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A victim in a car accident gets the run around with insurance, we help him win TPD compensation

Case Overview
  • Our client sustained multiple injuries when he was involved in a violent motor vehicle accident. 
  • The fund continued delaying the assessment of his claim and after 7 months appealed that they were not the correct insurer at risk.  
  • Our competent staff was able to deal with the complex issues, minimise the delay and have the matter determined without litigation to secure our client a TPD benefit amount of $300,000.00.

Our client was a 43-year-old IT specialist who sustained multiple physical injuries in a motor vehicle accident. He was hit and then violently thrown into the air before falling heavily onto the ground, tumbling and sliding across the concrete. He suffered severe injuries to his thoracic and lumbar spine. Our client also developed trichotillomania, a major depressive disorder and PTSD.

After submitting the claim with ample medical evidence, over the next six months, the superannuation fund and insurer continually requested updated reports and financial details. To respond to the continual delay, a letter of demand was forwarded to the fund, stating that they possessed sufficient medical and financial evidence necessary to determine the claim.

“We submitted a claim on our client’s behalf to the insurer through their superannuation fund.“

Angelica Adhar
Our Approach

Our team implored the insurers to make a decision within 14 days, reminding them that failing to do so would result in filing for Court proceedings. This exerted pressure on the superfund and insurer to assess the claim.  

On their review of the claim documents, it came to light that they were not the insurer at risk due to a policy underwriting process. The fund provided this advice almost eight months after the claim was submitted.

The claim was then forwarded by the fund to the relevant insurer for review. This process re-initiated the assessment cycle as per the Life Insurance Code of Practice Guidelines and the new insurer appealed that the claim will be assessed as a new claim under the guidelines. This meant that there could be a further delay of six months before the claim was determined. 

This was not acceptable in the circumstances, and our professional team exhausted their knowledge and expertise to ensure that a favourable outcome was received without further delay. 

It was necessary to remind the insurer and trustee that they owe a duty of good faith and fair dealing towards an insured member in their deliberations, having an obligation to act reasonably in forming an opinion that is objective, even-handed and realistic on the entirety of the evidence in a timely manner.  

When choosing a legal professional to assist you with your superannuation claim, it is important to seek the expertise of professionals who are 100% committed to ensuring your claim is fairly assessed. To discuss any potential entitlements you may have, please contact our firm for a free consultation on 1800 959 280 or by filing an enquiry.

The Result

With the help from GMP Law, our client received a TPD Settlement of $300,000.00 following significant injuries sustained in a motor vehicle accident.

Angelica Adhar

Senior Superannuation Case Manager
Thank you so much for your assistance & the hard thorough work you and the team did in successfully helping me and with no fuss, no lengthy delays and your communication, honesty, assurance & promptness. I’ll highly recommend you to anyone that needs help with their superannuation and insurance and appreciate all your efforts & patience with me not being well. I can finally improve a little & move on with my life as much as possible & with peace of mind & without so many financial, mental and physical struggles
Frequently Asked Questions

More Information

In general, a TPD insurance claim takes around six months for the insurance company to assess. However, it can take longer if there is a dispute, or it can be wrapped up in a shorter time frame if your claim is extremely clear and you have the right superannuation disability attorneys on your side.

Be aware that once the insurance company has made its decision in regard to your TPD claim, the trustee of the superannuation fund will need to follow up with their own separate assessment of the claim. This can add an extra month or two to the process.

In Australia, there are protections in place for people who suffer injuries or illnesses that render them permanently unable to work in their previous career. This is called total and permanent disability insurance (or TPD insurance) and it will provide a lump-sum payment that will help you maintain your finances to a certain extent, even as you can no longer earn an income in the traditional way.

It is important to note that you do not have to have suffered this injury or illness as a result of your job to make a TPD claim.

TPD claims, which are payouts from a type of disability insurance purchased either privately or through your super, have the lowest rejection rate of insurance cover and an approval rate of more than 80%.


More Case Summaries

About Us
Gerard Malouf & Partners have provided friendly, experienced legal advice to communities across Australia for over 35 years. Our Personal Injury Lawyers have taken on ten’s of thousands of cases and we are proud to have won billions of dollars for our clients.
Meet the diverse and dynamic team of compensation lawyers and supporting staff that have made this all happen below. Our multi-lingual team can discuss your claims in Arabic, Assyrian, Turkish, Greek, Italian, French, Serbian, Croatian, Armenian, Mandarin, Hindi, Punjabi or Malayalam.
Meet the diverse and dynamic team of compensation lawyers and supporting staff that have made this all happen below. Our multi-lingual team can discuss your claims in Arabic, Assyrian, Turkish, Greek, Italian, French, Serbian, Croatian, Armenian, Mandarin, Hindi, Punjabi or Malayalam.

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