Every employer, by law, must pay, on your behalf, a weekly amount into a nominated superannuation account. Due to the My Super legislation, it required super funds to offer Total Permanent Disability (TPD) insurance to all super accounts that were registered as My Super approved. To determine whether you have TPD insurance, we recommend you contact your super fund, check your annual statement, or log in online (if possible).
If you have suffered an injury or you have fallen sick and you have TPD insurance, you may be able to file a TPD claim to cover the financial hardship caused by the illness or injury. Once your claim has been submitted you will need to wait for it to be assessed before you find out if you are eligible for TPD payments.
When Can I File a TPD Claim?
You may only apply for a TPD payment if you meet the definition of being totally and permanently disabled either through an illness or an injury. While this wording is similar in most TPD insurance policies, there can be some small differences so if you are unsure, we recommend you contact one of our specialist TPD insurance lawyers.
However, generally, you must first be unable to work for a 6-month period due to the injury or illness. You will then need to show medical evidence that you are unable to work, by having a GP certify as such. To then be successful, the fund must be satisfied that you cannot return to work in your previous education, training or experience training. To determine whether you meet the policy definition, the insurance company may send you to see a specialist to seek their opinion.
What Is The Claims Process?
When the process of applying for TPD begins, you will need to complete a form called “Claim for Total and Permanent Disablement Benefit.” which requires you as the claimant to write a statement. Also, a Medical Attendant Statement will need to be completed by the doctor treating you, who is expected to describe your illness or disability. You may also be asked to provide one of the following:
- your driver’s licence;
- a passport showing evidence of your age;
- a certified copy of your birth certificate;
as well as a medical statement that describes your condition.
These forms and requirements can be confusing which is why many choose to engage a specialist insurance lawyer such as those at Main Lawyers. Many lawyers operate on a fixed fee to ensure legal fees do not get out of control when helping with a TPD claim. We find that many claims are denied due to the incorrect information contained in forms. Claims can also be delayed if you are not aware of what information and documents are required. Having a lawyer can help you avoid delayed or denied claims.
If the insurer wishes, you may be asked for more information about your condition such as further reports from your doctor or request information from your employer. The claims assessor may ask you to attend another medical examination which s/he will arrange for you and cover the payment. If you do not attend you may be asked to pay a fee called the medical non-attendance fee.
Many TPD claims are denied. As soon as your application has been assessed, you will be told if it has been declined, accepted or deferred. It is important that you talk to a lawyer before you start the TPD claims process as this will give you a higher chance of your TPD claim being accepted. Often, insurers defer an application if they are not sure of the extent of the applicant’s disability and will review it before reaching a final decision. If the application is denied is usually because the insurer doesn’t believe the applicant is not permanently and totally disabled so doesn’t fit the criteria for TPD.
Most TPD claims lawyers in Brisbane work on a no win no fee basis meaning no legal fees will be charged until there has been a satisfactory outcome to the TPD claim.
Related Tag: Public Liability Insurance
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If you require assistance to file a TPD claim, contact the expert team from Main Lawyers today for a free initial consultation.