercedes Benz C63 Coupe - cost him $185,000 and $194,000 respectively.

Taylor also spent money on overseas travel, including to Hawaii, a flight of some 12 hours, made despite his claims ''extreme back pain'' inhibited his ability to remain seated for work.

The court heard Taylor was a self-employed insurance broker when, in 2010, he lodged an income protection claim with Asteron.

Taylor claimed he had been too ill to work since December 2009, and Asteron accepted the claim and began regular payouts.

Then, in 2014, the company sought additional financial information from Taylor, including clarification of payments totalling $551,491 which were passing through a separate set of accounts associated with him.

When Asteron declined to make further payments until the matter was clarified, Taylor initiated High Court proceedings in December 2015.

In his claim, he outlined his medical conditions, including bone cancer, a radiation burn from treatment and two cases of meningitis, among other issues, but no medical evidence was called in court.

Under his policy, Taylor qualified for total disability payouts if he worked no more than 10 hours a week.

However, evidence to the court suggested Taylor remained ''actively involved'' in his business, working an average of four hours a day from home or in his office, and on other business ventures.

The income he received had remained ''essentially unaffected'', pushing him beyond the limits set for total disability payments.

Taylor's answers to questions about this were also deemed ''unreliable, and at times not credible'', and he was not totally disabled, Justice Cooke concluded.

His accounts had shown large losses - of up to $75,301 a year - during the period, but a separate set of accounts, unearthed during the court discovery process, recorded profits of up to $166,013 a year.

Justice Cooke concluded the profitable accounts had been deliberately changed to create a second ''false'' set of accounts that removed ''significant'' revenue streams to ensure losses were booked.

Justice Cooke was ''simply not in a position'' to know who created the false accounts, but the accurate ones confirmed Taylor was not entitled to a payment from Asteron.

Asteron, in its counterclaim, sought reimbursement for its payouts, arguing Taylor had breached his ''obligation of good faith''.

Justice Cooke agreed, dismissed Taylor's claim, upheld the counterclaim by Asteron, and ordered Taylor to pay the company $371,286.70.

Court costs and interest payments would be determined later.

- Otago Daily Times

Tags: Asteron Disability insurance

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