Total & Permanent Disability (TPD) insurance cover exists to provide compensation for people who have been injured (e.g. a workplace injury) or become unwell to the point where they are no longer able to work.
Your eligibility for a TPD claim will depend on you meeting the criteria as outlined by your insurance company. You may have standard TPD cover where you receive compensation if you can no longer perform any type of work. You may have opted for occupation specific cover which covers you if you are injured and no longer able to perform your particular occupational duties. You may also have TPD cover through your superannuation provider.
When assessing your eligibility for a TPD claim, your insurer will look at a range of factors and make a judgment as to your fitness to work.
TPD claims can be complicated as there are usually a number of factors to consider and you may need to engage with your insurance provider over a period of time. This can be difficult to sustain, and it is important to have support. Legal advice is important when making a TPD claim to ensure that all the appropriate elements are managed correctly.
Although this insurance may be provided by your Superannuation fund provider, the payout you receive is not an advanced payment of your own funds that are held in Super. Rather, it is a payout from a separate insurance policy, so you can make a claim no matter how little or how much is in your Superannuation fund. It will not affect the amount that is left in your Superannuation fund and you are still entitled to draw on these funds when you reach retirement age.
In making an assessment for a claim, your insurance provider will look at a range of factors including:
This depends on your insurance provider. For some companies it is sufficient to show that you are unable to perform your current duties. For other insurance providers you will need to present a range of disability factors.
Example - Jack works driving a forklift and unloading pallets at a factory. He is injured at work one day and his foot is crushed. After extensive rehabilitation and recovery Jack can walk again, but he is no longer able to drive the forklift. This means that he cannot reasonably perform his own occupation duties, but he may be able to work in another role within his workplace or within another industry. In this instance, it would be unlikely that Jack would be able to make a TPD claim under an any occupation cover policy. However, Jack might be able to make a WorkCover claim for his injuries.
It’s best to contact your insurance provider or super fund to find out what their criteria are for TPD claims.
It’s important to get advice for your specific situation. Check if you can make a risk-free compensation claim and get free initial advice from our Principal lawyer, Greg Smith.
Your TPD claim has been denied. Now what? Find out options to appeal a rejected TPD claim.
Find out situations what 'Total & Permanent Disability' insurance covers and how to claim