Total and Permanent Disability in Australia

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This content is for informational purposes only and is not intended to provide legal advice.

If you become totally and permanently disabled as a result of an injury, you may be entitled to receive a payout from your superfund. Unless specified on your policy, all diseases and injuries are covered by TPD insurance. If you are suffering from an injury that reduced your capacity to work, you can make a claim to secure yourself from possible financial difficulties. You can bring the claim either by yourself or with the assistance of a TPD insurance lawyer.

What is TPD insurance?

Most people will be covered with TPD insurance from their superannuation funds. Under the term of your policy, you can make a claim through your superannuation fund if you are unlikely to work again due to an injury or illness. Your injuries do not have to be related to your work. You can benefit from TPD payments if your injuries prohibit you from working. The extent of the insurance might differ from an insurer to another. Detailed information of your entitlements will be outlined on your policy, which can be requested from your superannuation fund.

Your TPD insurance will cover you either for your own occupation or for any occupation.

If you are covered in your own occupation, you will have to prove that you are unable to work again on your pre-injury job. While if you are covered for any occupation, you will have to show that you are unable to work on any occupation regarding your education, training, or experience. Usually, superannuation funds will have you covered for any occupation.

Can I make a claim?

To receive a TPD payment, your situation should meet the criteria set out in your policy. Although the extent of your entitlements differs from each policy, some common requirements will be the following:

Your injuries preventing you to work anymore
You meet the timeframe requirements specified on your policy
You fulfill the minimum requested impairment degree stated on your policy

How do I make a claim?

To understand your entitlements, you will have to get your insurance policy reviewed by a professional. Your policy will outline every detail about the time frames, steps to make the claim and relevant documents. Firstly, you will have to contact your super fund to find out by phone and by requesting your policy to find out if your policy has TPD. Your super fund will direct you to a case manager. Your case manager will ask you to complete 2 different documents

A Medical Attendant’s Statement (MAS)
Certificate of release to be given by 2 different doctors

You will be asked to arrange the appointments by yourself, while if you chose to work with a lawyer, your lawyer can arrange these for you. Your lawyer will also assess the policy to see if you are eligible and prepare your case accordingly. Once you provide the relevant documents including your pay slips, tax returns, medical reports, educational, training and work history reports as well as the 2 documents stated above, your claim will be reviewed and a decision will be made.

What if my application is not approved?

Although the insurers will act in goodwill, mistakes can be made. If you believe you meet all the criteria to claim TPD compensation, you have every right to apply for review or challenge the decision. In this case, it is strongly suggested to get your case evaluated by an experienced lawyer. Your lawyer will also ensure you understand your entitlements and help you get compensated with the maximum amount possible.

Do I need a lawyer to make a claim?

It is not obligatory to be represented by a lawyer in making a TPD claim. However, if you choose to work with an extensively experienced TPD lawyer, your lawyer will ensure you understand your entitlements and make sure the insurer is either correct in declining your claim or having the insurer reverse their decision. Your lawyer might also need to commence court proceedings in order to have it determined by court. The process might be frustrating to deal with especially given you already don’t have capacity to work due to an illness or injury. . Lawyers acting on no win no fee basis will only get paid if you can get compensated as well as covering your disbursements.

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