TPD Claims: Steps to a Successful Claim

Posted March 8th, 2013 and last modified July 30th, 2014

TPD Claims in Australia

TPD Claims Key Facts

  • It is possible to claim TPD for mental health conditions.
  • TPD claims within super must be approved by fund trustee.
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It is crucial that all TPD Insurance policyholders and anyone looking to take out TPD cover to have a clear understanding on the conditions around claiming TPD in Australia. The process of submitting a claim to actually receiving a benefit can take months and be complicated. An understanding of this process can ensure that the right steps are made by the policyholder and a successful claim can be achieved.

This article will outline the claims process for TPD insurance that is held within a superannuation fund and for cover that is held outside a superannuation fund. In doing so it will offer key advice to policyholders on how to best prepare for the event of a claim to ensure the process runs smoothly and that there is no delay in payment.

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When Can a Total and Permanent Disability Insurance Claim Be Made?

A TPD claim benefit can be received when the policyholder has satisfied the definitions of TPD as defined by the insurance company or Super Fund in which their cover is held. It is extremely important for policyholders to be clear on what definition their policy falls under to avoid any surprises in the event of disablement. Generally Total and Permanent Disablement will be considered under either “Own Occupation” or “Any Occupation”

  • Own Occupation: The policyholder has become disabled and is unlikely to ever return to full time work in the position of which they are employed for.
  • Any Occupation: The policyholder has become disabled and is unlikely to ever be able to engage in any form of regular paid work again for which they may be suited to by education, experience or training.

Requirements for a Successful TPD Claim

Most providers will also require the claimant to be unable to perform the duties of their occupation for at least three months before turning the age of 65.

Conditions of the TPD cover are also often subject to the occupation category of the policyholder.


Partial Disablement Feature

Some insurance providers will provide the option for Partial Disablement whereby as a result of sickness or injury the policyholder is not totally disabled and is able to work in their own occupation at a reduced capacity. As a result, the insureds monthly income is less than the pre-disability income. This must be certified by an approved medical practitioner.

The requirements of partial disablement feature generally comes under an hours or duties based definition.

  • Hours Based Partial Disablement: Benefit paid if policyholder has returned to work following being partially disabled for entire duration of waiting period and is able to perform duties in their occupation for defined number of hours, is earning less than their pre-disability income and is under medical care.
  • Duties Based Definition: Benefit paid after policyholder has returned to work following being totally disabled and is not capable of performing the duties essential in producing their income and is forced to earn less than their pre-disability income.

This benefit is determined using the following formula:

(Pre-disability income - post-disability income) / (pre-disability income x monthly benefit)

Some policies will provide this partial payment under certain defined conditions suffered by the policyholder. This may include the permanent loss of the use of;

  • One arm, or
  • One leg, or
  • Sight in one eye

Mental Illness, Depression and TPD Claims

One of the most common claims for disability insurance in Australia in recent years is for Mental Illness. As such, life insurance companies are becoming increasingly stringent around the requirements for a successful benefit payment. In 2006 alone there was $206 million paid out in TPD claims in Australia, 20% of which were related to mental illness (insuranceandrisk.com.au). In order to receive the TPD benefit payment for reasons related to mental illness, the condition must be severe enough for the policyholder to be required to take time off of work.

If an applicant has experienced a mental illness in the past, this will be taken into consideration by the insurance underwriter. It can be extremely difficult for underwriters to assess the risks of mental illness as there is such a great range of forms with different degrees of severity. Underwriters will in most cases require a medical attendant report in order to assess the applicants condition and the level of risk they carry.


Difficulty of Assessment of TPD Claims for Depression and Other Mental Illnesses

Policyholders should be aware that it can be difficult to prove that they will be unable to return to work again on account of mental illness. The episodic nature of mental illnesses can make it difficult for diagnosis to be formed.


Considerations for TPD Claims Related to Depression and Mental Health

  • The type of treatment prescribed by practitioner and the regularity of that treatment. This consideration is of particular importance for claims that are late in submission.
  • Benefit payment for a mental health claim may be deferred if it is believed that the permanency and severity of the insureds conditions is unable to determined. This can be prolonged until all treatment options are trialled.
  • Definition of total and permanent disablement in policy. For claims based on disability preventing individual from their own or any occupation as a result of work related stress, an underwriter will assess if they would still be unable to perform their duties at another place of employment or if their duties at their current work were adjusted.
Learn more about life insurance for mental illness

Superannuation TPD Claims

Some superannuation funds will now offer a default level of TPD cover for members. Members can check if there is TPD cover in their super fund by contacting a fund representative and requesting a copy of their online statements.


Payment of Total and Permanent Disability Claims in Superannuation

In order to receive a TPD benefit from their super fund a member must;

  1. Satisfy all conditions of the fund insurance contract.
  2. Satisfy the permanent incapacity definition as stated under super law.
  3. Satisfy “disability super benefit” definition stipulated under Australian tax law. This will allow the policyholder to claim an additional tax-free portion on the lump sum benefit.
  4. Fund trustee must be satisfied that the insured has met the conditions of the policy and is unable to engage in employment that they have are qualified in by education, training or experience.

TPD Claims Process: Inside Superannuation

  1. Contact Super Fund: Policyholder to contact their super fund after which they will be provided with necessary claim documentation. They will also need to provide additional documentation. This might include;
    1. Identification - Birth Certificate, Drivers Licence, Passport
    2. Existing medical reports
    3. Medical evidence to support claim
  2. Submit Claim: Claimant to sign their claim statement and attach to all necessary documentation. This will then be provided to their Case Manager. A Case Manager provides assistance throughout the claim process, ensuring all of the necessary documentation is received.
  3. Organisation of Claim by Case Manager: Case Manager will assess policyholders claim to determine whether they are eligible to receive a TPD benefit. They will usually contact the claimant's employer to receive a written statement as to why they ceased work.
  4. Claim is Assessed By Insurer: An insurance provider will assess the documentation submitted. In some cases further evidence may be require including;
    1. Doctors reports
    2. Further medical examination with an independent specialist
    3. Further information from the claimant's employer
    4. Further information from the claimant
  5. Claim is Assessed by Insurer: The insurance provider will assess the claim and determine if it is;
    1. Accepted: Claimant contacted with claim payment options.
    2. Declined: Claim is deferred while the provider assesses full extent of disability and its permanency. Claim is denied as the insurer has deemed the claimant has not satisfied the conditions of the policy.
    3. Deferred: Claim is deferred while the provider assesses full extent of disability and its permanency.

    If the claim is deferred or declined it will be referred to the fund trustee who will review the decision made by the insurance provider on the claimant's behalf.


    Payment of TPD Claims in Multiple Super Funds

    It is not uncommon for people to have TPD insurance that has accumulated in multiple funds that have been opened by different employers. It is possible in some circumstances for the policyholder to claim multiple benefits at the same time. However it is important that the claimant carefully checks the conditions of each fund before submitting multiple claims at the same time.


    TPD Claim Time Limit

    There is no time limit on when an TPD claim can be made for a benefit payment for TPD held within Superannuation. That said, there are time limits placed on when an appeal can be submitted for the refusal of a TPD claim. Legislation states that the Superannuation Complaints Tribunal can only review a complaint that has been made within two years after the making of the trustees decision of which the complaint is related to.

    Read more on tpd insurance inside superannuation

    TPD Claims Process Outside of Super

    Claiming standalone TPD Insurance is quite similar to claiming TPD held inside of Super though there are some differences between the two processes. Each claim process may differ depending on the type of claim and the insurance provider though in most cases it follow the following steps.

    Steps to make a TPD claim:

    1. Contact the insurers claims team: The claims team will provide the policyholder with the necessary claims form. Your financial adviser may assist you fill out the documents if necessary.
    2. Prepare Necessary Documentation: This will usually include;
      1. Completed claim forms
      2. Medical attendants statement completed by certified medical practitioner giving verification of the illness/injury.
      3. Bank details may be required to allow provider to deposit any benefits into nominated account.
      4. Details of previous health claims may be required.
    3. Submit Claims Documentation: Completed claim documentation to be submitted to insurance provider.

    Total and Permanent Disability Claims and Duty of Disclosure

    It is crucial for anyone looking to take out protection cover that they fully understand their obligations under a “duty of disclosure”. In the event that a claim is made, this is the first document that will be checked against the claim application form.

    Before applicants enter into an insurance contract for TPD cover, they are required to disclose any relevant information that may be required by the insurance provider to allow them to assess your situation. This is known as the duty of disclosure.

    This duty of disclosure is legally binding and applicants must disclose any relevant known information to avoid legal consequences for not informing the underwriter of information that may affect the policy.

    In the event that the applicant has failed to comply all information in their duty of disclosure and the policy is less than three years old, the insurer is within their rights to check the duty of disclosure and terminate the contract. In the event that the insurer finds that the duty of disclosure is fraudulent, they may also reduce the sum-insured in accordance to the premium that would have been payable had the correct information been disclosed at the time of application.


    Appealing a TPD Insurance Claim

    In the event that the claim is denied by the Insurance provider, there are certain steps that can be taken to have the decision reviewed.

    1. Submit a Complaint to the Insurance Provider

    Policyholders should contact the chief underwriter of the insurance companies claim department. It is important to Take the time to set out the complaint to the underwriter in full with evidence to justify request for further review. Policyholders should request that the chief underwriter addresses each issue.

    The policyholder may be required to receive further medical documentation from their doctor. A more comprehensive report may be needed if the claim is to undergo further review.

    2. Submission of Complaint to the Insurance Providers Internal Dispute Resolution Service

    If the policyholder is not satisfied with the response received by the underwriting division they are able to write to the Complaints and Disputes Resolution Manager of the Company. Each insurance provider is required to have this department under standards set by the Australian Securities and Investments Commission.

    3. Submit Complaint to the Financial Ombudsman Service

    If the claimant is not pleased with the response from the provider they are able to write to the Financial Ombudsman Service. All claimants will need to undertake the previous steps with the insurance company before contacting the Financial Ombudsman Service.


    Conclusion: Preparation is Key for a Successful Total and Permanent Disability Insurance Claim

    As with any form of protective cover, a successful claim for TPD will be the result of the insured clearly understanding the conditions of their policy and what events they are covered for. This goes hand in hand with disclosing all known relevant information at the time of application to the insurer and notifying the provider of new conditions that may not be covered as they surface. Policyholders who take the gamble of not disclosing important details are gambling their chance to receive a payout for events that could bring great financial hardship. In addition, understanding the actual claims process for cover held within and outside of super will ensure that the overall process is executed smoothly and there is no delay in the payment of their claim.


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69 Responses to TPD Claims: Steps to a Successful Claim

  1. Default Gravatar
    Marina | August 29, 2014

    Hi

    My TPD claim was approved. What happens if later on i feel like i can do some light work – do i have to pay back the money to the insurance company? Do i need to let the insurance company know if i start work? I have not been able to hold down a job and have been unemployed for three years. Thank you

    • Staff
      Richard | September 1, 2014

      Hi Marina,

      Thanks for your question. To the best of my knowledge, generally if you have already received the TPD lump sum payment, there should be nothing restricting you from returning to work, i.e. having to pay back the benefit amount. However, every insurer is different, so it would be of benefit to review your policy document for any caveats.

      I hope this was helpful,
      Richard

    • Default Gravatar
      Marina | September 1, 2014

      Thanks Richard.

  2. Default Gravatar
    Kellie | August 3, 2014

    Hi

    I have a tpd policy that I took out in 2008. At that time I had depression which was actively managed and controlled with regular visits to my doctor and by complying with my meds. THe policy does not cover me for pre-existing conditions Since then it is now suspected that I have an element of bipolar, and with a further diagnosis of narcolepsy confirmed. Can I make a claim under my tpd policy for bipolar (or is that part of the pre-existing condition – which at the time everyone thought it was straight depression) as well as for my narcolepsy? I am currently on income protection.

    Also the definition of “occupation relevant skills training experience etc” – what does that exactly mean for a eg executive director with a professional membership…..i.e if you can do photocopying are you not tpd as technically you learnt how to photocopy in your role?

    • Staff
      Richard | August 4, 2014

      Hi Kellie,

      Thanks for your question. When it comes to claiming for TPD, you generally have to be able to prove that you are no longer able to perform your duties to a reasonable level. That can be a real issue when it comes to claims relating to mental disorders. Whether or not your bipolar will be covered will depend on your insurer. In your policy document you should have a list of general exclusions where you’ll be able to find out if your insurer covers mental disorders in the first place. If they do, check the definitions section and see how they define pre-existing conditions.

      I hope this was helpful,

      Richard

  3. Default Gravatar
    cheryl | August 2, 2014

    I am 57 years old, and have not worked for the past 5 years. Previous to this period I was mainly self employed for over 20 years. I have a Retirement Super Fund-Term Life Insurance Super.
    Would I be eligible for total and permanent disability? I have medical records in relation to mental and physical inability to work and/or study for more than 8 hours a week.
    Thank you for your time.

    • Staff
      Richard | August 4, 2014

      Hi Cheryl,

      Thank you for your question. From what you have listed above, it does appear that you should be eligible to claim on your TPD policy. It would be worthwhile getting out your policy document and going through to make sure you meet the particular requirements for your insurer. Going through your PDS will also help you find out if the condition you are claiming for is covered.

      I hope this was helpful,

      Richard

  4. Default Gravatar
    Steven | July 21, 2014

    I have had surgery on my shoulder 12mths ago and have tried returning to labouring work which I’m skilled at nothing else and shoulder can’t handle it I also have been diagnosed with adjustment disorder and 4% impairment for shoulder could I claim tpd insurance

    • Staff
      William | July 21, 2014

      Hi Steven,

      Thank you for your enquiry. Generally, whether or not you are eligible for a TPD insurance benefit will depend on the conditions of your policy and the definition of TPD that is applied. It is worth checking your policies product disclosure statement to assess whether or not you satisfy the conditions for claiming. You may also wish to speak with your insurer directly to discuss your policy and injury.

      Thank you for your enquiry and all the best.

    • Default Gravatar
      Steven | July 21, 2014

      Thanks my policy says I must not of worked for 3 mths would that include going back to work for a few days but shoulder couldn’t do the work

  5. Default Gravatar
    Cornelia | July 1, 2014

    CAN YOU ADVISE WHERE I CAN OBTAIN A FORM FOR MY DOCTOR TO FILL OUT FOR MY TPD CLAIM

    • Staff
      Richard | July 2, 2014

      Hi Cornelia,

      Thanks for your question. If you go to your insurer’s website you should be able to download and print off the appropriate form for your doctor.

      Thanks very much,

      Richard

  6. Default Gravatar
    BARRIE | July 1, 2014

    HI I AM JUST ENQUIRING IF I CAN CLAIM TPD ON MY REST SUPER FUND INSURANCE .I HAVE BEEN WORKING PART TIME (15 HRS A WEEK )FOR APPROX 7 MONTHS I AM ON DISABILITY SUPPORT PENSION ,HURT MY BACK LIFTING AT WORK (HAD A BACK INJURY BEFORE)MY POLICY GIVES ME TPD FOR $12,500 WILL BE 65 IN OCTOBER IF I STOP WORKING ?????WOULD I HAVE A CASE FOR A CLAIM ???THANKS REGARDS BARRIE

    • Staff
      Richard | July 2, 2014

      Hi Barry,

      Thanks for your question and apologies for the delayed response. According to the first two conditions of the REST Super Insurance Guide, to make a TPD claim the insured:

      a) has been absent from employment for three consecutive months because of sickness or injury; and
      b) is so disabled at the start of those three months and continuously since that time, that the insured member is unlikely to ever engage in any reasonably suitable occupation. In determining whether an occupation is reasonably suitable for an insured member, the insurer considers the skills the insured member has acquired through education, training and experience.

      As for the age, REST provide TPD cover until you turn 70.

      Unfortunately I can not advise whether or not your claim will be successfully processed. You might want to contact REST to see whether or not you will qualify, in so far as to find out what documentation you will need and whether you have had enough time off work. You can contact REST on 1300 300 778.

      I hope this was helpful,

      Richard

    • Default Gravatar
      BARRIE | July 2, 2014

      Hi Richard your answer was VERY helpful Thank you Regards Barrie

  7. Default Gravatar
    | June 26, 2014

    If a Tpd claim is successful , what is the tax payable on this?

  8. Default Gravatar
    | June 23, 2014

    When receiving income protection payments, am I allowed to leave the country? And if so, for how long? If a Tpd claim is successful will the income protection payments need to be paid back? Thank you

    • Staff
      William | June 24, 2014

      Hi Jilly,

      Generally, an insurance provider would not deem you to be eligible for an income protection benefit if you are still able to leave the country despite your condition…you will need to clarify this with your provider. In the event of a successful claim, it is extremely rare for an insurance provider to require the policyholder to pay back repayments for a benefit that has already been paid. Again, you may wish to clarify this with your insurance provider.

      Thanks again for your enquiry and all the best.

  9. Default Gravatar
    | June 22, 2014

    When applying for a Tpd claim, the people who make the decision, do they have a good knowledge of medical conditions? Thank you

    • Staff
      William | June 23, 2014

      Hi Jilly,

      In the event of a TPD claim, the insurance companies claims department will do everything in their power to get a clear understanding of the medical condition and whether it satisfies the conditions of the policy. In most instances the insured will be required to provide additional evidence from a certified medical practitioner to show the nature of the condition and the claimants medical history.

      Thank you for your enquiry and all the best.

  10. Default Gravatar
    Jilly | June 20, 2014

    Have you ever heard of a cervical Dystonia being successful in a Tpd claim? It’s a neurological condition

    • Staff
      William | June 23, 2014

      Hi Jilly,

      Thank you for your enquiry regarding a TPD claim for Cervical Dystonia. As a life insurance comparison service, finder.com.au is not preview to any individual TPD claims that are lodged with different insurance groups. Whether the condition will be covered for a claim really comes down to the conditions of the policy. It is extremely difficult to state whether the condition would be covered as the policy conditions vary greatly between providers. It is worth reviewing the terms and conditions of your product disclosure statement or contact the insurer directly to get a better understanding of whether or not you are covered.

      Apologies for not being able to provide further assistance at this stage and all the best with your claim.

  11. Default Gravatar
    Jilly | June 8, 2014

    Have recently applied for a Tpd claim, have a Dystonia and deep brain stimulation seems to be the only option left, I’d preference to go back to my home country and be close to family, from start to finish how long should this process take? I hope it’s processed sooner than later as this condition is debilitating thank you

    • Staff
      William | June 10, 2014

      Hi Jilly,

      Unfortunately I can’t give a specific time-frame around how long it will take to process your claim as it will be dependent on a number of factors including;

      The nature of the condition
      The complexity of the claim
      Evidence required

      Provided you have satisfied the conditions of your policy there is no reason for you to experience a delay in the payment of your claim. Your insurer should be able to provide you with an idea of how long it will take provided all of the documentation is properly submitted.

      All the best with your claim,

      Will

  12. Default Gravatar
    SallyM | May 28, 2014

    I am assisting a family member with a potential TPD claim, they stopped work at 45 due to severe ill health. Their TPD policy stopped the year after they resigned.

    Now at age 55 they have enlisted my help. Are there statutory guidelines regarding the maximum timeframes for making a claim?

    • Staff
      William | May 29, 2014

      Hi Sally,

      Thank you for your enquiry. Most insurers will apply a time limit from the date the insured stopped working to when they are still eligible to make a claim. For TPD insurance provided through Superannuation, this is usually about two years. It is best that you check with the insurance provider to clarify this.

      Thanks for your enquiry and all the best.

      Will

  13. Default Gravatar
    Erik | May 6, 2014

    My TPD claim has been accepted, I have sent back relevant details ID , bank details etc how long does it take to deposit my funds.

    • Staff
      William | May 7, 2014

      Hi Erik,

      LifeInsuranceFinder.com.au is not an insurance provider. What insurance provider are you trying to get in touch with?

      Thanks and all the best,

      Will

  14. Default Gravatar
    jess | April 24, 2014

    Hi. I had super at time of disability but have only recently found i can claim tpd. On running my super fund i found they closed my account. Am i still able to claim from them??

    • Staff
      William | April 24, 2014

      Hi Jess,

      Thank you for your enquiry. In order to claim, you must be able to satisfy the definition of disability that is provided by the fund. It is unlikely that you will be able to claim funds from an account that you are no longer a member of. It may be worth speaking to the super fund or the financial ombudsman to see if you are eligible for a benefit payment.

  15. Default Gravatar
    oakley | April 16, 2014

    continues to be liked for that major top-quality and best look and feel of the products.I set up a meeting with a middleman in a well-well-known annual meeting. xboter 2014

  16. Default Gravatar
    Hatterville | February 23, 2014

    I have a chronic medical condition and was paid superannuation and TPD 2 years ago. I have been offered a very small job that the employer has enough confidence in me to do, but I asked them to wait for a decision. If I get paid, I have to pay super, then does that mean I have to pay back my TPD or Super Tax benefit received on the taxable portion of the early payment of superannuation. And can I get TPD again?

    • Staff
      Claude | February 24, 2014

      Hi Hatterville,

      Thank you for your question.

      Unfortunately, I am not in position to provide a tailored advice on superannuation and TPD based on your circumstances. You may wish to speak to a lawyer or authorised super fund representatives to provide tailored recommendation on your next steps.

      Generally speaking, you may still be able to obtain TPD cover, however, you will be required to complete a medical assessment due to your pre-existing medical condition and a loading may be applicable on your premiums.

      We apologise for not being able to be of assistance at this time. All the best.

  17. Default Gravatar
    HalfbrainedLITTERALLY!! | February 21, 2014

    I have an inoperable medical condition which has crushed part of my brain (best words I can think to describe what happened). My TPD insurance is through a super company. I have not worked for 2 years and am receiving DSP from centrelink. Super company has been asked 3 times for TPD claim form but are sending out IP claim forms. Do I keep asking for the correct claim form myself or get a lawyer involved?

    • Staff
      Claude | February 21, 2014

      Hi there,

      Have you checked whether you also have income protection cover through your super? It might worth looking into as your condition may also warrant a basis of claim for income protection. Consider speaking to your super fund’s representative directly to get to the bottom on why they continue to send you incorrect forms. Speaking to a lawyer might also help you to know what your options are.

      All the best and let us know how you go.

  18. Default Gravatar
    Simone | February 20, 2014

    Hi,

    The amount that a person claiming TPD is entitled to is based on the amount stated on the day of the injury or the amount on the date that the person is filling a claim?

    • Staff
      Claude | February 21, 2014

      Hi Simone,

      Thank you for your question.

      Upon a successful TPD claim, the policyholder is entitled to the benefit amount as nominated at the time of application.

      Hope this helps.

    • Default Gravatar
      Simone | February 21, 2014

      Hi Claude,

      Thank you very much for your information. However, if the insurer takes, let’s say 2 years to approve it, will there be any correction of the amount based on the day that you filled it?

      Regards,

      Simone

    • Staff
      Claude | February 21, 2014

      Hi Simone,

      While the time to process a TPD claim will generally vary between providers, due to the nature of the claim itself, the agreement of both you and the insurance provider on the sum-insured will be honoured. This means, no matter how long the claim assessment takes, the original nominated cover amount will remain the amount that is paid by the provider once the claim is settled. However, it is important to note that should you increase or decrease your benefit amount while your policy is in force and the new sum-insured has been accepted by the provider, this new amount will be the basis of the payout when you submit your claim.

      Let us know if you have anymore questions.

    • Default Gravatar
      Simone | February 21, 2014

      Hi Claude,

      Thanks once again for the explanation. Please clarify what is “original nominated cover amount”.

      Kind regards,

      Simone

    • Staff
      Claude | February 24, 2014

      Hi Simone,

      Your original nominated cover amount is the amount that you would like to be covered for at the time of application. So, for example, if you applied for $500,000 TPD cover, this will be the amount that will be payable upon a successful claim. However, should you decide to reduce your cover to $250,000 while your policy is in force and the new amount has been approved by the insurer, then this will be the amount that is payable when your claim is accepted.

      If you have more questions, don’t hesitate to ask!

  19. Default Gravatar
    Ian | February 8, 2014

    Hi,
    I have been out of work since April 2013 and left that job after suffering a number of panic attacks. I have since been diagnosed with bipolar disorder which I am now being medicated for.
    I have tpd insurance cover within my super fund, at what point am I eligible to apply for cover, and can I apply even if I may return to work at some stage after medication has had a stabilizing effect on my disorder.
    My doctor has marked a certificate as having a permanent psychological condition.
    Thanks ian

    • Staff
      Claude | February 10, 2014

      Hi Ian,

      Thank you for your enquiry.

      You may be able to claim on your TPD insurance cover through your super if your condition has caused a permanent disability in which you are unlikely to be able to return to work again (to the best of your knowledge). You will have to be able to prove this and you will be required to provide medical evidence, such as your doctor’s reports, which will be assessed by the insurer.

      It may be best to consult with a lawyer that specialised in claims for superannuation TPD cover to have a better understanding of what your options might be.

      Hope this helps and let us know how you go.

  20. Default Gravatar
    niss | January 12, 2014

    I have a tpd claim which has been running since june 2012 we are at the point now where the insurer has forwarded all medical reports to my lawyer and asked for their comments. My solicitor has said that all of the reports including that of the insurers cmo and the ime reports are all supportive of my illness and inability to return to work. There is however a line in my drs report that says “at least two years of psychological treatment before consideration of a return to work” I haven’t worked for 9 years in june just wondering what you think the outcome would be based on this I am hoping a decision will be made shortly as it has dragged out for a long time the claim is for anxiety disorder depression and ptsd

    • Staff
      Claude | January 13, 2014

      Hi Niss,

      Thank you for your question. Unfortunately, we won’t be able to provide a personal advice based on your situation. Different providers will have a different approach on how they assess claims, and I am very sorry to hear that you have waited for this long for a decision to be made. When you submit your claim in June 2012, were you appointed a specific claims officer? It may be worth to follow up with the insurer/claims officer directly on any issues that may have held up the outcome of your claim.

      Let us know how you go and we wish you all the best with your claim’s result.

  21. Default Gravatar
    Supramaniam | December 6, 2013

    Yes all my policies are based in Malaysia.Please clarify further.

    • Staff
      Claude | December 6, 2013

      Hi Supramaniam,

      LifeInsuranceFinder is a financial comparison service based in Sydney, Australia. As previously mentioned, I am not in position to provide general advice for policies that are not issued in Australia, as there may be certain differences with the way the policies are structured – these include built-in policy features and benefits, exclusions and claims process.

      It is important that you seek assistance from your local representatives that can provide information tailored to your situation or speak to the claims department of your policies to clarify any issues that you may have.

  22. Default Gravatar
    Supramaniam | December 5, 2013

    So can i claim TPD and critical illness from all these policies now if there is a chance for it to end after this claim?.All these are under Company B.

  23. Default Gravatar
    Supramaniam | December 5, 2013

    One more comes with A Medical card

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    Supramaniam | December 5, 2013

    the last one is a traditional Life Insurance.

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    Supramaniam | December 5, 2013

    I have claimed critical illness from company A only..
    In the 2011 policies apart from TPD it also covers critical illness in Company B.Can I claim critical illness from Company B apart from TPD claim.
    The 2012 policy is an Assurance plan called Tokyo marine Extra cash with a term for 20yrs and Premium payable period is 5yrs,another is Life income plan with participating and non participating with minimal payable period of 6yr.

    • Staff
      Claude | December 6, 2013

      Hi Supramaniam,

      Can you clarify if your policies are based in Malaysia? It may be best to check with your insurance providers as the terms and conditions may vary greatly between insurers and this might be the case with policies from different countries.

      I am also not in position to be able to provide general advice for non-Australian policies, as your TPD and critical illness cover may have certain differences in the structure and features that I am not aware of.

      However, I would suggest that you have a read through your Product Disclosure Statement/policy schedule that you would have received from your insurer when you sign up. This document will contain all the information that may be relevant to your situation.

      All the best.

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      Supramaniam | December 7, 2013

      Please say what the australian insurance will decide for cases like me

    • Staff
      Claude | December 9, 2013

      Hi Supramaniam,

      Similar to what I mentioned previously, the eligibility of your claim will depend on the conditions of the policy, which will vary between providers and each claim will be assessed on a case to case basis by the insurance provider.

  26. Default Gravatar
    Supramaniam | December 5, 2013

    Thank you.
    How about my other policies from 2012 and 2013 will it be terminated after successfully claiming TPD for 2011 policies?

    • Staff
      Claude | December 5, 2013

      Hi Supramaniam,

      I’m not quite sure what policies you have for 2012 and 2013, but generally speaking, once you have lodge a claim on your TPD and/or critical illness policy, your policies will end. You cannot submit another claim, unless you take out a new policy.

  27. Default Gravatar
    Supramaniam | December 5, 2013

    My policies with company B commenced in 2011 and my TPD was stated by the neurologist in 2012 December

  28. Default Gravatar
    Supramaniam | December 5, 2013

    I have claimed critical illness with success from company A.Now can i claim TPD from company B

    • Staff
      Claude | December 5, 2013

      Hi Supramaniam,

      You may be eligible to claim on your TPD insurance policy if you have been totally and permanently disabled as a result of your critical illness. It may be worthwhile to check with your insurance provider (company B) on your intention to claim and what documents that you will need to provide to them.

      All the best.

  29. Default Gravatar
    Supramaniam | December 4, 2013

    What is superannuation

    • Default Gravatar
      Supramaniam | December 4, 2013

      How long does a TPD claim takes in average

    • Staff
      Claude | December 4, 2013

      Hi Supramaniam,

      Thank you for your questions.

      Superannuation in Australia is a government-supported arrangement in which people put away a portion of their income so that they have funds available when they retire. it is compulsory for employees to meet the minimum provisions, which is currently set at 9.25%.

      The time it takes to process a TPD claim will vary considerably as they are assessed on a case-to-case basis. It may take as short as two weeks; however, in some cases, it may take much longer depending various factors in relation to the nature of the claim.

      Hope this helps, let us know if you have anymore questions.

  30. Default Gravatar
    Bertie | October 27, 2013

    I injured myself at work in nov2012. I put a claim in to an insurance company in April 13. My doctor have said that I am disabled and not going to return to work. I also been to see an insurance doctor and Medicare information and medical records were given to insurance months ago. The insurance company wrote to my work about the accident and my old workplace said I had the accident there and I can’t do any duties at the business . How much longer do these claims take? My husbands job is unsteady and we are on the verge of losing our home and have two young children to support. I took this policy out to cover accidents but it’s now taking forever and so worried about our future

    • Staff
      Claude | October 28, 2013

      Hi Bertie,

      Thank you for your enquiry and we are sorry to hear that your claims process has been taking longer than expected.

      Have you followed up regarding your claim with your insurance provider since? If you were nominated a case officer when you lodged your claim, it could be worth getting in touch with him/her to find information on how your claim is progressing. The time it takes for each life insurance claim often varies between cases, depending on the complexity of information that the insurer may require.

      We apologise that we are unable to offer you more help at this time, but we wish you all the best with your claim.

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    Emily | October 18, 2013

    I injured myself number of times the sec time I was injured I was off work for 4 mths I then was forced back too work as the insurance doctor claimed nothing was wrong with me , then I hurt myself again
    The insurance company’s from my super r declining my tpd are arguing the date of injury going by the thrus not sec injury have u heard of this before?

    • Staff
      Claude | October 21, 2013

      Hi Emily,

      Thank you for your question.

      Different insurance providers will assess TPD claims on a case-to-case basis and therefore, the outcome may differ depending on the nature of your claim.

      Did you put in a claim when you were injured the first time? It is important to obtain all the facts from your insurer on reasons for your claim being declined and get second opinions from other parties.

      Let us know how you go and all the best with your claim.

  32. Default Gravatar
    Lee | October 17, 2013

    Hello, I have a question regarding my husbands TPD Insurers. We have lodged a claim through our lawyers but the problem is the insurers keep requesting the same information (3 times now) Every time they request this same information our lawyer gives them another 6 weeks to make a decision. Is this the normal routine? I could understand if it was new information they were requesting
    Thank you Lee

    • Staff
      Claude | October 18, 2013

      Hi Lee,

      Thank you for your question.

      What sort of information did the TPD insurer ask? Claim assessment often takes some time and it will vary from one policyholder to the next, depending on the nature of the claim. Perhaps it could be best to clarify with the insurer on reasons for requesting information the same nature 3 times, they may have a good reason why.

      We wish you all the best with your husband’s claim. Let us know if you need help down the track.

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