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A TPD Claim is a ‘total and permanent disability' claim. Often it is part of your superannuation, or you may have a specific insurance policy that covers you for total and permanent disability.
If you are unable to work due to an injury or illness and you have total and permanent disability insurance, you can make a claim to your insurance fund for a lump sum payment.
If you have had an injury or you have been diagnosed with an illness and you can no longer do the type of work you have always been able to do – but you may be able to work in a different occupation – if you have total and permanent disability insurance, you may be able to make a claim.
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For more information, please refer to our client library and read ‘What is a TPD Claim?’ among other helpful articles and infosheets.
You can download the PDF here.
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The dates you are injured or diagnosed with an illness, and the date a doctor confirms that you are permanently impaired, are very important. They are important because they determine who the relevant insurer is and the extent of your insurance cover. Also – if relevant, these dates determine if an exclusion contained in the policy applies to you.
Dates can be very important. They may end up determining whether the application is initially accepted.
We always recommend you have a lawyer prepare your application/claim. This ensures dates (and information submitted with your application) are carefully considered.
For more information on TPD Claims, please refer to our website.
These are the steps we follow when lodging a TPD (Total and Permanent Disability) claim for our clients.
We Identify if you have TPD (Total and Permanent Disability) Insurance.
TPD Insurance can be held through your superannuation or as a separate policy outside of your super fund.
You can check whether you have TPD insurance by reviewing your annual statement or contacting your superannuation fund directly.
If you hold TPD insurance with more than one fund, we may be able to make multiple TPD claims.
We Identify whether you are eligible to make a claim.
We need to consider the following:
We request the TPD claim documents from your insurer.
We are finding that insurance companies can be quite uncooperative when claim forms and information are requested. Letters from insurance companies responding to our requests are often written in a manner that is confusing and complex, and sometimes suggestive that the claimant doesn’t have TPD cover. If a claimant didn’t have a lawyer, they could be very put off by this and probably do nothing further.
We complete claim documents and gather evidence.
Usually, the following needs to be provided:
It is very important to have a lawyer at this stage. If you make this claim yourself, you may include or exclude information that may result in your claim being rejected.
The Insurer will assess your claim documents. During this time, the Insurer may ask for further information.
The Insurer makes a decision.
The Insurer’s decision is referred to the Trustee of the superannuation fund for review.
If your claim is accepted, your TPD insurance will be paid into your superannuation account.
You will need to decide how much money you would like to withdraw, and you will be required to sign withdrawal documents.
It is very important to obtain formal financial advice about whether or not you should withdraw some or all of the money, or to leave all of the money in your super fund, or to roll it into another super fund.
Your claim is finalised.
Your Claim is Rejected.
If your claim is denied/rejected by both the Insurer and the Trustee, you will be provided with the reasons for the rejection.
Once you know why the insurer rejected your claim, you may have the following options:
Total and Permanent Disability Claims can be complex and overwhelming. There is a lot of evidence to be gathered and information to be provided in the process of making a claim.
A lawyer assists with the process and in understanding the details of the contract (of insurance) between you and the insurance company (Superfund). Your lawyer can give you advice about the interpretation of the insurance terms. Terms can be complex.
Superannuation Funds and their Insurers often make the process difficult, so having a lawyer who is experienced with TPD claims, will assist you in understanding what you are required to provide in order to have your claim accepted. A lawyer can also advise about your rights/options if your TPD claim is rejected.
When you lodge a TPD claim, what you put in the application is very important and may determine whether the application is initially accepted. It is critical to have a lawyer early on in the process.
O’SheaDyer Solicitors have experienced lawyers who work exclusively in this area of law.
Ask us about our no win no fee conditions for TPD claims. We offer personalised service. We would love to help you.
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Ivan Baxter
Tyla Leo
Sam Stewart
Bridget Barrie