||All England Reporter
|| All ER (D) 555 (May)
|| EWCA Civ 852
||Court of Appeal, Civil Division
Rix and Arden LJJ
||Simon Edwards (instructed by Palmers, Basildon) for the claimant.
||Edward Pepperall (instructed by Lee Crowder, Birmingham) for the defendant.
||14 May 2002
Contract - Terms of employment - Construction - Claimant a member of defendant's health insurance scheme - Claimant incapacitated after suffering injury at work - Defendant paying claimant benefit under health insurance scheme - Defendant's insurers refusing to continue payment of benefit - Insurers alleging claimant not totally incapacitated - Judge finding terms of health insurance scheme as incorporated in employee handbook precluding payment of benefit without total incapacity - Whether alternative terms of scheme contained within leaflet - Whether defendant estopped from defending claim - Whether claim an abuse of process.
In the instant case, the judge had been entitled to find that an employee's handbook had incorporated the terms of a permanent health insurance scheme, rather than a leaflet, and that the definition of total disablement in the handbook rendered the insurance scheme an any occupation scheme, rather than a normal occupation scheme as suggested by the leaflet, so that the claimant, who was not incapable of any work, would not be entitled to benefit under the scheme.
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