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Total and permanent disability claims

When you are injured or rendered ill so severely that you can no longer work in the same occupation, there are safety nets in place that allow you to receive some financial protection.

However, the process of filing a total and permanent disability claim can be rather complicated. It is often advisable to work with an experienced legal team focussed on personal injury that can help ensure you get the money you deserve.

Read on to learn more about what TPD is, how it works, and what you can do to ensure that you can receive the money you may need to protect your finances via a TPD claim going forward

What is total and permanent disability?

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.

What does total and permanent disability mean?

First, it is important to understand what actually constitutes a total and permanent disability, and unfortunately, there is no single answer to this question. Each TPD insurance provider will have its own definition of what TPD actually means.

With that in mind, if you believe you may be eligible to file such a claim, you need to carefully read over your policy and determine whether the injury or illness you have suffered will allow you to qualify.

As such, you should certainly start by determining whether your injury or illness actually makes it impossible for you to work, and that starts with a visit to a doctor (or more than one). Again, the damages TPD insurance actually covers vary by the insurer, but in general, you may be eligible if your doctor says you should not work going forward.

Common things for which claims are usually paid include significant impairment of vision or hearing, loss of use of limbs, mental disability, and so on. But consult your insurance cover documentation to determine exactly what qualifies for the benefit.

What is a total permanent disability assist claim?

When you believe you are injured or ill enough that you can never return to your previous work, and a medical professional agrees, it is time to file a claim with your insurer (or your superannuation fund, but we’ll get to that later).

However, you will have to provide a large amount of information to support your compensation claim, including proving your level of disability, work history, need for ongoing care, and more. Making a TPD claim can be difficult to do, especially for someone with little to no legal experience.

Can you have more than one TPD policy?

Often, payments made from one TPD insurance policy will not be enough to cover a potential lifetime’s worth of income replacement or medical care.

Typical lump sum compensation amounts from one TPD insurance policy can range from the tens of thousands of dollars into the mid-six figures, depending on a number of factors.

Fortunately, you are allowed to have more than one policy in most situations. Again, each insurer (or superannuation fund) will have its own definition of what constitutes permanent disability, so a disability that is covered by one may not be covered by another.

Determining if you qualify for a TPD claim

As noted above, your ability to qualify for a TPD insurance claim is hardly set in stone. Insurers and super funds will each set their own threshold to qualify and, even if you qualify across multiple coverage types, proving permanent disability on a TPD claim may not always be easy.

Should you have your total permanent disability insurance inside or outside super?

While everyone’s financial situation is different, the answer to this question is, “Ideally, both.”

Your superannuation fund may provide you some relatively small amount of coverage (at least in comparison to what you would receive from a TPD insurer), so you should probably have separate TPD cover as well.

What other benefits does total permanent disability insurance include?

Your TPD cover will depend on a number of factors, including the type of insurance you purchase.
For instance, if you have unitised cover, your insurance premiums will stay the same for the life of the policy, but the amount of financial compensation you receive in the event of permanent disability will change as you age and your needs shift.

On the other hand, you can also build TPD insurance into broader life cover, meaning that your life insurance company will also provide compensation if you are permanently disabled. In some cases, though, you may see your death benefit drop by the amount paid out on your TPD claim.

Other types of coverage here may include income protection insurance, life insurance, loan and mortgage protection insurance, sickness or accident insurance, and trauma or employment disability insurance.
Typically, claims are paid as a lump sum.

Can you claim TPD for partial disability?

By definition, partial disability is not total or permanent disability, but you may be able to make a TPD claim for such an injury or illness anyway, in certain instances.

You shouldn’t expect to receive the full value of your TPD benefit if your disability is partial, but you will likely receive some compensation in the form of a lump sum payment, as a means of getting additional income protection.

The TPD claims process

As far as the actual process of submitting your TPD claim, this is another issue that will likely vary somewhat based on your TPD insurance provider.

The whole process should start with a consultation with a doctor who can accurately diagnose your disability, and then getting together the necessary evidentiary documentation to prove permanent disability status. This is a process that can take months.

However, if you work with personal injury lawyers who specialize in TPD claims, you can expedite the claims process.

How long does a claim take to process?

In most cases, claims will be resolved within two or three months, once your insurers receive the right paperwork from you and your doctors. If they hit any snags because you have not submitted your claim in accordance with their unique rules, this can create an unnecessary – and potentially problematic – delay that could put your finances at risk if you have no other income.

Unfortunately, even small problems with your paperwork can take months or years to resolve, and all the while, you may find yourself living in financial precariousness. However, hiring TPD lawyers can help expedite the process, because sometimes even the threat of legal action spurs TPD insurance providers to process the claim quickly.

With all of this in mind, if you believe you are eligible to make a TPD claim based on a permanent disablement you have suffered, it’s time to call the experts at Gerard Malouf & Partners. We specialise in total and permanent disability claims and can help you get through that process as quickly and easily as possible, while ensuring you get every dollar you are entitled to.

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 — Personal Injury Compensation Lawyers

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