As a special counsel for Evolve Legal, Anna Morgan shares her expertise in Total and Permanent Disablement (TPD), and terminal illness claims on superannuation. Most employees have a superannuation fund that often includes insurance policies automatically attached to it. TPD insurance covers policyholders for permanent injuries or illnesses that prevent them from returning to work. In this article, we provide an overview of the TPD and terminal illness claim process, including how to understand policy definitions, insured amounts, and the timing of payments.

TPD Insurance and Your Superannuation

TPD, death benefits, and income protection insurance are some types of coverage that may be included in your superannuation account. TPD insurance provides essential funds to individuals who suffer permanent injuries or illnesses that prevent them from returning to work. Depending on the policy, payments can be made as lump sums, ongoing payments, or annual instalments.

TPD Benefits are Not Limited to Work-Related Injuries

Contrary to common belief, TPD benefits are not limited to work-related injuries. Workers’ compensation is separate from TPD benefits, intended to compensate individuals who suffer severe injuries or illnesses that prevent them from working. Some examples of medical conditions that can impact one’s ability to work include respiratory diseases, autoimmune diseases, and the aftereffects of a stroke. It is crucial to note that the specific medical conditions covered by TPD policies can vary between insurers, and it is essential to review the policy’s terms and conditions carefully to understand the scope of coverage.

Understanding Your TPD Cover

It is essential to have a comprehensive understanding of the insurance policies that come with your superannuation account to ensure that you have adequate coverage in unexpected circumstances. This includes knowing the limitations of each policy, the maximum payout amount, and the eligibility criteria you must meet for your cover to be valid. It is also essential to review your policies regularly to ensure that they still meet your needs and that you are not paying for coverage you no longer require. By staying informed and reviewing your policies regularly, you can ensure that your insurance coverage remains adequate and up to date.

Definitions

Insurers have different definitions of “total and permanent disablement.” Policies may have an “any occupation” or “own occupation” definition. Most TPD policies within superannuation accounts use the “any” occupation definition, while some policies outside of superannuation allow for claims based on the inability to return to one’s “own” occupation.

Insured Amount

Reviewing the amount, you are covered for under your TPD insurance policy is essential to ensure it is adequate to meet your financial needs should you rely on these funds. Some individuals may have multiple superannuation funds and can claim on multiple TPD policies, providing greater access to funds.

When Your Benefits End

Depending on the policy, TPD policies usually end once an individual reaches a specific age, typically around 55-60 years. Some policies may terminate earlier. It is essential to carefully review the terms and conditions of your TPD policy to understand when the coverage ends and what happens to the policy once it terminates.

How Long Does a TPD Claim Take to Be Paid Out?

The amount of time it takes for a TPD claim to be paid out depends on the type of claim and prognosis. TPD claims can take several months to resolve, mainly if the individual requires continual treatment or pending surgery. Factors such as the complexity of the claim and the insurance company’s internal processes can also affect the time it takes for a TPD claim to be paid out.

Making a TPD Claim

Individuals must meet the policy’s definition of total and permanent disablement to make a TPD claim. The process may involve gathering and submitting medical evidence and liaising with the insurer. A lawyer with experience in TPD claims can provide guidance and support throughout the process.

EVOLVE LEGAL – HOW WE CAN HELP WITH MATTERS INVOLVING TPD CLAIMS

At Evolve Legal, we understand the importance of regularly checking your superannuation insurance policies to ensure adequate protection in unexpected events. As such, we offer expert assistance in making TPD or terminal illness claims to ensure your entitlements are secured.

Our team of dedicated TPD lawyers can guide you through the complicated process of making a claim, helping you avoid the risk of having your application denied due to incomplete or incorrect information.

Unlike brokers or accountants who assume these applications are simple paperwork, we recognise the technicalities involved and provide personalised support to help you access all your benefits.

At Evolve Legal, we empathise with the turmoil and life changes of applying for TPD or terminal illness benefits. We aim to ensure all our clients receive their full entitlements as quickly as possible, enabling them to focus on their health and family without financial stress.

Please don’t hesitate to contact us if you need assistance with a superannuation, TPD, or terminal illness claim. Please book an appointment online instantly through our booking app.

Our conveniently located offices in Gold Coast, Brisbane, and Sydney, are open for appointments with our experienced lawyers.