Background
6 On 5 February 2015, the Civil and Administrative Tribunal of New South Wales (NCAT) published extensive reasons finding that, within the meaning of ss 5 and 149(1)(a) of the Health Practitioner Regulation National Law set out in the schedule to the Health Practitioner Regulation National Law Act 2009 (Qld) (as adopted and modified in New South Wales by s 4 and the definitions substituted and inserted in ss 139C-139E by the schedule to the Health Practitioner Regulation (Adoption of National Law) Act 2009 (NSW)), Mr Quach had engaged in unsatisfactory professional conduct and professional misconduct in the practice of his profession, and was likely to be detrimentally affected in the practice of medicine by reason of his narcissistic personality disorder (Health Care Complaints Commission v Quach [2015] NSWCATOD 2 at [419]).
7 NCAT adjourned the matter until 10 April 2015 to hear submissions on what orders it should make. On 21 April 2015, after a hearing on 10 April 2015, NCAT ordered that Mr Quach's registration as a medical practitioner be cancelled and prohibited him from applying to review the cancellation for seven years (Health Care Complaints Commission v Quach (No 2) [2015] NSWCATOD 32). NCAT based those orders on Mr Quach's impairment, being the narcissistic personality disorder, and numerous failings in his medical knowledge, diagnosis, treatment and patient inter-relationships. NCAT held that, because of those matters, he was incapable of practising safe medicine. Under the National Law, "impairment" is defined in s 5 as:
in relation to a person, means the person has a physical or mental impairment, disability, condition or disorder (including substance abuse or dependence) that detrimentally affects or is likely to detrimentally affect -
(a) for a registered health practitioner or an applicant for registration in a health profession, the person's capacity to practise the profession.
8 Any findings by NCAT in its reasons cannot be evidence in this proceeding of the existence of a fact in issue before it because s 91 of the Evidence Act 1995 (Cth) provides:
91 Exclusion of evidence of judgments and convictions
(1) Evidence of the decision, or of a finding of fact, in an Australian or overseas proceeding is not admissible to prove the existence of a fact that was in issue in that proceeding.
(2) Evidence that, under this Part, is not admissible to prove the existence of a fact may not be used to prove that fact even if it is relevant for another purpose.
9 The dictionary to the Evidence Act provides that "Australian proceeding" means "a proceeding (however described) in an Australian court", and, relevantly, "an Australian court" means:
(e) a person or body authorised by an Australian law, or by consent of parties, to hear, receive and examine evidence
10 The disciplinary proceeding before NCAT was such an Australian proceeding because NCAT was a body within the meaning in (e) of the definition of Australian court. Accordingly, s 91 provides that evidence of the decision or finding of fact by NCAT is not admissible to prove the existence of a fact that was in issue in the proceeding.
11 On 28 September 2015, MLC wrote to Mr Quach in response to a communication from him enclosing a claim form under the policy.
12 On 9 October 2015, Mr Quach completed and returned the claim form to MLC. The claim form stated that:
on 22 July 2009, Dr Jonathan Phillips had diagnosed him with impairment which had first shown symptoms on 7 January 2008;
Dr Phillips and Dr Andrew Petherbridge had diagnosed him having respectively impairment and narcissistic personality disorder that was severe and getting worse.
13 The claim form also included a report by Mr Quach's treating psychiatrist, Dr Yvonne Skinner, in which she wrote that:
she had not made a psychiatric diagnosis of Mr Quach, but that Dr Phillips, on a referral by the New South Wales Medical Board, had diagnosed an impairment in July 2009 which had placed limitations on Mr Quach's ability to practice;
Dr Petherbridge, on a referral by the New South Wales Medical Council, had diagnosed narcissistic personality disorder.
14 Dr Skinner also recorded answers to questions in the claim form as follows:
Q21: Are the patient's current symptoms impacting their ability to perform any of their usual work duties?
A: No, in my opinion.
She referred to the date of Dr Phillips' opinion of 22 July 2009 in answer to question 22, namely:
Q22: Did the patient stop working at any time?
A: Yes - ceased work for periods 2011 - 2014. Last day of work 11/08/04.
…
Q24: When do you expect the patient to return to full-time work?
A: Depends on legal proceedings.
Q25: Do you expect the patient to return to work in the future?
Yes.
Please advise when you expect them to be medically fit to return to work?
Depends on legal proceedings.
Q26: If the patient hasn't returned to work, are they currently able to return to restricted or limited to duties?
A: No, due to ongoing legal proceedings.
15 I admitted Dr Skinner's recounting of Dr Phillips' and Dr Petherbridge's diagnoses but limited their use under s 136 of the Evidence Act to evidence of a communication so that they were not evidence of any medical condition of Mr Quach of the kind described in Dr Skinner's report.
16 On 26 November 2015, Mark Forrest, a claims officer with MLC, telephoned Mr Quach to discuss his claim. A recording of the telephone call is in evidence. I have listened to all of its about 30 minutes. Mr Quach alleged that, in the call, MLC had breached its duty of utmost good faith under s 13 of the Insurance Contracts Act 1984 (Cth) by inquiring about the findings against him in the NCAT decisions. He said this was because Mr Forrest suggested that Mr Quach may not have complied with his duty of disclosure in 2005 when he completed his proposal for the policy. Mr Quach asserted that, at a late point in the conversation, Mr Forrest had become aggressive towards him. Having listened to the recording, I am satisfied that Mr Forrest did not become aggressive at any stage. No doubt, Mr Quach was feeling defensive after Mr Forrest had raised MLC's wish to investigate possible non-disclosure. Toward the end of the call, Mr Forrest said he would write to Mr Quach to specify what MLC was seeking, including its inquiries in respect of the possible non-disclosure. Mr Forrest told him that MLC could not process his claim until it had Mr Quach's response to what it required. Mr Quach told Mr Forrest that he had no choice. Mr Forrest replied that Mr Quach did have a choice between not replying, and thus not pursuing his claim, or authorising MLC to ask other doctors and bodies about his medical history. During the conversation, the following exchange occurred:
Mr Forrest: I need to find that information there because for our point of view if you had this condition prior to your claim coming up … because you haven't told us, you haven't disclosed any of this information to us when you completed your policy application. So we need to know exactly what that … the nature of those … those restrictions are, what the medical condition was at that time. So that's the reason why, because we need to …
Mr Quach: I think … I think … I think I answered that. I think Dr Skinner answered that, there was no medical condition. There was no medical condition back then. There's no medical condition now that they … that Dr Skinner can diagnose. It is unfortunate that they've used an illness against me. That … that's the whole thing. So there was no medical condition back then. There's no cond- … there's no condition now, but they …
Mr Forrest: Okay.
Mr Quach: … used a medical condition against me. Do you understand what I'm saying?
Mr Forrest: So the policy needs to be looked at and this is what we're going to do I'll put that in writing and stipulate who we're getting stuff from, what we need from you and if you choose not to pursue that or choose not to advise us or do anything until April, all that will do is delay any claims assessment from our point of view.
Mr Quach: Well I have no choice. I have no choice. You're [talking together].
Mr Forrest: Well you do [talking together] have a choice Michael, you can choose not to do it and not pursue the claim or you can choose sign it and let us do it and then we will just go ahead and do what we need to do. So, …
Mr Quach: Well you're ju- … oh … yeah, look … don't get agro on me I'm trying to …
Mr Forrest: I'm not … I'm not getting agro Michael.
Mr Quach: … I'm trying to … I'm trying to tell you that whatever it is that you're trying to use .. the information is now before the courts and I don't think that you or I …
Mr Forrest: Okay.
Mr Quach: … can make a determination before the court can. That's all I'm saying. So all I'm asking you to do is wait until the court proceedings are over and then I will call you and I will continue with the claim. I … that is really simple for both of us, because you're asking … you're asking me to disclose that information whether directly or indirectly. Okay. I can't do that. The court have … you know, the courts have ways.
Mr Forrest: Okay, alright … look I won't question you any more about this, because I just seem to be upsetting you and we both of us don't seem to be getting anywhere with this. I will send you some correspondence with that authority, telling what we're going to do and if you read that questions they will have all my contact details on there and I'll be more than happy to run through it with you Michael, okay.
(emphasis added)
17 Mr Quach has persisted in that untenable view throughout his engagement, or lack of it, with MLC and during this proceeding. That includes in failing to comply at all with orders that I made on 16 December 2020, that on or before 12 January 2021, he give discovery and simultaneous inspection of the medical reports to which he referred in the claim form, together with the medical reports referred to in NCAT's reasons. He has chosen not to provide MLC or the Court with medical evidence of any kind, except Dr Skinner's report in the claim form, that would be relevant to an evaluation of whether he was or is suffering from an illness causing his incapacity to practice medicine, which the policy covers.
18 Today, Mr Quach said that he had not referred to any medical reports in his claim form and did not, therefore, have to comply with that part of the order of 16 December 2020. He also asserted that he had legal advice that he did not have to produce anything to which the implied undertaking not to use a document produced under compulsion of a court order otherwise than for any purpose for which it was provided to him unless it was received into evidence: see Hearne v Street (2008) 235 CLR 125 at 131 [3] per Gleeson CJ, 154-155 [96] per Hayne, Heydon and Crennan JJ.
19 This, in part, explains the lack of any medical evidence, in terms of reports from practitioners establishing what, if any, illness Mr Quach may have had, the subject of his claim for total or partial disablement under the policy, in the context in which his own treating doctor said in her report in the claim form that he was not ill. The extensive use of the medical reports in evidence before NCAT, even assuming that it was a court in which the implied undertaking operated, made Mr Quach's assertion that he could not produce those reports untenable.
20 On 30 November 2015, MLC wrote to Mr Quach saying that it understood that his claim related to the narcissistic personality disorder referred to in the NCAT decisions and that his return to work depended on the outcome of his legal proceeding (the November 2015 letter). The letter referred to those decisions and NCAT's orders and said that, in light of those, it was unclear if Mr Quach was entitled to benefits under the policy. The letter attached a copy of his proposal and noted that it appeared to be inconsistent with information that by then was known. That information included that his application for registration as a medical practitioner had been deferred in 1998 due to concerns regarding his health. The letter asked for copies of the decisions of the Medical Board and Medical Council about his medical registration, including decisions made in 1998, 1999 and 2004, as well as any associated medical reports. In the alternative, the letter asked Mr Quach to sign and return to MLC a Government Information (Public) Access Act 2009 (Cth) application form so that MLC could obtain that material itself. MLC disclosed that it had also written directly to five doctors seeking information, including to Dr Phillips and Dr Skinner.
21 Mr Quach declined to respond to the November 2015 letter and has never provided such reports or permission.
22 On 15 February 2016, MLC wrote to Mr Quach. It said that it had not received any reply to the November 2015 letter and had closed his file, because it assumed he was not proceeding with his claim.
23 The next communication occurred on 30 April 2018, when Mr Quach wrote to the complaints department of MLC about the November 2015 letter. He said:
I would like to raise a complaint about the assessment of my income Protection and Disablement Claim. With respect, the letter from Mark Forrest dated 30 November 2015 is a "fishing" expedition and is illegal. Due to the actions of one psychiatrist, Dr Andrew Petherbridge, I am unable to earn an income as a doctor. I am making an income protection and disablement claim for the alleged disability, since 2008. With respect, the delay in assessing and withholding income protection payment is unacceptable.
24 On 28 May 2018, MLC responded. After outlining the absence of information in his claim, the letter identified the policy definitions for total disability, its conditions for payment and the amount of benefit to which an insured was entitled for each type of insurance in the schedule. It told Mr Quach that a claim would only be paid when MLC had proof that the events entitling the insured to payment of a benefit had occurred and that MLC could ask for further information to satisfy itself that the insured was entitled to benefit. The letter said that, by then, MLC had not received sufficient information to make a decision on his claim, noting that requests in its communications in November 2015 had gone unanswered, as a result of which MLC had written to him on 15 February 2015 advising that it had closed the claim. MLC wrote that, moving forward, it was willing to reopen the file and continue assessing his claim. It noted that all but one of the doctors that it had written to in 2015 had responded. It attached a new authority for release of further information for Mr Quach to complete and return. It also referred again to the 1998, 1999 and 2004 decisions affecting Mr Quach and sought information about those.
25 Mr Quach responded on 4 June 2018. He wrote that Mr Forrest had told him the claim had been assessed "due to the decision of" NCAT, but that there were ongoing matters involving the Court of Appeal of the Supreme Court of New South Wales. He asserted that there was some court order "by way of implied undertaking by all parties not to disclose court material." He asserted that MLC was not entitled to have access to the court documents it was seeking, and if need be he would seek court orders to prohibit MLC from embarking on a fishing expedition.
26 On 12 June 2018, MLC emailed Mr Quach saying that his concerns had been referred to an officer to consider. It told him that MLC was willing to assess his claim but required further information to assist in that assessment and that, if he was unable to provide the documents as requested because of ongoing court matters and they could not be disclosed, it may have to consider other means to access the information.
27 On 11 July 2018, Suzanne Oliver the senior in-house legal counsel of MLC wrote an internal opinion in which she stated that:
If Dr Quach did in fact suffer from narcissistic personality disorder and that is a sickness and that it was that sickness that caused the behaviour that constituted the professional misconduct, and that caused him to be unable to perform the duties of occupation, it is arguable that he may have been totally disabled.
(emphasis added)
28 Mr Quach interpreted that qualified opinion as some form of admission as opposed to it articulating a possible argument that might arise if Mr Quach could establish the premises, including that he actually suffered from a narcissistic personality disorder.