Total and Permanent Disability Insurance

Total and permanent disability claims

Crew Legal is a personal injury law firm, north of Brisbane. Director, Shane Crew recently sat down to discuss Total and Permanent Disability (TPD) Insurance and to provide a clearer understanding of it.

What is it Total and Permanent Disability (TPD) Insurance?

TPD Insurance is a type of insurance policy you can purchase either privately or through your superannuation account. This policy will pay out a benefit should you meet the definition of becoming totally and permanently disabled from employment.

There are two types of TPD policies:

  • An Own Occupation Policy – for this policy, the definition you would need to meet to receive a payout is that you become totally and permanently disabled from your own or usual occupation.
  • Any Occupation Policy – for this policy, the definition you would need to meet to receive a payout through illness or injury is that you are totally and permanently disabled from any occupation or form of employment you might be reasonably suited to undertake through education or experience, making this one a little more difficult to meet.

How does the application process work?

When you first lodge your application, you need to obtain your own medical report from a treating general practitioner and a treating specialist which sets out if you meet the threshold of being totally and permanently disabled from work.

Once the insurer receives the application, they are entitled to review it and perhaps send it off to an independent expert or specialist to collaborate. The specialist may choose to have another examination conducted to get an independent view.

Obviously, the insurer’s specialist is employed by them, so if they come to a different conclusion than the original treating practitioner and specialist, you can seek a further independent specialist to review the reports and conduct a further examination if necessary. These doctors will all help the insurance company to make a determination on your claim.

Let’s break the application process down:

The first step is to complete an application form or pack. This comprises of:

  • Statement by the applicant
  • Treating GP report
  • Treating Specialist report
  • Employer’s statement

This all gets sent to the insurance company who have a ‘reasonable period’ to assess it. The standard for this is around a 6 month period, depending on the complexity of the claim.

Once the insurance company has reviewed all the evidence, they will make a determination. This will be either a successful claim or a rejection of the claim. If your claim is rejected, there are avenues to dispute the rejection.

If you are successful in your TPD claim, how restricted are you in taking on future work?

The sheer definition of a TPD claim is that you are totally and permanently disabled from work, so the majority of claimants will never work again. However, there may be a very small percentage of people whose condition does in fact improve. In that instance it is okay to take on future work as the determination by the doctors and specialists was made at a specific moment in time when the application was made.

The personal injury lawyers at Crew Legal have extensive experience in conducting TPD claims. Please don’t hesitate to contact us for a free initial consultation. We are here to ensure your rights are protected.

How can Crew Legal help?

Crew Legal pride ourselves on providing quality advice at the right price. We will ensure that you receive the best advice for your situation and are committed to ensuring that everybody has access to that advice.

We provide a first consultation completely free and with no obligation. If the claim is undertaken, we will proceed with such claims on a ‘No Win/No Fee’ basis.

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