If you have suffered an injury or illness that prevents you from returning to work, you may be entitled to a TPD insurance benefit through your superannuation.
What is a TPD claim
A TPD claim is a claim made under a Total and Permanent Disability insurance policy. TPD insurance provides cover to people who become totally and permanently disabled and cannot work because of an illness or injury. See general guidance from Moneysmart and speak with Jameson Law for tailored advice.
What is TPD insurance
TPD insurance is a policy that pays a lump sum, and sometimes ongoing support, if you are totally and permanently disabled due to illness or injury. Benefits can help with medical expenses, care needs and living costs. Many Australians hold TPD cover inside their super fund by default.
Eligibility to make a TPD claim
If you are unable to work, or are unlikely to work for at least 6 to 12 months due to illness or injury, and cannot return to your job in the same capacity, you may be eligible to claim a lump sum under your policy. The illness or injury does not need to be work related.
If you are unsure whether you have TPD cover, check with your super fund or insurer, or review your latest super or insurance statement. You can also ask us to review your policy terms. If in doubt about your prospects, speak to a TPD lawyer at Jameson Law as soon as possible.
What is considered a TPD
Definitions vary by policy. Typically they include severe, permanent conditions such as:
- Loss of sight in both eyes
- Loss of hearing in both ears
- Loss of limbs or amputation
- Paralysis
- Traumatic brain injury
- Severe mental health conditions (for example schizophrenia, bipolar disorder, PTSD)
- Cognitive impairment or dementia
- Severe back injury affecting mobility and preventing work
- Chronic pain or illness preventing you from performing any occupation
- Terminal illness with a life expectancy of less than 12 months
Some policies also assess whether you can perform activities of daily living such as bathing or dressing. Always review your policy wording carefully.
How to successfully claim TPD
- Understand your policy. Check definitions, exclusions and waiting periods.
- Seek medical advice. Obtain detailed reports from your GP and specialists about diagnosis, treatment and capacity for work.
- Gather evidence. Include employment records, statements from employers and colleagues and any rehab reports.
- Contact Jameson Law. We can prepare and lodge your claim, manage the insurer or super fund and keep your matter moving. Start here: contact us.
- Be patient and accurate. Claims can take time and often involve several rounds of information. Be honest and consistent in all forms.
- Follow up. Keep in touch with your fund, insurer and our office to ensure deadlines are met.
What to do if your TPD claim is rejected
A decline is not the end. Once you understand the reasons, you can seek review by:
- Sending a written complaint to your super fund or insurer
- Using the fund’s internal dispute resolution process
- Lodging a complaint with the Australian Financial Complaints Authority (AFCA)
- Seeking urgent legal advice from Jameson Law
Why would a TPD claim be denied
- Insufficient evidence to prove total and permanent disability
- Does not meet the policy definition of TPD
- Waiting period not satisfied
- Policy exclusions apply
- Non-disclosure or misrepresentation on the application
- Incomplete or incorrect information during the claim
Carefully check your policy and provide complete, consistent evidence. We can help build the strongest case possible.
Can I have a workers compensation or motor vehicle accident claim at the same time as a TPD claim
Yes. Workers compensation and CTP motor accident claims can run alongside a TPD claim. Those schemes address treatment and income loss, while TPD is a separate insurance benefit. If your injury is permanent and total and prevents work in any occupation, you may be able to claim TPD in addition to your other entitlements.
Can I make a TPD claim if I am on Centrelink
Yes. Centrelink payments do not prevent a TPD claim. Some insurers will consider Centrelink assessments as part of the evidence. See Services Australia for DSP information. You will still need to meet your policy definition with medical and vocational evidence.
For clear, practical advice about TPD claims in Sydney, call (02) 8806 0866 or reach us via the Jameson Law contact page.
