How Do I Make a TPD Claim?

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The process of making a TPD claim can be daunting, especially when you're already facing the challenges of an injury or illness. Here's a detailed roadmap, including tips, to help you understand what to expect and how to submit your claim – both on your own or by working with an experienced TPD claims lawyer.

Step 1: Understand Your Coverage

  • Locate Relevant Policies: Check your superannuation statements and any standalone insurance policies for TPD cover. Note the policy numbers and the insurer.
  • Review the Definition of "Total and Permanent Disablement" in your policies. Does the policy define you as disabled based on your "own occupation" or "any occupation"?
  • Understand Your Benefit Amount: Determine the potential payout you'd be entitled to if your claim is successful.

Step 2: Contact Your Superannuation Fund or Insurer

  • Initiate the Claim: Call your super fund or insurance company to begin the TPD claim process. They will guide you through their specific requirements.
  • Request Claim Forms: Secure the necessary claim forms directly from your insurer. These will be detailed and extensive.

Step 3: Gather Evidence

The most crucial part of your TPD claim revolves around proving that your disability meets the insurance policy's definition. This requires extensive documentation. Gather:

  • Comprehensive Medical Reports: Obtain reports from your treating doctor (GP), specialists, surgeons, physiotherapists, or other health professionals involved in your care. These should include diagnoses, treatment plans, prognosis, and your limitations.
  • Medical Imaging: Collect copies of x-rays, MRI scans, or other imaging tests related to your condition.
  • Vocational Assessment (if applicable): In some cases, insurers may ask for a report from an independent occupational therapist or rehabilitation specialist. This assessment determines jobs suitable for your skills and limitations.
  • Employment Records: Gather documents such as payslips and work contracts to showcase your work history and usual occupation.
  • Supporting Statements: Personal statements from yourself, your employer, witnesses, or family members can help illustrate the impact of your disability on your daily life and work capacity.

Step 4: Complete Claim Forms

  • Meticulous Accuracy: Fill out all forms thoroughly and accurately. Provide detailed information about your disability and its resulting impact on your life.
  • Supporting Documentation: Include all the medical and vocational evidence you gathered in Step 3 in your claim application.

Step 5: Submit and Follow Up

  • Submit Your Claim: Carefully review your forms before submitting them to the super fund or insurer alongside your supporting evidence.
  • Be Proactive: Don't be afraid to follow up on the status of your claim. The insurer has an obligation to process your application promptly.

Do It Yourself vs. Using a TPD Lawyer

DIY Method:

  • Pros: Potentially save on legal fees.
  • Cons: Complex forms, navigating technical definitions in the insurance policy, risk of errors and delays, and greater potential for claim denial.

Hiring a TPD Lawyer:

  • Pros: Experienced in interpreting clauses in insurance policies and maximising your chances of success. A TPD lawyer will also help in reducing the stress involved including handling all of the paperwork. They can potentially secure a larger payout for you through negotiation. Research supports  this, - those with legal representation have a significantly higher chance of having their claim accepted.
  • Cons: Legal costs involved.

How Smith's Lawyers Can Help

  • Free Initial Consultation: We'll analyse your TPD policy and medical documentation to assess your eligibility and likelihood of success. Call us at 1800 960 482.
  • Guiding You Through the Process: Our expert lawyers will assist you in gathering relevant evidence, completing the claim forms, and liaising with the insurer for a smoother experience.
  • Fighting for Your Rights: We'll negotiate aggressively with the insurer to secure the maximum compensation you deserve.
  • No Win, No Fee. No Catch®: We're confident in our ability to get TPD claims approved. You won't be charged unless your claim is successful.

Important Note: Regardless of whether you choose to manage the claim yourself or seek legal representation, it's crucial to act promptly. Insurance policies often have time limits for filing a claim.

Contact Smith's Lawyers today for a free consultation to discuss your TPD claim. Call us today on 1800 960 482. We have offices conveniently located in Brisbane, Gold Coast, Sunshine Coast, Cairns, and Toowoomba, and service all of Queensland.

Last updated:
May 30, 2024

Disclaimer: This information is designed for general information in relation to Queensland compensation law. It does not constitute legal advice. We strongly recommend you seek legal advice in regards to your specific situation. For help understanding your rights, please call 1800 960 482 or request a free case review to talk to one of our lawyers today.

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