It is likely you have recently seen advertisements about ‘TPD’ or ‘super claims’, but what is Total and Permanent Disablement insurance cover, who is entitled to make a TPD claim, and how can lawyers help? Attwood Marshall Lawyers Senior Personal Injury Paralegal Amy Lewis explains.
What is Total and Permanent Disablement (TPD)?
Total and Permanent Disablement or ‘TPD’ insurance is a type of insurance generally linked to superannuation. TPD insurance covers you if you are unable to return to work due to an injury or illness. It is common for super funds to automatically sign you up for TPD insurance when a superannuation account is opened. You may also hold a TPD policy directly with an insurance company.
Who is entitled to claim a TPD benefit?
Generally, to be eligible to make a claim for a TPD benefit you must have ceased employment due to an illness or injury, and as a result, it is unlikely you will return to the workforce. Your injury or illness does not have to be work related for you to be able to make a claim.
Each policy is different in that you may have an “any” or “own” occupation policy. Some policies also have age and employment restrictions involved.
Essentially, an “any” occupation definition suggests if you are able to return to work in any occupation which suited for by training, education or experience, the insurer may deny or delay your claim on the basis they believe you are able to undertake another line of work.
An “own” occupation definition simply means you are unable to return to your own line of work, it does not take into consideration other alternatives.
It is best to seek legal advice to understand your policy definition to determine if you are eligible to make a claim.
A claim for TPD benefits may be available even if you have another entitlement to compensation. For example, injury or disability arising from a motor vehicle accident (in Qld or NSW), a slip and fall accident, or a workers’ compensation claim.
How do Attwood Marshall Lawyers help to start a TPD claim?
Firstly, we will contact your super fund or insurer to confirm you held relevant insurance as at the date you ceased employment. We will also request the relevant policy and claim forms on your behalf.
To qualify for a TPD benefit, you must be able to satisfy the definition of TPD under your policy. TPD definitions can differ, but generally, there are two criteria which must be satisfied:
- It must be shown that you have been unable to work for a specified period of time.
- It must be established you are unlikely to be able to engage in your usual occupation or any occupation for which you are qualified, by education, training and experience.
What happens after you are eligible to make a TPD claim?
Should you be eligible to make a TPD claim, we will assist you throughout the process to ensure it is as easy as possible. We will complete the relevant claim forms, gather medical and financial material required and submit your claim with your insurer. We will be the point of contact for the insurer to eliminate any unnecessary worry for you.
Once your claim has been lodged, we will continue to follow up with the insurer on a regular basis to ensure a timely determination of your claim. Occasionally, it may be necessary for you to attend an independent medical examination organised by the insurer, however this is dependent on your individual circumstances.
What happens if you have more than one superannuation fund or TPD policy?
It is common to belong to more than one super fund and therefore you may have more than one TPD Insurance policy. We can help you with a “super search” through the Australian Taxation Office. It is important to check every super fund you have because you may be entitled to more than one TPD insurance policy claim.
In the event you do hold more than one policy, we will assist you to lodge a claim with each individual superannuation fund/insurer. If successful, the total value of multiple TPD policies can be quite considerable.
Do time limits apply to a TPD claim?
Generally, there are no time limits apply to your entitlement to seek TPD benefits. However, there may be strict time limits which apply if your claim has initially been rejected or a decision has been made and you are seeking a review. The time limit will vary depending on your policy. There may also be issues concerning ongoing contributions to keep the cover ‘alive’ under the policy. It is best that you obtain legal advice as soon as possible to make sure you preserve your entitlements! Take advantage of our free initial consultation and advice in relation to your possible claim. Give us a call now and speak to our friendly staff so we can assess your claim, before it’s too late!
Can insurers use your social media posts as evidence?
A recent NSW court case shows anything you put on social media can be used against you in court proceedings. Insurers may attempt to access your social media posts as well as your private messages in order to obtain information to reject your claim. Therefore, when preparing to lodge your TPD claim, Attwood Marshall Lawyers strongly encourage you to deactivate your social media accounts.
Get professional legal advice for a successful TPD claim
Attwood Marshall Lawyers have successfully helped those who have been injured and become sick to make TPD claims for decades. If you believe you may be eligible to make a claim for TPD benefits, please contact our highly experienced TPD legal team to assist you. We will make an initial obligation free inquiry with your super fund(s) to establish whether you hold TPD insurance and can make a claim for you.
