Woman sues over alleged failure to pay income-protection payments

A woman has sued over an alleged failure to pay out income-protection payments under an insurance policy after she suffered serious pain. Rose Prendergast was about 51 when she had to cease working at Baxter Healthcare's plant in Castlebar, Co Mayo, in 2002 due to health problems, including pain in her leg, back and neck, the High Court heard.

She was diagnosed with fibromyalgia (FM), a medical condition characterised by chronic widespread pain. Ms Prendergast was never able to return to work and, in an agreement with the company in 2008, her employment was terminated. She claimed benefits under the terms of a group income protection plan which Baxter had with Irish Life.

In her High Court proceedings against Baxter Healthcare and Irish Life Insurance, she claims her application to be paid under the terms of that group policy was refused. Ms Prendergast (64), Clogher, Claremorris, Co Mayo, claims she is entitled to be paid under the scheme.

John Jordan SC, for Ms Prendergast, said she was seeking orders for specific performance of Baxter’s income-protection plan which was underwritten by the insurer. She is also claiming damages for alleged breach of contract and misrepresentation. The claims are denied.

Gabriel Gavigan SC, for Baxter, said Ms Prendergast had no claim against his client which, he said, did everything it could to process her claim under the income protection plan. The decision refusing her claim was made by the insurer and Baxter had no hand, act or part in that.

Baxter has also sought to be indemnified by Irish Life against any finding in favour of Ms Prendergast. James Devlin SC, for Irish Life, denied any negligence in rejecting Ms Prendergast’s claim. The court was also told a report compiled on the insurer’s behalf by a healthcare professional suggested she had exaggerated her symptoms.

In his arguments, Mr Jordan told Mr Justice Donald Binchy that medical evidence showed his client suffered from chronic pain and other conditions and was not able to return to work in any capacity. She did not exaggerate her illnesses and the insurers based their claim that she had exaggerated her complaints on one report by an osteopath who conducted a functional evaluation test on his client in 2005, he said.

This was a case where an award of exemplary damages should be considered by the court, he argued. His client was entitled to payment and the refusal to pay out her claim was “utterly unfair” and “utterly unjustified by people and corporations who ought to have known better, and perhaps did know better”.

The defendants had thought Ms Prendergast, who lives on a small farm with her husband in the west, could not take them on, Mr Jordan argued. These entities had refused “a valid claim” so as to increase their profits at the end of the year.

In evidence, Ms Prendergast said she remained in pain and required medication. She had started working at Baxter in the early 1990s, first experienced problems in the mid-Nineties and had to stop in 2002 due to the pain. She said she was unable to do many of the things she was once able to do and was thankful for the support given to her by her husband and family.

The case continues.