Seymour Furlong Lawyers

Total and Permanent Disability (TPD) insurance provides a safety net to catch you when all else fails — it’s there to ensure continued quality of life and financial security in the aftermath of a life-changing injury or illness. 

Queenslanders who may be eligible for a TPD payment because they are not expected to resume work (in their profession or any other for which they are reasonably qualified) do have to navigate a challenging bureaucratic process. 

This overview demystifies key aspects of TPD payments. We’ll cover who is eligible for TPD, how the claims process works, how long it usually takes to process TPD payouts, and how to increase your chance of a successful outcome.

What Is a TPD Payout?

TPD insurance pays you a lump sum to cover your medical needs and daily living expenses if an illness or injury has rendered you unlikely to ever be able to work again. These lump sum payments are called TPD payouts. 

TPD payouts are intended for adults who have yet to reach retirement age.

Many Queenslanders have TPD coverage through QSuper, but private insurance companies can also offer TPD insurance. Eligible candidates receive their TPD payouts after initiating a claims process and waiting for the investigation to be completed. Those insured through QSuper  receive this lump sum directly from their Supers.

Eligibility for TPD Payouts

Are you ready to make a TPD claim? Make sure you meet the eligibility criteria first — and if you do, we highly recommend you seek legal advice to increase your odds of a successful outcome. After all, red tape is always tricky, and a lot rides on your claim!

Criteria for Qualifying

You may be eligible for a TPD payout if:

  • An injury has left you permanently and totally disabled, and you can no longer work. The causative injury is not necessarily related to a workplace accident.
  • You suffer from a chronic illness that renders you unable to work (e.g depression).
  • You have been diagnosed with a terminal illness.

Queenslanders who qualify for TPD payouts are below retirement age and cannot work in their profession or any other for which they are reasonably qualified.

Claimants are generally expected to wait until their full prognosis becomes clear. Because the full extent of an injury or chronic illness is not always apparent immediately, there is no time limit to claim TPD insurance.

Understanding Your Insurance Policy

Once it becomes clear that you are unlikely to return to work, you may consider filing a TPD claim.

Carefully reading your insurance policy should always be your first step. While many super companies use plain language, private insurers often rely on legalese. Your policy outlines who is eligible for TPD coverage and under what circumstances. Don’t hesitate to consult a TPD lawyer if you aren’t sure whether you qualify.

The Process of Claiming a TPD Payout

Your TPD claims process starts by downloading a digital copy of the claim form. Claimants should ensure the claim form is completed adequately and accurately. 

Claimants or their lawyers complete the first step of the TPD claims form. The next steps lie in asking your last employer and medical providers to fill in their portions.

TPD claims forms look straightforward on the surface, but they form the basis for your future. Don’t underestimate the power of legal advice — a lawyer can ensure that your claims form is completed carefully and appropriately.

Navigating the TPD Claim Process

The TPD claim process is more challenging than a first look suggests. The most common hurdles claimants face include:

  • Discerning whether or not they are eligible for a TPD payout. 
  • Gathering adequate medical evidence to prove Total and Permanent Disability.
  • Proving an inability to work in a different profession, which may require an occupational assessment. 
  • Complex legal jargon in policy documents.
  • Claim denial. If your claim is denied, it doesn’t have to spell the end. TPD claims may be rejected due to incomplete or inadequate applications. Your next steps from when your TPD claim is rejected is important. The guidance of a skilled lawyer can help claimants overcome all of these hurdles.

Getting Professional Help

Your TPD claim process is too important to navigate the unfamiliar process on your own. Seeking legal advice is the best course of action if you are Totally and Permanently Disabled and determined to maximise your chance of getting the TPD payout you need to live a dignified and independent life.

Seymour Furlong works on a no win, no fee basis. That means consulting us is free, and you won’t pay us a cent unless we can successfully navigate the TPD claims process on your behalf.

The Timeline of a TPD Payout

While it doesn’t give a precise timeline, the Australian Prudential Regulation Authority’s 2022 report suggests that the average claims processing time is just over five months. 

More complex cases can take longer to review, and claimants who made errors in completing the TPD claim form may also have to wait longer.

Financial Implications of TPD Payouts

Queenslanders in a position to file a TPD claim have no other choice, but still want to know how receiving a lump sum from their TPD coverage impacts their financial situation.

Tax Considerations

The tax implications of a TPD payout depend on their source — whether the TPD payout comes from your Super or a private insurer.

Super TPD payouts are taxed the same way as superannuation withdrawals, while TPD payouts from private insurers are tax-free.

Impact on Other Benefits

TPD payout recipients of working age cannot claim jobseeker allowance as they are, by definition, unable to work. However, working-age TPD recipients aren’t subjected to Centrelink means tests. Therefore, a TPD payout does not impact other Centrelink benefits.

It’s a little different for pensioners. Centrelink assesses how you use your TPD payout to decide whether to apply means testing. TPD funds used for daily living expenses are not subject to means testing, while funds transferred to a bank account are.

TPD Payouts Are a Complex Maze: Get the Help You Need

TPD insurance is designed to ensure you have what you need even if the worst happens and you’re not expected to be able to work again. Unfortunately, the TPD claim process is challenging — and you may have concerns even after you receive a TPD payout. 

Do you have questions? Do you wish someone could simplify the TPD claim process for you while giving you the best chance of a secure future? 

Get in touch with Seymour Furlong Lawyers today, and receive answers to all your burning questions. Our no win, no fee model ensures you don’t pay if you don’t benefit — and you’ll have a lawyer who staunchly advocates for your needs in your corner.

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