What should I consider when making a TPD claim

Suffering from an injury or illness that prevents you from working can be extremely stressful. Fortunately, you can benefit from the insurance in your superannuation and gain access to funds to cover your living and medical expenses.

If you are looking to lodge a Total and Permanent Disability claim, there are several things to consider. The claims process can be complex and overwhelming; filling out forms and gathering the required evidence for your claim might be too challenging to accomplish on your own. Most individuals do not even know where to start, only to have their claims rejected in the end.

Insurers can refuse to pay claims for many reasons, including:

  • Your situation does not fall under any stated definition of TPD in their policy; or
  • You do not meet certain working hours requirement; or
  • There is no sufficient medical evidence to show your incapacity to work; or
  • They believe that you can still find another form of employment within your education, training, and experience

Unfortunately, lodging an insurance claim can be tedious and difficult and can often discourage people from making a claim. 

You should consider these things when making a TPD claim:

  1. The definition of TPD under your respective policy and your rights

    There is no one established definition of TPD – it differs from one policy to another, which makes it harder for individuals to understand the requirements to access their benefits.

    A TPD lawyer is well-versed in various policies and can advise whether your situation falls under the policy of your superannuation/insurer. A claim may be denied solely on the basis that it does not fall under the respective policy. Your lawyer will ensure that you understand your rights before making a claim and during the claim process itself.

  2. Your claim value and the corresponding paperwork

    To avoid wasting your valuable time and resources, it is important to know at the onset whether you have a TPD cover. Your lawyer can investigate your entitlements and subsequently advise if your claim will be viable.

    The paperwork involved in TPD claims are extensive. Having a lawyer can ease the burden of having to gather necessary evidence – allowing you to focus on improving your health.

    In Littles, our lawyers have years of experience and can easily determine if your claim has a high chance of success. Our experienced experts know what kind of evidence is needed to support your claim, and we will help you present a stronger case that can get quickly approved.

  3. Possible rejections and court proceedings

    Chances are your claim will be denied if you come unprepared. You have the right to challenge an insurer’s decision, but there are cases where claims are taken to court. This situation might be too confusing and overwhelming for you, hence it is better to find an excellent legal team to make the process manageable.

    Littles can help you challenge the insurer’s rejection and represent you in court if needed.

Can I make a claim on my own nonetheless?

You can always make a claim without engaging a lawyer but keep in mind that you will be facing several obstacles and difficulties without having the necessary knowledge and expertise, which otherwise would have been available to you if you had engaged a lawyer.

Insurers will examine your medical history – and may find a potential pre-existing condition you had, dispute the diagnosis of your current condition, or even bring up a non-disclosure issue.

If you are suffering from an injury or illness that prevents you from working, you should prioritise your recovery and leave the rigorous process to Littles.

Littles conduct TPD claims on a No Win, No Fee basis. We will not require you to pay out-of-pocket while we help you process your claim. Contact us today to discuss your TPD needs.

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