Total and Permanent Disability Claims
How We Can Help with Your Total and Permanent Disability Superannuation Claim (TPD Claim)
The superannuation system which provides for your retirement is a great Australian institution – but it’s not simple. It is designed to provide a cushion when your working years are finally over, but what if that time comes before you reach retirement age? What if you suffer a catastrophic injury or illness in the prime of your life? Then you could be looking at a Total and Permanent Disability claim, and that can get complicated.
Do You Understand Your Rights in a Total and Permanent Disability Claim?
Law and insurance have one huge similarity: they are incredibly complex. Perhaps without meaning to, those who draft laws and insurance policies make them very difficult for the lay person to understand. These documents do not make light reading and the amount of detail they contain can make most people’s eyes glaze over, but when you are in the process of trying to get what is rightfully yours, you can’t afford to do that. Failing to read one little clause properly, or not understanding it, can be your downfall. That is why, although you could file a TPD claim yourself, it is better to get professional help.
Aren’t All Super Funds and TPD Claims the Same?
Superannuation schemes are not standard; they are drafted individually in different areas and there may be significant differences between them. One of the key differences can be whether a TPD claim can be made when the health issue is not directly related to your work. Are you covered for that or not?
Anyone thinking of making a TPD claim is doing so because they have suffered a serious injury or illness that has destroyed their ability to work, and this is a traumatic event. Even if you were in the best of health, the process of filing such a claim might have been daunting. Attempting it when you are still reeling from this misfortune is harder still.
How Can a Lawyer Help with Permanent Injury Compensation?
Among our 160 members of staff, we have some brilliant lawyers who spend much of their time dealing with total and permanent disability claims. They know the law inside out and are aware of the potential pitfalls hidden within the small print. What might be bewildering to you – and most of the population – is crystal clear to them, so if they are on your side, you have a much better chance of getting what you deserve, what you are entitled to. At Marsdens Law Group, we ensure every legal challenge is met with expertise and dedication.
How To Start the Process for Free
Because legal matters are so complex, we offer the first 15 minutes of your first appointment with us free of charge and obligation. This gives us the chance to get a good idea of what you are looking at and gives you the chance to hear about the process and how much it is likely to cost. You can then balance all that against what you stand to gain and decide whether to proceed. If you have tried already and your claim has been rejected, we may be able to help you lodge an appeal. This TPD claim of yours is vitally important to your future and we aim to help you get the best result.
What is superannuation?
Most superannuation policies include an insurance benefit known as a Total and Permanent Disability (“TPD”) benefit.
Alternatively you may have “stand alone” TPD cover, outside of your superannuation policy, but this is much less common, as most superannuation policies include the benefit.
Am I entitled to claim a TPD benefit?
If you are no longer able to earn income, you may be entitled to claim a TPD benefit.
The eligibility criteria for accessing a TPD benefit will be outlined in the policy document. You must be able to satisfy the definition of TPD within your own policy.
Although every policy is different, in most cases the definition of TPD contains two criteria which must be satisfied:
- The applicant has been unable to work for a specified period of time; and
- The applicant is unlikely to ever be able to engage in their usual occupation, or any occupation for which they are qualified by reason of their education, training and experience.
The circumstances that resulted in your injury or medical condition are not relevant, to the extent that there is no requirement to prove fault or negligence against another party.
How does the claims process work?
The claims process will differ depending on the insurer on the policy however, as a general rule, the initial steps in the process will involve completion of a claim form by the applicant and provision of supporting documentation.
Supporting documentation will usually include:
- A statement from the relevant employer.
- A report from your treating doctor – GP and / or specialist.
It may be necessary to provide additional medical evidence from your doctors, to specifically address the definition of TPD. It may be reasonable for the insurer to request your attendance at an independent medical examination.
The insurer will ultimately issue a determination based on all of the evidence available.
In the event of a successful claim, you will receive a tax-free lump sum which represents your TPD benefit. A successful application will also entitle you to access the balance of your superannuation fund, usually upon medical certification of permanent incapacity.
Are there any avenues for review?
If the claim is denied, the first step is to request a review of the determination by the insurers internal review process.
If you are unhappy with the outcome following the internal review, an application can be made to challenge the decision by lodging a complaint with the Superannuation Complaints Tribunal, or commencing Court proceedings.
Do any time limits apply?
Although there are usually no time limits which apply to a claimant’s entitlement to seek TPD benefits in the first instance, there may be strict time limits which apply to any application for review of a determination or application to a Tribunal or Court.
What if I have more than 1 superannuation policy?
If you have more than 1 superannuation policy, it may be possible to claim TPD benefits under each of those policies. The success of each individual application will depend on whether you satisfy the relevant eligibility criteria under each policy.
What can Marsdens do to help?
Marsdens can advise and represent you if you are seeking to claim TPD benefits. We can provide expert legal advice and guide you through the process, contact us today.
How much will it cost?
In most cases if we are of the view that your claim has reasonable prospects of success, we will accept your instructions on a “no win no pay” basis.
This means that you will not be required to pay for our professional costs up front or on an ongoing basis.