Superannuation / TPD Claims

If you’re injured or ill and unable to work, then it can often result in financial concerns. Should you find yourself in this position, then you may find that your superannuation policy comes with a monetary benefit.

Specifically, many people have attached a Total and Permanent Disability (TPD) component and/or Income Protection (IP) cover to their superannuation policy. These are typically additional benefits to your superannuation policy, so your take-home amount won’t be affected. However, you should check your policy details before claiming.

You can claim for any accident or injury, and your health issues do not need to be caused by the fault of another person. If you are the dependent of a deceased loved one, then you may also be entitled to claim on TPD insurance via a post mortem or after death claim.

What is a TPD Claim?

A TPD claim is a claim against a person’s superannuation fund, allowing a benefit to be paid if a member can no longer work again or is unlikely to ever work again due to a physical or mental injury illness. For this reason, it’s sometimes known as a disability benefit or an incapacity benefit.

TPD claims cover a range of accidents, injuries and illnesses. The main focus is not on what caused the medical condition, and instead these claims focus on the individual’s ability to work again as a result of the condition.

In some cases an individual may have a right to make two claims, for example if they are injured in a motor vehicle accident, then they can make a claim against the CTP insurer and also a claim under their superannuation policy.

All policies have specific wording as to the entitlement of a person to make a claim. As a result, your policy must be carefully reviewed to ensure that you have the correct entitlements. It is therefore important to ensure you obtain expert legal advice before proceeding. This way, you can ensure that the correct evidence is placed before the insurer before a determination of your claim is made.

When Can I Make a TPD Claim?

Generally speaking, you need to be absent from work for a minimum period of 6 months before a claim can be considered (although this varies between policies). The types of injuries covered by these policies are far ranging and include both physical injuries and also psychological/psychiatric injuries.

Provided you had insurance coverage in place at the applicable time, then you will be able to make a claim regardless of the cause of your injury or illness. Instead, you will just have to show that the injury or illness you sustained has affected your ability to earn an income or has severely impacted your ability to carry out daily tasks.

Proof Required for TPD Claims

To claim for TPD, you will need to provide medical evidence that you meet the criteria outlined in your policy. This will generally include medical certificates from doctors and other medical practitioners.

You will also need to meet the definitions laid out in your policy in order to make a claim. Most TPD policies are ‘any-occupation’ policies (including all under supers). This means that you’ll need to prove that you are unlikely to ever be able to work in a job again that is suited to your level of education or experience. As this can include all forms of paid work (depending on the policy wording), it can be difficult to prove, which is why expert help is recommended.

However, some TPD policies are what’s known as ‘own-occupation’ policies. This means that you’ll only need to prove that you will never be able to return to work full-time in your previous role. This can be easier to prove if, for example, you are a bricklayer who has broken their back.

Depending on your level of cover, you may also be required to submit your work history to satisfy eligibility criteria. This can include: 12 months of employment history, whether you’re a full-time or part-time worker, or whether you work a minimum number of hours.

If you’re successful in making a claim, some policy providers will then ask that you prove that you’re receiving ongoing medical care to improve your condition or prevent further illness.

Consulting a Lawyer about TPD Claims

We are happy to provide individuals with a free check of their entitlements to claim under any such policy. Despite the process not being overly complicated, there have been unfruitful outcomes for some who are not properly represented. In these cases, a more positive result may have arisen if they had been properly represented. By instructing us to help with your matter, we will be able to ensure that you hit all deadlines, provide the right evidence and stand the best possible chance of success.

If you’re interested in lodging a TPD claim, then please contact us to discuss your case.

FAQs

Is there a time limit for lodging my claim?

A time limit will apply for your claim, but this varies from fund to fund and from insurer to insurer. Under some schemes, you can claim immediately, while others require you to spend at least six months off work. To ensure that you’re meeting all of the relevant legal requirements, we suggest instructing a lawyer. If your employment is terminated, then you usually need to claim within two years.

How long will it take to process my claim?

How long it takes to process your claim will depend on the complexity of the matter. Generally speaking, most claims are settled within two to three months, but if your claim progresses to trial (which is highly unlikely), then it may take much longer.

How much money will I receive for a successful claim?

The amount of money that you receive will depend on the type of insurance cover you have and how much you’re insured for. You can usually find this information in the fine print of your policy documents.

How TPD claims work for multiple super funds?

If you have multiple super funds from different employers, then you may be able to claim multiple benefits at the same time. However, before you make such claims, you should carefully check the conditions of each fund.