If you have an illness or injury that stops you from working, you may qualify for a Total and Permanent Disability (TPD) payment. This is a lump sum insurance payment – normally through your superannuation fund.
Many people assume that they are “not sick or disabled enough” to get this payment. However, “Total and Permanent Disability” is just a terminology that insurance companies use – you don’t have to be “totally disabled” to get this payment. Rather, the question is whether your physical or mental condition stops you from working.
From time to time we get asked if there is a time limit to make a TPD claim.
Often there is no time limit so even if you stopped working many years ago, you can make a claim. But that’s not always the case. Some TPD insurance policies and superannuation fund rules have time limits. Find out more about this video…
Our successful outcomes over the years include some pretty difficult claims and we have included below some examples to show you our TPD claims experience.
Our client was a lady in her late 20s. She was referred to us by a personal injury lawyer colleague who was not able to act in this particular matter.
Our client’s last job was 10 years ago, just after finishing high school. She had a range of psychiatric conditions that prevented her from engaging in gainful employment.
We investigated her situation and found that she had a superannuation account from her employment 10 years ago. We found that she had TPD cover included in her superannuation account. We then went back and obtained all her medical records from the last 12 or so years. We even contacted her previous employer from 10 years ago to get witness statements to support her TPD claim.
We prepared a claim on behalf of our client and provided supporting medical evidence. When the insurance company wanted to reject the claim, we prepared written submissions setting out the correct position and we also made it clear that we will be suing the insurance company if payment was not made.
Our client’s claim was successful, and she was able to receive her full lump sum TPD payment, plus her superannuation balance.
Our client suffered from a neurological condition. It caused both physical and psychiatric symptoms which prevented our client from continuing in his sales role. He was referred to us by a defendant insurance lawyer colleague.
The interesting feature of this matter was that it turned out that our client had not one, but two TPD policies. One through a superannuation fund, and one purchased privately outside of his super. As a result, we were able to double up our client’s insurance payout, because both insurance policies paid 100% each.
Our client was in his early 40s. He worked in the meat industry his whole life.
A few years earlier, our client was involved in a terrible car accident. He suffered physical injuries that prevented him from going back to work. He sued for compensation. He was at that time represented by different solicitors.
Our client’s compensation claim was eventually successful. However, he was unhappy with how much his previous lawyers charged him so when it came to making a TPD claim, he came to us.
We successfully claimed all of our client’s TPD benefits and superannuation balance. Plus, by obtaining the previous lawyers’ file and reusing as much of the already existing medical evidence as possible, we were able to achieve a substantial costs savings to our client.
Our client had been diagnosed with a number of psychiatric conditions. However, these conditions did not prevent her from working and she continued to work for a number of years. While still working, our client purchased additional units of TPD cover. (When you have default TPD cover through your superannuation fund, it is for a set number of units. You can increase your cover if you decide to purchase extra units.)
Subsequently, a workplace incident happened which led to a new psychiatric condition. Our client made a TPD claim. The insurance company tried to argue that our client was not eligible for her extra units of cover (worth $300,000) because a waiting period applied for her new condition. This meant the insurance company wanted to pay approximately 60% less than what our client claimed (and had paid for).
We obtained expert medical evidence which showed that the insurance company’s interpretation of the medical evidence was incorrect, and that our client was eligible to receive payment for all of the units which she purchased.
As an aside, at the time of the workplace accident, our client made a workers’ compensation claim also. The workers’ compensation insurer alleged fraud due to some mistakes contained in the application for compensation form. Of course, the insurer’s position turned out to be entirely wrong.
In all TPD claims, we act on a No Win No Fee Basis. What this means is, if you don’t get the insurance payout, we don’t get paid.
What’s more, in TPD claims, our fees are fixed. This means that we can tell you at the start how much you will be paying us if and when your claim succeeds. It doesn’t matter how many hours we invest in your claim, you have the peace of mind from day one that you know what your legal bill is going to be.