My TPD claim has been rejected. What do I do next?

Across Australia, thousands of people are paying for TPD insurance through the hard earned money in their super funds. Many people are unaware they even have TPD insurance. However, if you suffer from an injury or illness that means you are unable to work, finding out that it is available and that you may be eligible to claim a lump sum can come as a great relief. However, this relief may be short-lived if your insurer rejects your TPD claim. If you have a chronic illness or have sustained a serious workplace injury, rejection of your claim can add worry and stress to an already difficult situation, particularly after you’ve already participated in the insurers’ claims process in good faith. The important thing for you to know is that you have options. This blog provides practical information on what to do next.

I’ve done everything the insurer asked as part of my TPD claim. I can’t understand why they rejected it.

Our clients come to us having bent over backwards to do the right thing and do everything that the insurer has asked of them. They have provided medical reports confirming that their injury or illness prevents them from working. They have obtained a statement from their employer confirming that they stopped work due to injury or illness. They have provided tax returns, Medicare and pharmaceutical benefit records. Some have even submitted to an independent medicolegal examination by a doctor of the insurer’s choosing, or undergone an interview with an investigator engaged by the insurer. All of this takes place over a period of many months that follow lengthy waiting periods.

When, after all of this process, they receive a letter advising that their claim has been rejected, they find themselves deflated and demoralised. Clients often come to us not knowing what their next steps are, or whether they have any further options.

Let Littles help. We can do a free super claims check, and provide legal advice on what your options are. 

My TPD claim has been rejected. I’m really upset with the way my insurer handled my claim. Should I write a letter of complaint, or request a review of the decision?

We understand that having your TPD claim rejected can give rise to a range of emotions, including anger, frustration and worry over your family’s financial future. While we understand that you may want to write an angry letter of complaint, there are a number of important things to consider before you take your next step.

First and foremost, you need to closely look at the insurer’s reasons for refusing your claim. Have they misinterpreted your TPD policy? Have they made a mistake or mischaracterised your illness or disability? Is the insurer relying on a technicality to deny the claim?

If this is the case, seeking review of the insurer’s decision may often be a more effective approach in terms of helping you get access to much needed funds to help pay the bills and put food on the table. There’s nothing to stop you from making a complaint at a later date.

Seeking a review of the insurer’s decision can be a complex process that often involves complex legal considerations. Let Littles help. We are TPD experts and have helped many clients successfully seek a review of insurers’ decisions to refuse TPD claims. 

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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