If you are unable to work due to an illness, injury, or disability, you may be able to make a claim for Total and Permanent Disability (TPD) benefits through your superannuation fund.
Total and permanent disablement (TPD) or disability cover is a form of insurance providing a lump sum payment if you are permanently unable to work due to injury or illness. Notably, how you were injured or became sick does not have to be related to your employment.
Whilst TPD insurance may exist as a stand-alone policy it is often bundled with death cover within a superannuation policy. In fact, many people with an active superannuation policy are unaware that they have this form of insurance and being able to access TPD benefits can provide life-changing financial assistance.
If you are facing a serious illness (e.g., cancer, MS, leukemia, Parkinsons and a range of other illnesses), or you have been injured (whether or not it was someone else’s fault), you should check to see what options are available to you.
Finding out if your superannuation policy includes TPD cover is not as straightforward as it should be. Our TPD lawyers can review your superannuation documentation to see if you have TPD cover.
To be eligible for a TPD insurance claim, the insured individual must meet the definition of Total and Permanent Disability as outlined by their superannuation fund in their policy documentation. The definition can vary between different insurers, however, typically a claimant will need to demonstrate that their disability (physical injury, mental health condition, illness) is likely to be permanent and that it prevents them from working in any gainful employment for which they are reasonably qualified by ”education, training and experience” (a typical phrase used by super funds).
Making a successful claim for TPD compensation involves completing forms that require detailed information. You will need to contact your superannuation fund and advise that you wish to make a TPD claim. Generally, you will be assigned a case manager who will try to guide you through the process and provide you with the required forms.
However, it’s important to keep in mind that the relevant insurance company’s interests are not the same as yours. Getting some good legal advice at the outset will ensure you maximise your prospects when making a TPD claim.
Most policies require a waiting period to allow for all injuries and symptoms to stabilise before assessing the full extent of the injuries or illness. The policy documentation will detail what these waiting periods are.
Relevant evidence needs to be gathered to support your claim, including:
Medical evidence and assessments from healthcare professionals. It is vital that your medical specialist has the correct details about how you sustained your injury, as well as any pre-existing medical conditions you may have. If you do not provide details of pre-existing conditions relevant to your disability and the insurer discovers this, they may challenge the validity of your claim or reject your TPD claim outright.
Evidence demonstrating that you are unable to work in any other type of occupation to which you are suited by your education, training, or experience.
Payslips and a statement from your previous employer and evidence about why you are unfit for other types of work. If self-employed, your BAS and business tax returns.
If you were on WorkCover or receiving any other benefits, for example, under a CTP scheme, your claim file(s).
ATO and Medicare records.
Centrelink records, if applicable.
As you can see, there is a lot of information to collate, and if you miss anything, this could give the insurer a reason to reject or delay your claim. When you’re sick or injured, the added stress of dealing with an insurance claim can often be overwhelming. An experienced TPD lawyer will ensure that all the necessary information and supporting evidence is collated and submitted to the super fund at the outset and ensure that any further information or evidence is provided to the fund if needed.
You can apply for TPD yourself, however, insurance companies which provide TPD cover typically are not interested in paying out more than they have to.
It is therefore important to make sure your claim documentation is completed accurately, addresses the necessary matters relevant to the policy, and is supported with adequate evidence. After all, if you are permanently unable to work, this lump sum may need to last the rest of your life.
We can explain the process in simple language and use our experience to ensure your claim is on the right track from the outset.