The Court of Appeal has dismissed Damien Murphy’s appeal against the striking out of his breach of contract proceedings against Canada Life Assurance Ireland Limited and Irish Life Assurance plc. It upheld the High Court’s decision that the proceedings disclosed no reasonable cause of action because the dispute had already been determined by the Financial Services Ombudsman (FSO) and Murphy had not appealed that decision.
Murphy had held an income protection policy with Canada Life from May 2002. After a January 2010 road traffic accident left him unable to continue working as a taxi driver, he claimed under the policy. Canada Life initially paid €632 a month, based on his 2009 earnings. Murphy said he should have received about €800 a week. Following a medical examination in September 2011, Canada Life stopped payments, concluding that he no longer met the policy’s physical health criteria.
The FSO rejected Murphy’s complaint on 11 June 2012. It relied on two medical reports and concluded that it was reasonably appropriate for Canada Life to decide that he no longer met the policy’s disability criteria. The FSO decision was binding on the parties, subject to an appeal to the High Court within 21 days. Murphy did not appeal.
He began the later High Court proceedings against Canada Life in February 2015, seeking damages for breach of contract. The Court of Appeal judgment said his pleadings traversed the same ground as his FSO complaint. Canada Life sought to have the case struck out as an abuse of process.
Delivering judgment on 4 May 2016, Mr Justice Gerard Hogan said a claimant generally could not take an unsuccessful complaint to the FSO and then re-litigate the same matter in the High Court through separate proceedings. He referred to the statutory binding effect of FSO findings, subject to appeal, and to earlier High Court decisions applying res judicata to Ombudsman determinations. Hogan J noted that the rule might have exceptions, but said it was unnecessary to consider them in this case.
The appeal concerned the strike-out, not a fresh assessment of the medical evidence or a new decision on the policy claim. The Court of Appeal concluded that the High Court was correct to strike out the proceedings as disclosing no reasonable cause of action and dismissed the appeal.