Total and Permanent Disablement (TPD) Insurance
TPD means “totally and permanently disabled”. If you are no longer able to work as a result of illness and/or injury, you may be eligible for a Total and Permanent Disablement (TPD) payment and early access to your superannuation.
Most superannuation funds include insurance/income protection for TPD.
TPD insurance is a life insurance policy that pays a lump sum benefit when there is an absence from work and sometimes the inability to carry out the Activities of Daily Living, due to injury or illness.
At the end of the waiting period, if the insurer forms the opinion that the insured is so disabled that it is unlikely they will work again in any occupation of which they are suited by education, training and experience, then TPD insurance pays out.
Do I have TPD insurance?
There are two ways that most Australians hold TPD insurance:
- In superannuation where the superannuation trustee owns the policy.
- Held directly by you with an insurance company and you pay the premium.
The majority of Australians hold TPD (or income protection) insurance through their superannuation. If you are working and employed, your employer will be required to pay into a superannuation fund the 9.5% superannuation guarantee levy. Most superannuation levies are paid into large industry funds and these will insure their members under the one policy.
Is TPD the same as my superannuation fund?
No. It is an insurance policy bought by the trustees of your superannuation fund for you and all other members. It is a group insurance.
I have more than one superannuation fund - can I claim TPD more than once?
If you have more than one TPD policy, you may be able to claim more than once. This is a complicated area so it is vital to discuss with a lawyer to ensure the best outcome.
A DBH Lawyer can assist you by finding out whether claiming on one policy stops you from claiming on another. There is a lot to take into consideration:
- Which policy is most likely to be required to pay the TPD benefit.
- Which policy or, if you can claim more than one policy, which order will result in the most money to you and the best order to claim in.
If you have multiple policies, don’t do anything until you have obtained expert legal and financial advice. This includes rolling multiple policies into one policy.
I have claimed compensation through WorkCover, motor vehicle accident or another injury claim. Does this matter?
No. In most cases, a claim for the same injury or illness causing the disability under workers compensation insurance, motor vehicle accident insurance will not stop you making a TPD claim.
Can I simply fill in the forms, have my doctor and employer fill in their forms, submit the claim and, when the insurer says no, get the lawyers to fix it?
This is a high-risk strategy and we do not recommend this approach. If the insurer rejects the claim, a lawyer may not be able to help.
The best strategy is for a lawyer to gather all the relevant evidence of your inability to work in employment for which you are suited by education, training and experience, and present it in the best possible way. This will involve stress testing all of the available information and ensuring it can withstand a sceptical attack by an insurance company. Remember, in most cases, the insurer will look for a reason not to pay.
How will Duncan Basheer Hannon deal with my claim?
We take the following steps when dealing with your TPD claim:
- We investigate all possible TPD insurance claims:
- Consider the documents you have;
- Look for lost superannuation through MySuper.
- Full briefing with you where we discuss:
- Injuries, illnesses, disabilities;
- Medical treatment;
- Employment history – both before and after the disability.
We may also talk with you and your family about your incapacity and limitations.
DBH will consider all policies and ask your doctors and employers the right questions to assist your claim. We may need a report from an expert insurance doctor and/or occupational therapist.
Remember – lawyers are trained to be sceptics and critically analyse all information. A lawyer investigates any weaknesses in your claim to ensure they are dealt with in the best way to maximise your chances of a TPD payment.