What is Total and Permanent Disability Insurance?
Total and Permanent Disability (TPD) Insurance provides for you financially if you are to become permanently disabled due to an accident or illness. A TPD claim can be brought in any situation where an injury, disability, or illness has prevented you from working. Unlike other insurance policies, such as workers compensation or motor accident insurance, you do not need to prove that your injury or illness was caused by your work or by the negligence of a third party.
Many people receiving workers compensation payments, motor vehicle accident compensation or that are in receipt of a Centrelink Disability Support Pension are also entitled to make a claim under their TPD insurance.
How can I check if I have TPD Insurance?
Many people hold TPD insurance without knowing it, as most superannuation funds have a TPD insurance benefit as part of the fund. To check if you have TPD insurance, you can download a recent super statement and check for "TPD", or alternatively contact your superannuation provider and ask them.
How much can I claim?
TPD Insurance provides you with a lump sum payment which can be accessed to assist you meet the costs of living, to be able to access medical and rehabilitation treatment, and provide you and your family with financial security for your future.
The amount of your TPD benefit will depend on the terms of the policy that your superannuation provider has arranged with the insurer. You can check the benefit amount on your policy statement, or alternatively by asking your superannuation provider directly.
How does it work?
Because TPD insurance is governed by individual policies and not legislation, each policy is different and will need to be reviewed. However, in our experience the two most common types of TPD policies are categorised as "own occupation" and "any occupation".
If you have an "own occupation" policy, there will be a requirement to show that your injury or disability has rendered you incapable of working in your own occupation, subject to the specific terms and wording of your policy.
If you have an "any occupation" policy, there will be a requirement to show that your injury or disability has rendered you incapable of working in any capacity in any occupation for which you are reasonably suited, based on your previous education, skills, training, and experience, subject to the specific terms and wording of your policy.
Does my injury or condition have to be physical?
No. The injury or illness also does not need to be a physical injury. You can also make a TPD claim related to any psychological injury or illness including for example a diagnosis of anxiety, depression, PTSD, bipolar disorder, schizophrenia, or other psychotic disorder.
What is the process I need to follow to lodge a claim?
To ensure the best chance of a successful application for TPD it is important to seek appropriate legal advice early. A lawyer will ensure that you have obtained the relevant documents required and have properly considered the definition of total and permanent disability that you are required to satisfy under your individual policy of insurance. Obtaining legal advice will also ensure that you will receive the full range of any benefit you are entitled to and ensure that you undertake the specific steps required to satisfy the superannuation fund to approve your application.
If you have had a TPD claim rejected, it is also important to obtain legal advice early to see if the decision can be challenged successfully.
Examples of successful TPD claims that Carroll & O'Dea Lawyers have run in the past include claims for injuries sustained at home or playing sport, claims for psychological injuries, and for chronic illnesses such as cancer.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
