Total and Permanent Disability (TPD) insurance provides crucial support for those unable to work due to injury or illness, yet many are unaware of their entitlements. In this article, our TPD Lawyers explain common misconceptions about TPD cover, and eligibility, highlighting the benefits of expert guidance to simplify the claims process and improve outcomes.
What is TPD insurance?
Total and Permanent Disability (TPD) insurance is an insurance benefit often put in place and maintained by your superannuation fund. It is insurance that you pay fees to hold, like any other insurance. However, typically the fees are taken from your superannuation account balance, so these benefits can sometimes go unsuspected. Other types of insurance held with superannuation can include Income Protection or Salary Continuance, Terminal Illness, and Death Cover.
TPD insurance is there for when you have been injured or have fallen ill and are unable or unlikely to return to work as a result. Your injury or illness does not have to be related to your work, and your condition may also be psychological in nature, meaning no physical injury has to have occurred. Similarly, it can be a combination of multiple injuries or illness combined that have resulted in your inability to work.
How do I know if I have TPD cover?
We often get questions from people who are uncertain as to whether they hold TPD insurance or may have never known they held insurance until they engage a lawyer for another matter.
As a general rule, your TPD entitlements are based on your date last worked or date of disablement, and not necessarily as at the current date. So, while you may no longer be a member of a super fund, you may still have held insurance benefits at the time you ceased working. Some people may hold or have held more than one superannuation account throughout their working life too, and while you may not hold insurance with one fund, it’s possible you might hold it with another. Sometimes multiple TPD claims can be made.
At Evolve Legal, we undertake free claims checks, which allows clients to have their insurance investigated and receive free advice on their prospects of making a claim. As part of this enquiry process, our helpful team can request entitlements on your behalf to find out what funds you hold cover with, how much your potential insurance benefit is, and review your particular policy of insurance to consider eligibility. We’ll also discuss with you any other circumstances that the fund may take into account when assessing a claim, such as attempts to return to work and light duties programs arranged by WorkCover, which may in some cases alter your date of disablement or benefit amounts.
I can work, but not in anything I’ve worked in previously. Am I still eligible?
The idea of being unable or unlikely to return to work due to your injury or illness can be overwhelming, and you may consider retraining or returning into a different field of employment. Generally, a TPD claimant needs to show that they are unable or unlikely to return to work within their education, training, or experience. Some policies, however, also take into account any reasonable retraining that you may be able to undertake. So, the answer to this question really depends upon your circumstances and policy of insurance.
Regardless, any suggested employment still needs to be a real-world job obtainable on the open labour market and not a made-up or light duties role. As part of your claim, your doctors will also be asked to assess your ability to return to work and may be asked whether you can reasonably retrain. As part of our claims handling process, we always consider whether there are real world prospects of you doing so, whether you could complete work free of pain, and whether you could do the role without the need for frequent breaks or risk of injury aggravation.
Whatever your circumstances, we always recommend obtaining advice about your prospects of making a claim and what it might mean for your claim if you do retrain or return to work.
Why engage a law firm?
Putting together evidence and lodging a TPD claim can be stressful, and TPD policies can be more complicated than you may think as they vary from insurer to insurer.
All too often we are contacted by claimants who have tried to make a TPD claim themself, only to have had their application declined by their super fund. Whilst there may be a way to overcome a rejected claim, it is a much harder process. Getting things right from the start is often a quicker and easier path.
Using a legal service like Evolve means we can assess your eligibility, determine the correct date last worked for you where there might be multiple, request supportive evidence upfront to address your policy specifically, and make legal submissions about any concerns to give your claim the best chance of success from the outset. We utilise our extensive experience in these claims to approach any hurdles upfront, and most importantly, take the stress away from you, so that you can focus on taking care of yourself and wellbeing.
While we are always a phone call away, you can be assured that we will always be there to provide you with timely updates on your claim as they happen.
If you’d like to discuss your prospects of making a TPD claim, please give us a call on 1300 633 805 or email us at [email protected].
Evolve Legal – How We Can Help You
Navigating a TPD claim on your own can be inherently overwhelming. At Evolve Legal, our team is here to assist you and alleviate the stress of your claim, allowing you to focus on your health and wellbeing. We will assess your eligibility, gather the necessary evidence, and handle the complexities of your policy to give your claim the best chance of success. For expert guidance and support, please do not hesitate to contact us on 1300 633 805 or email us at [email protected] to book a free, no-obligation initial consultation with one of our experienced lawyers.
Posted in: Latest News
November 27 2024
