Help! My TPD claim is taking too long

‘Total and permanent disability’ (TPD) insurance is an insurance product that lets you claim benefits if you become sick or injured (or both) and unable to work again as a result – regardless of what caused the injury or illness.

Most people will have TPD benefits available through their superannuation fund – they just don’t know it! If you cannot work because of injury or illness, being able to receive TPD benefits will be an important part of ensuring your financial wellbeing. However, lengthy waiting periods and delays by insurers can often mean that you wait much longer than you have to for this crucial additional support. This blog provides practical information on what you need to know.

I can no longer work. How long do I have to wait before I can lodge my TPD claim?

If you find yourself unable to work because of injury or illness, you will understandably be eager to explore every available option to ensure you can still pay the bills, including claims on any insurance policies straight away. Before you can claim a TPD benefit, you will generally need to be off work for the designated waiting period, which is usually around three to six months. Insurers will often tell you that you are not allowed to lodge your claim until after the wait period expires. However, we have had clients who have been able to have their waiting period waived so that they could claim sooner.

I’ve lodged my claims form with my insurer. How long will my TPD claim take before I know if I’ve been successful?

It can take insurers some time to make a decision on your claim – anywhere from three to 12 months. We know that this can be frustrating if you’ve already had to hold off on submitting your claim form due to lengthy waiting periods. There are a number of factors that affect how fast, or how slowly, an insurer processes your TPD claim. The key one will be the length of time it takes for them to gather the relevant information and documentation they need to assess your claim and make a decision. They may also ask for you to attend an interview with an investigator.

My insurer has told me that my disability insurance claim is under investigation. What do I do? – Littles

What sort of information or documentation will my insurer need to make a decision on my TPD claim?

At minimum, insurers will usually make requests for the following information:

· Medicare and Pharmaceutical Benefits Scheme (PBS) history

· ATO documents (including income tax returns and notices of assessment)

· requests for Centrelink documents and payment history, and

· requests for medical records or medical reports.

 

I am off work and I have bills to pay. How can I speed up the process of providing further information?

Insurers sometimes request documents or information that are not required to assess your claim, or that for whatever reasons, they are just taking too long to process your claim. Whatever the reason, we know that you still have to pay your bills and put food on the table, and dealing with endless requests for material from insurers with no end in sight can make an already difficult situation worse.

Communicating with insurers, and dealing with their requests for information and documentation can be complex and stressful. At Littles, we are TPD experts. We handle every aspect of our clients’ TPD claims, including responding to request for information, and pushing back when insurers claim information or documentation that is not needed, or is designed to slow down the process. Let Littles help. Get peace of mind, and know where you stand. Contact us here!

I am upset about the length of time my insurer is taking to assess my claim. What can I do about it?

Wet get it. If you are unhappy with how your insurer has handled your claim, you can complain directly to the insurer, or to the industry regulator, the Australian Financial Complaints Authority.

Before making a complaint, you should consider seeking legal advice. Let Littles help. We are TPD experts, and can communicate directly with the insurance company and help to speed up the assessment of your claim. We will focus on communicating with the insurer, so that you can focus on your health.

Don’t delay – seek advice now

If you have an illness or injury that prevents you from working, you might be worrying about how you are going to pay your bills and put food on the table. You could be entitled to receive a TPD lump sum, as well as other insurance benefits. Get in touch with Littles for a free super claims check. We can help you understand what you’re entitled to. Know where you stand, and get peace of mind.

Free advice and no upfront fees

Not only do we offer a FREE claims check – we handle most insurance claims on a no win, no fee basis.

Our Head of TPD and General Insurance, Rowan McDonald, is an insurance law expert. If you think you might have a claim, get in touch with Rowan and his team for high quality legal advice.

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