There is no standard length for the TPD claims process. This can be frustrating for anyone going through it, as it’s difficult to know when they might receive compensation.
However, if you are working with an experienced lawyer, there is a typical timeframe you can roughly base your expectations around.
- With a Lawyer: Most experienced TPD lawyers strive to finalise claims within 6-12 months. Sometimes they are much faster; however, certain factors can also cause delays.
- Self-Managed Claims: Expect significantly longer delays if your claim is self-managed. It will often exceed 12 months due to a lack of resources and skill to push these through the various approval stages. It's unwise to go it alone unless your case is extremely clear-cut.
Also read: What Does TPD Insurance Cover?
Factors that impact TPD claim timeframes
Various factors can complicate the process of getting a claim accepted.
- Policy Definition: Most TPD cover held inside super is now assessed on an 'any occupation' basis, since 1 July 2014, super trustees generally can't offer new 'own occupation' cover unless it was already held before that date. 'Own occupation' is easier to satisfy, but now mainly survives in policies held outside super.
- Medical Evidence: Depending on your illness or injury, gathering appropriate reports from specialists with suitable expertise often becomes a major bottleneck.
- Insurer and Fund Responsiveness: Turnaround does genuinely vary between insurers and between funds. Rather than relying on reputation, check the published figures: APRA and ASIC release claim acceptance rates and the time taken to pay claims, insurer by insurer, in their Life insurance claims and disputes statistics.
- Disputes: A declined claim does not go straight to court. The first step is a complaint to the fund's trustee or the insurer. Under ASIC's Regulatory Guide 271, a super fund trustee has a maximum of 45 days to give you a written response to a complaint of this kind. If that does not resolve it, you can take the matter to the Australian Financial Complaints Authority, which is free for consumers. For a superannuation complaint, an AFCA determination is binding on both sides and takes effect without you having to accept it. AFCA closed superannuation complaints in an average of 116 days in 2024-25. Court is a last resort and can run for years. Because a TPD benefit is a fixed sum insured, these disputes are usually about whether the claim is accepted, rather than about the amount.
Breakdown of typical claim steps with approximate timeframes
Claims follow a particular structured process, and each step in the claim will take a different amount of time.
- Initial Assessment & Lodgment (Lawyer involved): A few weeks to a month where your lawyer works to make sure your claim is robust and you understand the policy definition you're relying on.
- Insurer Assessment: This is usually the longest stage. Under the Life Insurance Code of Practice, an insurer signed up to the Code must decide a lump sum claim such as TPD within six months. That runs from when it receives the claim, or from the end of any waiting period if that is later (cl 5.49). If circumstances beyond its control stop it deciding in time, it must tell you in writing what those circumstances are, keep you updated, and tell you how to complain (cl 5.59(c), 5.60). Note that two organisations are involved: the insurer assesses the claim, and your fund's trustee then releases the benefit into your super account.
- Dispute Stage (if needed): This stage may take months or even a year or two, depending on how your fund handles this level. A lawyer is key here in negotiating, and if necessary, litigation may commence.
- Settlement/Payout: This can be weeks after a clear decision has been approved. If further court steps are required, however, it can drag out many more months. Your lawyer should try to get interim or 'lump sum advance' payments at intervals within the larger claim when situations involve hardship.
Advice for those making a claim
If you are about to make a claim, keep in mind: getting an experienced TPD lawyer involved early means the claim is lodged with the medical and employment evidence the insurer needs, which is where most avoidable delay comes from.
It’s also a good idea to maintain frequent contact with your lawyer for updates and provide any extra material your fund asks for swiftly. This will speed up their processes.
Resources
- Information about TPD and Super: Your own superfund will have details and so does the government's 'Moneysmart' website https://moneysmart.gov.au/
