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Total and Permanent Disability

What is a TPD Claim?

Severe illness or injury can strike at any time and in the most unexpected of ways.

Total and Permanent Disability (otherwise known as TPD) can happen despite medical treatment and rehabilitation, and it can be physically, mentally, and financially devastating. It can also severely impact your loved ones who may rely on your income, or who may need to care for you.

While nothing can make up for the physical and mental impact of TPD, sometimes you can make a disability claim on an insurance policy.

Even if you don’t have TPD cover, sometimes you can also make a superannuation claim. When you’re dealing with bad news, the good news is that we can help you.

How do I qualify for a TPD insurance claim?

An insurer may accept a TPD claim if your injury or illness is so severe that you can no longer work in any job to which you are suited. They may also accept a claim if you can no longer perform basic living tasks, for example, dressing, bathing, or grocery shopping.

Many superannuation policies provide TPD insurance cover. If your super doesn’t have separate TPD insurance, your fund may approve the early release of superannuation on compassionate grounds.

 

If you have separate cover for life insurance or income protection insurance, TPD is usually part of your cover, and we can assist you in making a claim.

Usually, there’s a waiting period before the insurer or superannuation fund decides whether to accept your claim. They will often do so if there’s evidence (for example, medical reports) showing that your disability is so severe that it’s unlikely you’ll work again in any job to which you’re suited.

It’s complicated to work out which jobs may suit. We recommend that you contact us for expert legal assistance.

Need advice? Just ask us a question

What can I claim for TPD?

TPD pay-outs are usually lump sum amounts.

There aren’t separate payments for medical expenses, lost earnings and other items. In assessing your claim, the insurer or superannuation fund will look at various elements, including:

  • The terms of your insurance cover, particularly if there are any exclusions
  • The circumstances of your injury
  • The evidence of your injury, including medical reports
  • Whether there is evidence that your injury is permanent
  • Whether your injury is likely to worsen or has stabilised
  • Whether you are permanently unable to perform work to which you’re suited
  • Whether you have served any waiting period required by the policy
  • Whether you have worked for your employer for a minimum period (as set out in the policy)

What kind of legal fees should I expect?

Your first interview will be free.

If we believe that your claim is likely to succeed, we may offer you a no-win, no fee arrangement.

You’ll only pay our fees if your insurer accepts and pays your claim. This arrangement doesn’t include disbursements, which are out-of-pocket expenses such as fees for doctor’s reports, photocopying and other charges. If you can’t afford to pay our disbursements, we can arrange funding through a third party.

The aim of our no win no fee arrangement is to give you peace of mind that you may secure a lump sum payment without worrying about whether you’ll be able to pay your legal bill.

We also act on a fixed-fee basis so you will have the comfort of knowing what you will pay (if successful), right from the start of your claim.

Need advice? Just ask us a question


How long will it take to resolve my TPD claim?

As with other injury claims, your injury or illness must have stabilised before we can work out how long it’s likely to be before you receive a lump sum payment. This is the point at which your injury isn’t expected to get any worse. We can then work out what you should claim based on your injuries.

However, in our experience, most claims are usually resolved within 12 months.


Frequently asked questions

If you have superannuation, it’s likely that you have TPD insurance.

You can contact your superannuation fund to find out. Remember that if you’re employed, it’s a legal requirement that your employer pays super contributions on your behalf.

You may also have separate cover for income protection insurance, paying premiums directly to an insurance company for the cover. Income protection insurance usually covers TPD. You can find out more by contacting your insurer.

We can also help you find any lost super funds.

In some circumstances, you may be able to make multiple claims on multiple policies.

However, this isn’t straightforward. Sometimes you can only claim under one policy. It’s possible that one policy is likely to offer a bigger pay-out than another policy. We recommend that you get our legal advice before deciding how to claim.

You should also seek financial and legal advice about rolling over your superannuation policies into one policy.

You may have claimed for workers compensation, a motor vehicle accident, or another type of claim for the same injuries. Even so, you should still be able to make a TPD claim. Speak to us for advice.

It’s not essential to have legal representation when you’re making a disability claim. However, sometimes an insurer will look for a reason not to pay a TPD insurance claim. A rejection can be difficult and expensive to overcome, so it’s safer to engage a lawyer to collect all the evidence, assess it and to work out the best approach before submitting the claim.

The timing of your claim will often depend on when your injuries have stabilised, and when your long-term recovery prospects are known. This may take months or even years.

Usually, there aren’t time limits on making claims.

You may claim after that time, but there are no guarantees that Super SA will allow this. It may end up being more costly.

The sooner you make a claim, the better off you’ll be. While events are fresh in your mind and you remember how to locate the evidence, you’ll have a better chance of acceptance of your claim.

What happens next?

When you instruct us to make a TPD claim on your behalf, we:

  • Look into all possible sources for making a claim
  • Gather all relevant documents and consider whether they help your claim
  • Check for any lost superannuation
  • Have a detailed briefing with you in which we discuss your illness, injuries, disabilities, medical treatment and employment history
  • Consider the impact of the disability
  • Consider how the disability has affected your capacity to do things for yourself
  • Seek more information from your doctors and employer
  • Stay in close communication with you throughout the process
Meet our specialised

TPD Insurance Claims team

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