Everything You Need to Know About TPD Insurance Claims
If you’ve been permanently injured or are no longer able to work due to illness or disability, Total and Permanent Disability (TPD) insurance may be available to support you financially. But understanding what qualifies, how to claim, and when to seek legal advice can be daunting. This guide explains what TPD insurance is and how it works, especially when life has taken an unexpected turn.
Can I claim TPD insurance if my disability was caused by a pre-existing condition?
Yes, but it depends on the terms of your insurance policy. Some TPD insurance policies exclude pre-existing conditions, while others may provide partial or full cover if you met certain work or health requirements before becoming disabled.
To assess your eligibility, a lawyer can help by:
- Reviewing your policy’s exclusions and inclusions
- Determining if you had continuous cover prior to your disability
- Advising on any medical history disclosures that may affect your claim
If you’ve been told you can’t claim because of a pre-existing condition, don’t take the insurer’s word as final. Our team offers legal services for disability claims and can challenge unfair denials based on complex or vague wording in policy documents.
Does TPD insurance cover disabilities caused by workplace accidents?
Yes, many TPD insurance policies cover permanent disabilities caused by work-related accidents. If your injury has left you unable to return to your normal job or any similar employment, you may qualify for a TPD compensation claim.
In these cases, you may also be entitled to:
- Workers compensationunder state-based schemes
- Superannuation-linked TPD cover
- Additional benefits such as income protection
Our workers compensation lawyers can assess which benefits apply and guide you through both systems. It’s important not to delay because strict time limits apply.
How do superannuation funds assess TPD claims?
Super funds assess TPD claims based on the definition of “total and permanent disability” in your specific policy. Generally, they look at whether:
- You are unlikely to return to work in your usual or similar occupation
- Medical evidence supports the permanent nature of your disability
- Your condition is stable and not expected to improve
Some policies use an “own occupation” test, others apply an “any occupation” test. The difference is crucial. We recommend seeking TPD claim legal advice before lodging your claim to avoid delays or misinterpretation.
We assist clients with:
- Reviewing claim criteria
- Preparing and submitting documentation
- Responding to additional information requests
- Appealing if the claim is denied
Our disability lawyers in Australia have the experience to deal with superannuation trustees and insurers head-on.
Can I claim TPD insurance if I am self-employed?
Yes, self-employed people can still be eligible for TPD insurance benefits, especially if they’ve been paying into superannuation. If your cover is through your super fund, the same definitions and assessment rules generally apply.
For self-employed Australians:
- Your work history and job duties must be well documented
- Evidence from your GP and specialists must show permanent incapacity
- Income and business records help demonstrate the impact on your earning ability
Let our injury compensation lawyers help you gather the right evidence and make sure your claim reflects your real work circumstances. Self-employed people often face added scrutiny, so getting professional legal support early is key.
What happens if I have TPD cover with multiple super funds?
You may be able to make multiple TPD claims, but there are conditions.
Here’s what to keep in mind:
- Some policies are “linked,” meaning you can only claim once across funds
- Others are “standalone,” allowing separate claims
- You’ll need to check the terms and exclusions of each policy
- Duplicate or overlapping cover may reduce payouts
Our team can review all your superannuation statements, explain what your policies allow, and manage multiple claims if you’re eligible. With the right legal help for TPD claims, you won’t leave any entitlements behind.
How do I check the terms and conditions of my TPD policy?
You can request your full insurance policy and Product Disclosure Statement (PDS) directly from your super fund or insurer. These documents outline:
- What disabilities are covered
- What exclusions apply
- Waiting periods and time limits
- Definitions like “own occupation” vs “any occupation”
Reading the fine print can be tough, some policies are 50+ pages long and full of legal jargon. Our disability claim lawyers make sense of it for you.
We provide:
- Clear summaries of your policy conditions
- Advice on how the terms apply to your situation
- Help spotting potential red flags or claim risks
If something seems unclear or unfair, let us investigate it for you.
What happens if my TPD claim is delayed?
Delays in TPD claims are common, but they’re not always acceptable. Insurers and super funds must follow reasonable processing timeframes. If your claim has stalled:
- We can chase updates on your behalf
- Demand reasons for the delay
- Lodge complaints with regulators if needed
- Push for timely outcomes
We understand how frustrating it is to wait for answers when your finances are on the line. Our team takes swift, strategic action to move things forward.
Are partial disabilities covered under TPD insurance?
Typically, TPD insurance requires that your condition be “total and permanent.” That said, if a partial disability prevents you from returning to your usual occupation, and if your policy is based on an “own occupation” test, you may still qualify.
We examine:
- How your daily work duties are affected
- Whether retraining or alternate work is viable
- What your doctors say about long-term limitations
Never assume you won’t qualify. With personal injury TPD lawyers by your side, you may have a case even if your injury isn’t “100%” disabling.
Can I claim TPD insurance if I am receiving Centrelink disability benefits?
Yes, receiving Centrelink doesn’t automatically stop you from making a TPD claim. In fact, many Australians do both. But there are things to watch:
- Your TPD payout may affect your eligibility for Centrelink
- You’ll need to report the lump sum and provide updates
- Tax implications may apply depending on your age and withdrawal method
Our TPD insurance lawyers can guide you through Centrelink compliance and help minimise impact on your existing benefits.
What legal support is available if my TPD claim is rejected?
If your claim is rejected, don’t panic, and don’t give up. At Gordon Legal, we specialise in fighting back when things get tough. We’ll assess your rejection letter, identify where the process went wrong, and put together a strategic response.
We can:
- Request full claim files and review all decisions
- Obtain new or updated medical reports
- File internal disputes and external appeals
- Represent you in the tribunal or court if necessary
Our no win no fee lawyers mean you won’t pay unless we succeed. You deserve justice, and we know how to deliver it.
Legal Help When You Need It Most
At Gordon Legal, we understand that TPD claims aren’t just paperwork, they’re about your life, your livelihood, and your future. When you work with us, you get more than legal help. You get advocates who listen, stand up for your rights, and fight with everything we’ve got.
From early guidance to fierce representation, our disability lawyers in Australia are here for every step of your journey.
Reach out today. Let’s take the next step together.
No Win, No Fee TPD Claim Lawyers
Financial concerns should not deter you from seeking justice. Gordon Legal operates on a no win, no fee basis, meaning you only pay legal fees if we successfully secure compensation for you. This approach underscores our commitment to accessible legal representation for all.
You don’t have to face this alone
At Gordon Legal, we offer more than legal advice, we offer solidarity. If you’re wondering how to claim TPD compensation, reach out.
Our lawyers are here to listen without judgment, fight with purpose, and support you at every step.
Contact us today for a free, confidential consultation. Simply fill out our online form, and one of our TPD claim lawyers will be in touch to discuss your case or give us a call on 1300 59 95 17.
No win, no fee
Help when you need it most without the added stress of upfront legal fees engaging a
no win, no fee lawyer.
When you need legal help, understandably, the first thing people often think is ‘can I
afford it?’ To address this, our Senior Partner, Peter Gordon and Partner, Paul Henderson pioneered the ‘no win, no fee’ system to create greater access to the legal system.