Answers to Frequently Asked Questions – TPD Super Claims
How much money will I get from a TPD Super Claim?
It will depend on the terms of your insurance cover. Policies range from $30,000 to millions of dollars.
How long will my claim take?
Some are quick (a couple of months) and others take longer (6-12 months).
If your injury/illness is complex it could take longer. The exact length of time will depend on the terms of your policy, how well your claim is prepared, the amount of your claim and the complexity and severity of your injury or illness. Every claim is different.
Do I have a TPD Super Claim that will give me some financial benefit?
A TPD Super claim is a ‘total and permanent disability’ claim. Most superannuation funds include a specific insurance policy that covers members for total and permanent disability.
- (tick icon) If you can no longer work due to an injury or illness, you may have a TPD super claim.
- (tick icon) If you can no longer do the type of work you have always been able to do, but you can work in a different occupation – you may still have a TPD claim.
TPD claims allow you to receive a lump sum or periodic payments.
A TPD payment is a financial benefit that is additional and separate to the contributions you made to your superannuation fund during your membership.
Do I have a TPD Super Claim that will give me some financial benefit?
A TPD Super claim is a ‘total and permanent disability’ claim. Most superannuation funds include a specific insurance policy that covers members for total and permanent disability.
- (tick icon) If you can no longer work due to an injury or illness, you may have a TPD super claim.
- (tick icon) If you can no longer do the type of work you have always been able to do, but you can work in a different occupation – you may still have a TPD claim.
TPD claims allow you to receive a lump sum or periodic payments.
A TPD payment is a financial benefit that is additional and separate to the contributions you made to your superannuation fund during your membership.
What do I need to take to my lawyer at the first appointment:
- Details of your superannuation funds.
- The last 2 statements that show your super balance and details of any insurance connected to your super.
- Details of your insurance policy.
- The name of any doctors you have seen for treatment.
- Any medical reports you have.
- If you choose to retain us as your lawyer, we will need you to sign a written authority to allow us to liaise directly with your super funds (as the super funds will require this).
Do I have TPD cover in your Super?
You should be able to check whether you have TPD insurance by looking at your annual superannuation statement. You can also contact your superannuation fund directly.
Every super fund has different requirements for TPD Claims. The terms of the insurance policy need to be read carefully before making a claim.
You may have a TPD claim if an injury or illness permanently affects your ability to work.
Unlike income protection or weekly workers compensation payments, a TPD benefit is a lump sum that provides financial support while you are off work. This is often a substantial amount.
TPD insurance is usually attached to your super policy. Many people have this insurance cover without even realising it.
Can I make a TPD Super Claim?
YES, you can, IF:
- you have an injury or illness that prevents you from returning to work and
- you have TPD cover with your super fund or in a separate insurance policy.
Often people in the middle of litigation for a compensation claim (which may be due to injuries from a motor vehicle accident, something that happened at work, or something that happened in a public place) are unable to work due to their injury. A successful TPD claim helps them to get by financially while the compensation claim is progressing.
Do I need a lawyer to make a TPD Super Claim?
When you lodge a TPD claim, the information you include in the application is extremely important as it will determine whether the application is initially accepted. For this reason, it is critical to have an experienced lawyer early in the process.
TPD (total and permanent disability) superannuation claims are not always straight forward. There is often a lot of paperwork required to substantiate your claim. Navigating the claims process in conjunction with the terms of the policy can be complicated and overwhelming. Knowing what evidence to include/exclude and how to fill forms out can be daunting. Having a lawyer who works in this area to handle the claim will set you up for success and allow you to focus on your health.
An experienced lawyer understands the details of the contract of insurance between you and the insurance company (usually your superannuation fund). Your lawyer can give you advice about the legal interpretation of the (often complex) insurance terms.
Superannuation Funds and their Insurers often make the claims process difficult. Having a lawyer who is experienced in dealing with insurance companies and TPD super claims is highly beneficial. They will know what information you are required to provide to have your claim accepted. A lawyer can also advise about your rights/options if your TPD claim is rejected.
We have experienced lawyers who work exclusively in this area of law.
What if I can still do some work?
Many policies only require proof that you are unable to do your regular job, or any job within your education, training and experience. For example, if you have been an electrician for most of your career, you may still have a TPD super claim even if doctors say you are well enough to work in an office.
You don’t have to be bedridden or confined to a wheelchair to have a TPD super claim.
Does it matter how I became injured?
No. It doesn’t matter where your injury or illness happened. You can have a TPD super claim if you are injured at work, or outside of work.
(If you were injured at work, you may also be entitled to Worker’s Compensation and other benefits).
What if no one was at fault?
This is not like a compensation claim for a motor vehicle accident or an injury that occurred in the workplace. You don’t have to prove that someone else was at fault to make a successful TPD super claim.
How much does a TPD super claim cost?
- Our lawyers’ fees are very reasonable. Fees are usually between $10,000 – $20,000 however they may be less and sometimes they are more. We only charge for the time we spend working to progress your claim. We record the time we spend working on your claim and you receive an itemised invoice at the end.
- We are no win, no fee lawyers. You only pay fees if your claim is successful.
- You pay at the end when you receive your claim money.
- We never charge extras like ‘uplift fees’ which many other lawyers charge.
- If you need medical reports, we can arrange for a funding body to pay for medical reports. (This is paid back at the end of your claim along with some interest.)
- Your first appointment is FREE. If you then choose to retain us, we provide a Costs Agreement which contains a written estimate of fees so you know up front what the fees will be.
Do Time Limits Apply?
Time limits may apply for TPD claims depending on your policy. While some policies don’t specify a time limit, others policies do require a claim to be made within a set time.
If you cease working, your policy may ‘run out’ at some point in time. It is very important to make a claim before this happens.
If your claim has been denied, you are entitled to appeal the decision. Strict time limits apply to appeals. We recommend getting legal advice from an experienced compensation claims lawyer before you start the appeal process.
How much can I expect to receive?
It will depend on the insurance cover terms and conditions. Super funds that include TPD insurance can have cover that ranges from $30,000.00 to $500,000.00 and some are in excess of a million dollars.
How long will my claim take?
The average time for a claim to complete is between 6-12 months though some may be completed in a few months. If your claim is complex (due to a complicated injury or illness and medical history) it could take longer.
The exact length of time will depend on the terms of your policy, severity of your injury/illness, how well your claim is prepared, the amount of your claim and the complexity and or illness. Every claim is different.
What if my claim has been rejected/denied?
We are happy to meet you for a free first appointment. We’ll discuss the circumstances with you and give you advice about whether we think it’s appropriate to dispute the decision. If we think it is, we can assist in getting your unfair determination overturned.
There are strict time limits that apply to disputing TPD decisions. It is important to get advice quickly.
What if there is a delay with my TPD Super Claim?
Insurers will often delay claims and discourage unrepresented claimants from pursuing their entitlements. Letters from insurers can be confusing and at times lead you to think you don’t have a claim. An experienced TPD super claims lawyer can ensure you receive all of your entitlements.
Usually, an insurer/super fund has 6-12 months to make a decision. There are occasions when an insurer has delayed due to ‘unexpected circumstances’. If this is the case, they will give details about why they have been unable to reach a decision. They should also set out the next steps. An experienced TPD super claims lawyer will be able to assist in this situation and will outline the best way forward.
How does a pre-existing condition affect my TPD super claim?
In certain circumstances, you may be excluded from receiving a TPD payment due to an exclusion. This usually means you may not be entitled to TPD benefits if you had symptoms of your injury or illness prior to beginning your insurance cover.
Insurance companies refer to this as a pre-existing condition.
There are also exclusion periods for pre-existing conditions. This may mean, if you have a pre-existing condition, you can be excluded from claiming for a period of years. In some situations, you might be permanently excluded from making a claim.
When can I make a TPD super claim? What is the ‘wait period?'
If it seems unlikely that you will return to work, you should enquire about lodging a TPD Super Claim.
Most polices will set out a designated wait period 3 – 6 months that must expire before a person can bring a claim. You can only start your claim once this period has expired.
This means you need to have been off work for 3 – 6 months. The time differs for each fund and there may be other requirements that need to be met. For example, some superannuation funds may require that your injury or illness has ‘stabilised’ or reached ‘maximum medical improvement’ before they consider your claim.
Is it possible to have more than one TPD claim?
Yes, it is. If you have TPD cover with more than one super fund or insurer, you may be able to make a claim with each fund for the same illness or injury.
Often, people aren’t aware they are insured by multiple super funds. This can happen when you change jobs and haven’t consolidated your super. Multiple super fund memberships may mean you have multiple TPD insurance policies.
Our experienced TPD super claims lawyers will help you understand your entitlements.
Every fund has its own policy, conditions and definitions, and each case will need to be approached uniquely. Success in one claim doesn’t necessarily mean success in another claim. Also, some funds have a condition which states that a TPD payment will not be made where a claimant has already been paid a benefit.
Will my employer have to pay my claim?
Some people are concerned their employer will be liable to pay their claim or compensation. While your employer may have to provide a statement about what happened, they are actually not involved in your claim. In the case of insurance and super claims, it is the insurer who pays your claim.
Does it matter how old I am?
Your current age and the age at which you were injured or diagnosed with an illness may impact the amount of TPD benefits you will receive.
Generally, the older you are the less the insurance company is required to pay. Accordingly, it is important to make the claim sooner rather than later. Starting a claim even a year later than you could have, can impact the amount of your TPD super claim.
TPD Super Claims – We are no win no fee lawyers.
We are compassionate, experienced and committed to the efficient progression of your claim. Make an appointment to see one of our experienced injury claim lawyers sooner rather than later, to ensure your rights are protected.
