Know Your Rights: TPD Superannuation Claims Explained
When injury or illness prevents you from working in your regular job, the impact on your life can be enormous. In this event, you may be entitled to pursue a TPD insurance claim through your superannuation fund.
Understand what TPD insurance is, how to make a claim, and how Ryan Carlisle Thomas can support you throughout the process.
Key Takeaways:
- Most Australians have default TPD insurance in their super fund. Check your latest statement to see if you’re covered, and remember you can claim even if you’re able to do some work.
- If your claim is denied, you have multiple pathways to challenge the decision, from submitting new evidence to escalating to AFCA or pursuing court proceedings within 6 years.
- A TPD claim is a lump sum that won’t reduce your super or impact any active WorkCover or TAC claims you’re pursuing simultaneously.
- Legal support removes the stress of navigating complicated TPD claims.
What Is TPD Insurance?
TPD (Total and Permanent Disability) insurance pays a lump sum in the event that an illness or injury leaves you permanently unable to work. It can provide:
- Income replacement to cover living expenses.
- Debt elimination to pay off your mortgage, car loans and credit cards.
- Medical costs to fund treatment, rehabilitation and necessary home or vehicle modifications.
How Does TPD Insurance Work Inside Your Superannuation?
TPD insurance is commonly held within your superannuation fund. Many (but not all) super funds bundle this coverage automatically for policy holders over the age of 25.
It is possible to have more than one active super fund at the same time, and within this, multiple TPD insurance claims.
Premiums are deducted directly from your super balance, but making a claim will not reduce your retirement savings.
How Do I Know If I Have TPD Cover?
Most Australians have default cover, but it’s important to check your individual policy by logging into your super fund’s member portal and reading your most recent statement – it will be listed under “Insurance Benefits”.
What Qualifies as Totally and Permanently Disabled?
There are several injuries that can qualify for a TPD insurance claim:
- Physical illness, including back injuries, heart conditions, blindness and terminal illness.
- Chronic illness, including arthritis, diabetes, auto-immune conditions and asthma.
- Mental health conditions, including anxiety, depression, post-traumatic stress disorder, bipolar disorder.
Can I Make a TPD Claim If I Can Still Do Some Work?
Yes – you can still be eligible to make a claim if you are able to work in some capacity. Most TPD policies fall under two categories:
- Any occupation – if injury or illness means you are unable to work in any job reasonably suited to your education, training or experience.
- Own occupation – if injury or illness permanently stops you from being able to do your specific job, but you could theoretically work in a different field.
How Do I Make a TPD Claim Through My Super?
Navigating the claims process can be a daunting task – but it doesn’t have to be. To start making your claim, follow the following steps:
-
- Confirm that you held TPD insurance within your superannuation fund at the time of your injury or illness, or the date you last worked.
- Request and complete the claim forms from your insurer or super fund.
- Gather medical evidence to support your claim – a detailed submission will help bolster your claim
- Submit your claim to your insurer or super fund for their assessment.
How Long Does a TPD Claim Take?
A successful TPD claim takes an average of 6-12 months. Once the insurance company has received your claim, there’s typically a 6-month assessment period to determine the outcome.
What Happens If My TPD Claim Is Rejected?
If your initial claim is rejected, this isn’t the end of the road. You can still explore several different pathways to challenge the decision.
- Seek legal advice: specialist TPD insurance expertise might highlight where your claim can be improved or if you have further cause.
- Submit new evidence: additional evidence can often strengthen a claim if submitted within 60-90 days.
- Escalate to the AFCA: the Australian Financial Complaints Authority can review rejected claims up to two years from the denial result.
- Pursue court proceedings: if the AFCA cannot resolve the dispute, you can take your case to court within 6 years of the claim being denied.
Can I Make a TPD Claim and a WorkCover Claim at the Same Time?
Yes, you are able to pursue a TPD claim alongside an active WorkCover or TAC claim.
Because a TPD is a lump sum insured benefit and not considered income, it won’t affect workers compensation or TAC claims. Many of our existing and former WorkCover and TAC clients have achieved successful TPD claims with our services.
Do I Need a Lawyer to Make a TPD Claim?
You are not required to make your claim with a lawyer – anyone can submit a claim directly through their insurer or super fund.
However, the process can be complicated and stressful, particularly in the event of an unsuccessful claim. Engaging the legal services of a specialist team can help to alleviate some of this pressure. Our expert team approaches every claim with sensitivity, helping you to navigate the intricacies of the claims process with clarity, compassion and confidence.
With our No Win, No Fee OR Expenses policy, there are no fees upfront, and in the unlikely event that you claim is unsuccessful, we will waive any fees and out-of-pocket disbursements.
Understanding Your Options and Next Steps
As Victoria’s leading superannuation and TPD insurance lawyers, we service individuals across the region.
Our No Win, No Fee OR Expenses services will ensure you can pursue your claim without concern over any financial ramifications of the result.
Contact us to arrange a free, no-obligation consultation.
