Total and Permanent Disability (TPD) Insurance provides a lump sum payment if an individual suffers a permanent injury or illness, which can be life-altering. These conditions often make it extremely challenging, if not impossible, to return to work. TPD insurance is designed to be a crucial financial safety net during such tough times. Navigating the claims process can be complex, but with the help of our experienced TPD lawyers in Brisbane, Queenslanders can ensure they receive the financial support they are entitled to, allowing them to focus on their health and well-being.

What type of permanent illness or injury is eligible for a TPD claim?

TPD insurance typically covers a wide range of injuries and illnesses that result in the insured person being unable to return to their occupation, a similar occupation, or any occupation, depending on the policy’s definition of disability.

The specific injury or illness conditions that are covered depend on the definitions within the TPD insurance policy.  

Some examples of permanent injury or illness that may fall under TPD Insurance cover include:  

1. Serious Musculoskeletal Injuries: Injuries that significantly impair mobility or dexterity, including severe back injuries, paralysis, or amputations. 
2. Chronic Illnesses: Conditions such as chronic heart disease, kidney failure, or other progressive illnesses that result in an inability to work. 
3. Neurological Conditions: Diseases that affect the nervous system, such as multiple sclerosis, Parkinson’s disease, or severe traumatic brain injuries. 
4. Mental Health Disorders: Severe mental health issues including depression, anxiety, bipolar disorder, or schizophrenia, which significantly impair one’s ability to function in a work environment. 
5. Cancer: Advanced or terminal stages of cancer that prevent a return to work. 
6. Blindness or Significant Visual Impairment: Conditions that result in loss of sight, making it impossible to engage in one’s usual occupation or any occupation. 
7. Deafness: Severe hearing impairment that cannot be corrected with hearing aids, affecting one’s ability to work. 
8. Chronic Respiratory Diseases: Conditions such as severe asthma or chronic obstructive pulmonary disease (COPD) that are debilitating. 
9. Autoimmune Diseases: Conditions like lupus or severe rheumatoid arthritis that result in significant functional limitations.
   

Do I have TPD Claim Cover?

TPD coverage is an insurance product that can be purchased as a stand-alone policy. For peace of mind, many people have this type of policy, which they have customised to their circumstances.  

Millions of Australians unknowingly have a default TPD insurance policy attached to their superannuation account or a life insurance policy. This default insurance can provide financial protection from disability and illness with the lumpsum payout.  

How much is my TPD payout amount?  

The TPD payout amount will be dependent on your insurance coverage. On the entry-level side, a range of insurers offer baseline coverage from $25,000 to $100,000. Moving towards the premium end, TPD coverage limits can escalate to between $1,000,000 and $2,000,000. There are a small number of insurers that offer policies that have coverage of $5,000,000.  

In our experience, many people have the default TPD insurance attached to their Superannuation account, which typically ranges between $120,000 to $200,000.  

This table provides a clear overview of the range of TPD payout amounts depending on the type of insurance coverage. 

You may also have multiple TPD policies if you have multiple superannuation accounts. A TPD claim can be made against each policy, potentially meaning numerous payouts.   

How long does A TPD Claim take?

In our experience, TPD claims take between six to twelve months. This timeframe can vary depending on the complexity of the claim, the responsiveness of medical professionals, and the efficiency of the insurance company handling your claim. 

How to make a TPD Claim?  

1. Review Your Policy: Carefully read through your TPD insurance policy to understand the specific criteria, definitions, waiting periods, and any exclusions that may affect your claim eligibility. 
2. Gather Documentation: Collect all relevant documents supporting your claim, such as medical records, specialist reports, diagnostic test results, treatment history, and any other evidence that demonstrates the severity and permanence of your disability. 
3. Notify Your Insurer: Contact your insurance company as soon as possible to inform them of your intention to make a TPD claim. Obtain the necessary claim forms from the insurer and ask about any additional documentation or information they may require. 
4. Complete Claim Forms: Fill out the claim forms accurately and thoroughly. Provide detailed information about your medical condition, the impact on your ability to work, and any other relevant details as required by the insurer. 
5. Obtain Supporting Statements: If necessary, obtain statements from healthcare professionals, specialists, or other relevant parties to strengthen your claim. These statements should emphasise the permanent nature of your disability and its impact on your ability to work. 
6. Submit the Claim: Submit the completed claim forms and supporting documentation to your insurance company. Ensure that you keep copies of all documents for your records. 
7. Cooperate with Insurer: Cooperate with the insurer throughout the claims process. Be responsive to any requests for additional information or clarification and keep communication lines open. 
8. Await Assessment: The insurer will assess your claim based on the provided documentation and may conduct their own investigations, such as obtaining medical opinions or consulting with specialists. 
9. Decision and Notification: Once the assessment is complete, the insurer will make a decision on your TPD claim. You will be notified of their decision and if approved, details regarding the payout amount and any associated terms. 

Do I need a Lawyer for a TPD Claim? 

TPD policies are complicated documents that vary between insurers. While one insurer may accept your injury, another may not. Our lawyers can guide you through our experience with documentation and policy we will be able to read and understand the legalities of your policy.  

1. Applying for a TPD:
   You only have one opportunity to apply informally for a TPD payout through the insurer application process.  Our lawyers can represent you and present your application to increase your chances of success, which will help you avoid having to appeal to the insurer or the high court.
2.  Medical Certificate:
   Claims require a medical certificate to evidence the injury or illness. Some Doctors or Specialists are unwilling, non-compliant or unable to provide the necessary medical certificate. We have solutions for this to obtain a successful outcome for you. We can refer you to medical professionals who specialise in providing thorough and compliant medical assessments for TPD claims. Additionally, our team can assist in coordinating appointments and gathering all necessary documentation from your healthcare providers.
3.  Provide Evidence: 
   The evidence proving your injury or illness can differ depending on the requirements of each insurer. A lawyer will know which evidence to obtain and the best way to document and present this evidence to the insurer. 
4.  Professional Expertise:
   An Insurer may attempt to avoid having to make a payout by way of exclusion clauses. A lawyer will better understand how to prevent and challenge a rejection claim. Every year, up to 8% of TPD claims are withdrawn. It is easy to become overwhelmed with the complexities of making a TPD claim and give up, especially when you are suffering an injury or illness. 
5.  No Win, No Fee Cost Agreement:  If we aren’t successfully obtaining a TPD payout for you, then you don’t have to worry about the legal fees or expenses we have incurred.    

 Why Revolution Law for your TPD Claim 

At Revolution Law, we understand the complexities and challenges of personal injury claims. Our experienced team of personal injury lawyers is dedicated to providing compassionate and effective legal support to ensure you receive the compensation you deserve.  

With a proven track record of success, personalised attention, and a deep understanding of Australian accident law, we are well-equipped to handle your case from start to finish. 

Trust Revolution Law to be your advocate and guide, helping you navigate the legal process with confidence and peace of mind.  

Contact us today to learn how we can assist you.