TPD insurance claims can be a long, difficult process and most claimants will have some doubts about what TPD means, what they are entitled to and what to do if their claim is rejected. In order to help you with your concerns here are the answers to some of the most common questions about TPD insurance claims.
What is the difference between an any occupation and own occupation TPD claim
The two most common types of TPD claim are based on the inability to work in “any occupation” or your “own occupation” due to injury or illness.
As the name suggests the “any occupation” claim is pursued when an injury or illness has meant that you are unable to work in any occupation for which you have the required skillset, training, experience and education. Every insurer has their own standards for how total and permanent disability is defined, some common standards are that you have lost somewhole person function, or you are unable to perform a list of activities of daily living.
While similar, the “own occupation”claim is pursued when an injury or illness has meant that you are unable to work in your usual occupation or chosen field of employment for which you have the required skillset, training, experience or education.
Can I make a TPD claim from multiple superannuation funds?
If you have multiple superannuation funds and they are separate from each other then you may be eligible to claim TPD benefits from each of them. This means that if you can prove that you have a total and permanent disability in regards to your own or any occupation then you can lodge a claim for TPD payout from each of your superannuation accounts or insurance policies simultaneously. Usually, you must be paying TPD insurance premiums within your fund or funds, at the time of incapacity in order to make a claim.
How long does the TPD claim process take?
Once you’ve lodged your TPD claim and supporting evidence it will need to be reviewed by the insurance company. Once approved by the insurance company it will often be assessed by the trustee of the superannuation fund as well. This whole process normally takes between 6 to 12 months depending on the complexity of the case and the strength of the evidence supplied.
What happens when my TPD claim is accepted?
If you’ve lodged your TPD claim with your superannuation insurance and it has been approved, then you have the option of receiving the payout as a lump sum or leaving it within your superannuation. Most people prefer to receive the lump sum directly instead of leaving it in their superannuation account.
Can I get a decision reversed if my claim is rejected?
If your TPD claim has been rejected and you believe that it was wrongfully refused then you can dispute the decision and attempt to have it reversed. This can be done in numerous ways including requesting an internal review by the super fund, referring the decision to the Australian Financial Complaints Authority or commencing your claim in court. Whatever you choose it is often best to consult a professional TPD lawyer to assist you in lodging your dispute.