If you have recently lodged a Total and Permanent Disability (TPD) claim, you may have noticed a requirement in your policy stating that you must be “under the care of, and following the advice of, a medical practitioner.”

But what does this actually mean in practice? And what is considered “reasonable” when it comes to treatment?

What Does “Under the Care of a Medical Practitioner” Mean?

Many TPD insurance policies require you to be receiving ongoing medical care and following recommended treatment. This is often used by insurers to assess whether you are doing everything reasonably possible to improve your condition and return to work.

However, this requirement is not always straightforward.

For example:

  • What if your doctor has advised that no further treatment will help?
  • What if treatment is recommended but you cannot afford it?
  • What if you live in a regional area with limited access to specialists?

These are all important factors when determining what is reasonable.

When is Treatment Considered Reasonable?

The concept of “reasonable treatment” depends on your individual circumstances and the specific terms of your insurance policy.

Generally, treatment may not be considered reasonable if:

  • It causes significant financial hardship
  • It involves serious medical risks, such as major surgery
  • It is unlikely to improve your ability to return to work

In the current cost of living climate, affordability is a key consideration. Similarly, access to treatment can be limited for those living outside major cities or those with restricted access to transport.

When Might You Be Required to Undertake Treatment?

On the other hand, treatment may be considered reasonable if:

  • It is recommended by a qualified medical practitioner
  • It has a real prospect of improving your condition
  • It could help you return to work within your education, training, or experience

In these cases, insurers may expect you to follow the recommended treatment before making a decision on your TPD claim.

Why Individual Circumstances Matter

Every TPD claim is different. There are many valid reasons why a person may not have pursued certain kinds of treatment, and these reasons must be carefully considered.

A proper assessment should consider:

  • Your medical condition
  • Your financial situation
  • Your access to treatment
  • The risks and likely outcomes of further treatment

Get Advice on Your TPD Claim

Understanding your treatment obligations can be complex, and getting it wrong can affect your claim.

At Evolve Legal, we carefully review each person’s insurance policy and circumstances before providing free advice. This ensures you understand any potential issues with treatment requirements and your chances of success.

If you are unsure about what your policy requires or how “reasonable treatment” applies to you, contact Evolve Legal today for advice.

Posted in: Latest News

March 31 2026