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Total and permanent disability’ (TPD) insurance is an insurance product that pays a lump sum benefit if you become sick or injured (or both) and unable are unable work again. Most people will have TPD benefits available through their superannuation fund – they just don’t know it! However, it’s important to be aware of. After all, this insurance is often paid for through your super fund, and that’s money you have worked hard for!
Many people who make TPD claims do so at a time of financial or emotional hardship. While TPD claims can relieve some of the associated stress, making a successful claim can be complex. Insurers do not seek to make the process easy, and can be formidable opponents.
Having high quality legal advice and support throughout the process is important. However, not all lawyers are created equal. This blog explores the process for making a TPD claim, how and why an expert lawyer can value add, and what you should expect to be charged.
Almost all super funds provide automatic coverage for TPD for members when they join the fund. Members can also usually apply for additional insurance cover. The amount of your insurance cover will usually depend on your age and the super fund that you are a member of. Remember, having a total and permanent disability doesn’t mean that you’re unfit for all work – just that you’re unable to do the work fitting your area of skill and expertise. Sometimes, you may need to show that you cannot be retrained to do another different job. This will depend on the fund, as different insurers may have different claim thresholds and requirements.
Importantly, the cause of the illness or injury doesn’t usually matter. Your illness or injury doesn’t have to be work-related. A TPD benefit can be payable for any illness or injury that prevents you from working. We have assisted people claiming for many illnesses and conditions, including:
•Multiple Sclerosis (MS)
• Parkinson’s Disease
• kidney/renal failure, and
• mental health disorders.
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If your claim is successful, you will usually be paid a lump sum into your super fund. If your insurance is not held by your super account, benefits will likely be paid directly to your personal account.
It depends who you ask! While insurers say that the system designed for people to manage their own claims, there’s little regulation to ensure unrepresented claimants aren’t mistreated. We’ve seen clients struggle with the convoluted superannuation claims process, and complex legalese in their insurance policies. If you’re unable to work due to serious injury or illness, you probably want to focus on getting well and looking after your family – you don’t want to spend your time filling out complicated paperwork and providing evidence to support a superannuation insurance claim. The right lawyer can streamline the superannuation claims process, and make your life easier. But remember – not all lawyers are created equal. If you’re going to consult a lawyer, consult an insurance law expert.
At Littles, that’s exactly what we are. We’ll ensure that you know your rights, we’ll help you take care of paperwork, and push back on unreasonable requests. We’ve got our clients’ best interests at heart – insurers don’t.
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To make a successful TPD claim, you need to:
• have TPD insurance
• demonstrate through medical and other evidence that you’re unable to do your normal job or any other work related to your training and experience
• complete the complex and time-consuming insurer claim forms, including statements form your previous employers and doctors, and
• navigate the slow and difficult claim assessment process (usually 6 to 18 months!).
Remember, being a good candidate for a total and permanent disability claim doesn’t mean that you’re unfit for all work – just that you’re unable to do the work fitting your area of skill and expertise. Sometimes, you may need to show that you cannot be retrained to do another different job. This will depend on the fund, as different insurers may have different claim thresholds and requirements.
Generally, the earlier you seek advice, the better. This ensures that we can make all relevant investigations, lodge all necessary claims, and help you put your best foot forward from the very beginning – making your life easier. However, we’ve successfully assisted clients who have come to us when their claims are under investigation by the insurer, or have been rejected.
Yes! In most cases, you can make a TPD claim against each policy that you or your super fund holds for you, without affecting the outcome of any other claim.
The amount that you are entitled to claim will depend on the policy your fund holds. Generally, the benefit amount is worked out based on your age when you cease work. If you have more than one super fund, you might be able to make more than one claim. These benefits are usually paid by lump sum into your super account. This lump sum is often substantial and can be more than $100,000 depending on your super fund and your personal circumstances.
At Littles, we are TPD experts and always check what insurance cover you had when you last worked, not the cover that you have at the time you made an inquiry to Littles. This is because the amount of the insurance benefit available to you changes over time. In some cases, your insurance can stop without you even knowing.
Even if your super fund is telling you that you have no insurance cover, it’s worth getting independent legal advice. You’ve worked hard for your super, and the insurance that comes with it. If you’ve been sick or injured, we can help you understand if you’re entitled to make a claim.
Your legal costs will depend on the exact circumstances of your matter. However, all of the costs associated with your claim will be laid out clearly in our costs agreement for you to consider before we commence acting for you. Importantly, we handle most insurance claims on a no win, no fee basis.
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. Don’t put your health at further risk. You might 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 you’re your rights are, and manage the process efficiently and sensitively. Know where you stand, and get peace of mind.
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.