Things can get pretty tough when someone can’t work anymore due to an illness or injury. That’s when a Total and Permanent Disability claim, or TPD claim, can really help. Like with any type of claim, if you want it to be successful, you need to be aware of the proper procedures, and this is where hiring a TPD lawyer can be very helpful.
For those who want to claim but need help knowing where to start, here’s a quick look at how to process a TPD claim.
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What is a TPD Claim?
A TPD, Total and Permanent Disability, claim is an insurance claim that pays out when you can no longer work due to a serious injury or illness. It’s often part of your superannuation policy, though sometimes it could be a completely separate insurance policy.
The payout is designed to support you financially if you can no longer earn an income. You can use it to cover medical treatment, rehabilitation, debts, or day-to-day expenses.
How the process works
Making a TPD claim can take time and plenty of paperwork, so the keys to success generally lie in being prompt and patient. It’s important to know that each insurer may have its own rules regarding TPD claims, but generally, you’ll need to prove that your disability meets the policy’s definition of “total and permanent”.
Insurers will assess whether you can return to your job or any job suited to your skills and experience. They’ll also look at your medical reports, employment history, and other supporting documents before deciding on whether your injury is, in fact, total and permanent. Only once these details are confirmed can the claims process officially begin.
What steps can you follow to claim TPD?
Processing a successful TPD claim isn’t always as straightforward as it should be. There are many reasons why TPD claims are rejected. For example, if the medical evidence supporting the claim is incomplete or there are inconsistencies with any follow-ups that are done. For this reason, it’s essential to ensure that you process the claim the right way. These steps will give you an overview of how to process a TPD claim:
Step 1: Get a claim form
Your first move is to contact your super fund or insurer and let them know you plan to make a TPD claim. They’ll send you a claim form and a list of requirements. You’ll probably need to provide basic details like your policy number, injury or illness, and when it started affecting your ability to work. A clear list of what’s needed from the start helps you avoid delays later on.
Step 2: Check if you’re eligible to claim
Before filling out the forms, make sure you’re actually eligible. Your policy must be active when you become disabled, and you’ll need to meet the insurer’s definition of total and permanent disability. Some policies define this as not being able to work in your own job anymore, while others mean not being able to work in any job that suits your background or training.
There are also policies based on your ability to perform everyday tasks. If you’re unsure what applies to you, look at your policy’s Product Disclosure Statement or ask for help from a lawyer specialising in TPD claims.
Step 3: Ensure that you have all the medical evidence and documents
This is one of the most essential parts of the process. You’ll need solid medical evidence to show that your condition is permanent and prevents you from working.
Start by collecting all relevant documents, such as:
- Reports and certificates from your treating doctors
- Statements from your employer or colleagues
- Proof of income and expenses
- Tax returns or payslips
- Any other insurance or workers’ compensation files
Keep copies of everything you send and note down dates and details of any communication with your insurer. Staying organised can make a big difference in how smoothly things go.
Step 4: Write a supporting letter
You don’t always have to do this, but having a supporting letter can strengthen your case. This letter gives you a chance to explain your situation in your own words and highlight how your condition affects your daily life and ability to work. Ensure you attach your policy number, and keep the letter clear and concise. Also, try to avoid any ambiguous statements.
Step 5: Submit your claim
Before you send off your claim, double-check that everything’s complete. Ensure your forms are filled out correctly, your medical evidence is attached, and you’ve made copies of every document. Once it’s submitted, take note of the date and any reference numbers. This will come in handy if you need to follow up later.
Step 6: Follow up
Once submitted, it’s a waiting game for the insurers to review your request. Usually, this could take a few weeks or even a few months in some cases. It helps to follow up with your insurer to check in on the progress of your claim, and if they give you ambiguous answers, you can take it up the ladder by placing a complaint against them or hiring a lawyer.
Step 7: Hire a lawyer
Speaking of hiring a lawyer, if your case is taking too long or gets rejected, don’t panic. A lawyer who understands TPD claims can step in to help. They’ll review your documents, check what went wrong, and help you appeal or negotiate with the insurer. They can also ensure your claim meets all the technical requirements, which often trips people up. Having a professional handle can take a lot of pressure off your shoulders, especially when dealing with health issues.
Where to find a TPD lawyer
TPD claims are complicated, and for good reason. If someone will pay you for most of your life due to an injury, you need to see if that injury really prevents you from earning an income. Still, some insurers like to take chances and avoid paying out when your claim is legitimate. In this situation, you need a good lawyer in your corner. Smith’s TPD lawyers in Brisbane have a reputation for being one of the best TPD Specialists in Australia. Give them a call and explain your case to them, and allow them to help you navigate your situation.
Final thoughts
A TPD claim can make a real difference when you can no longer work. The process can feel tricky at first, but it becomes much more manageable with proper guidance and preparation. Getting advice from a TPD lawyer can help you avoid mistakes and ensure everything’s done correctly. They’ll guide you through the paperwork and keep things on track so your claim has the best chance of success. Sometimes, having someone experienced on your side is all it takes to get the outcome you deserve.
