If you are unable to work due to an illness or injury, you may be curious as to whether you’re eligible to make a Total and Permanent Disability (TPD) Insurance claim. You might be, but the process of filing a claim can be confusing. The best course of action is to enlist the services of an experienced lawyer who can help you navigate the process. Here, we will discuss what Total Permanent Disability Insurance is and the most common types of claims.
Total and Permanent Disability (TPD) Claims
Total and Permanent Disability Cover offers you insurance benefits if you are too injured or ill to work. A successful claim provides a lump sum payment if you are unable to work in your own occupation, or any occupation at all, depending on the wording of your policy.
The payout varies, depending on the specifics of your policy and your cover at the time you became disabled. A lump sum payment could be in the tens of thousands or the hundreds of thousands. However, if you have multiple active and valid policies, you could receive a payout much larger. While many people have Total Permanent Disability cover in super, others have this in addition to personal policies for additional cover. Depending on the wording, you may be able to claim against all of your policies.
Am I Eligible?
If you have TPD insurance, you can make a claim if you are totally and permanently disabled. Total and permanent disability means that you are unable to work and that medical professionals expect your injury or illness will prevent you from returning to work in your lifetime.
A TPD claim can be made regardless of whether your illness or injury occurred as a result of your employment. You are covered for TPD for illnesses and injuries that arose out of your employment or outside of your employment.
The injuries or illnesses you are allowed to claim vary from policy to policy, but they usually encompass physical injuries, mental health conditions, or chronic illness. If someone dies as a result of their injuries or illness, their spouse or child may be able to claim TPD successfully.
The 5 Most Common Types of TPD Claims
- Accidents
Accidents can result in a range of disabilities, from traumatic brain injuries to paralysis and amputation.
- Cancer
According to statistics from the Australian Government, 624 people per 100,000 will receive a cancer diagnosis in 2024. Though mortality rates have decreased, there are many disabilities attributed to cancer. In addition to pain and fatigue, many people struggle to perform daily tasks at home, so work would be out of the question.
- Musculoskeletal Disorders
A musculoskeletal disorder can lead to a range of issues, including trouble with daily tasks, stiffness, pain, and difficulty moving.
- Mental Illness
Mental illness can lead to severe anxiety, depression, difficulty concentrating, and decision paralysis, and some sufferers struggle with daily tasks, such as showering.
- Heart disease
Heart disease results in many issues, including severe fatigue, shortness of breath, and chest pain.
The Claims Process
While the process varies by insurer, the first step in every case is to notify the insurer you will be making a claim. This is carried out via phone, email, or writing so the insurer can send you the relevant claim forms. The insurer will assess your claim once you submit the paperwork and make a decision based on the evidence presented. If upheld, you would receive a lump sum. If rejected, you can appeal.
You should consult a lawyer experienced in TPD claims before you submit your forms. Gathering medical reports, physicians’ statements, and test results to support your claim will increase your chances of success. The better your records, the more likely you are to succeed in your claim, including medications, treatments, and appointments. You have to be honest about your limitations and the condition because an insurer can deny if you withhold or hide evidence.
Likewise, it’s vital that you familiarise yourself with the claims process for the insurer you’re dealing with and follow their requirements.
How AJB Stevens Can Help
You are more likely to succeed and maximise your payout by working with a TPD lawyer, a professional will assist you with the claims process and ensure your rights are upheld. There are time limits when making claims, so the quicker you act, the better off you will be. Your lawyer can gather evidence and prepare the claim and if you are denied, they can handle the appeal as well.
AJB Stevens has a team of specialists who are experts in dealing with TPD insurance in super, ensuring you get the payout you deserve without the stress of dealing with the complex process on your own. Whether you’ve had a slip, trip, or fall at work or in the supermarket, you were the victim of a dog attack or an accident on public property, AJB Stevens can help you receive compensation. Get in touch with the team today to discuss your case.
