Total and Permanent Disability (TPD) insurance
If you are injured or unwell and have had to stop working on a permanent basis you may be able to make a TPD claim. Total and Permanent Disability insurance provides a lump sum payment if you can no longer work in your usual occupation or other type of employment, taking into account your qualifications, experience and training.
Insurance for TPD may exist as a stand-alone policy or form part of your superannuation. People are often unaware that they have TPD insurance so it is important to check your documents carefully.
The terms and conditions vary between policies and the process for making a claim can be complex and confusing, particularly when you are unwell. Our lawyers have assisted many clients who can no longer work claim their TPD entitlements and have successfully challenged decisions by insurers or fund managers to deny a TPD claim.
Making a TPD claim
Our lawyers will review your policy to determine your eligibility, complete your claim and help to arrange supporting evidence such as medical reports, employer statements, trade certificates and information regarding your training and experience.
Superannuation funds and insurers have their own governing rules and TPD definitions. Generally, TPD means that you have been unable to work in your usual occupation for at least six months and you are likely never to be able to engage in any gainful work for which you are reasonably qualified.
TPD insurance may be paid if any injury or illness prevents you from working, no matter what the cause. In other words, you do not have to establish that your illness or injuries are somebody else’s fault.
After your claim is lodged, the insurer will usually ask for you to be examined by its own medical expert and may request more information. The insurer will assess your claim and determine whether to accept or deny it.
If your claim is denied, our lawyers will review the reasons for denial and provide guidance on challenging the decision.
A TPD claim may be rejected on technical grounds or because of the insurer’s interpretation of the policy terms. This often concerns the meaning of TPD as defined in the policy in light of the medical evidence provided.