7 ways legal advice can help your TPD claim
Your superannuation is more than just a retirement fund — it’s also packed with extra benefits like income protection, death benefits and Total and Permanent Disability (TPD). If you’re permanently injured or ill and unable to work, a TPD claim can provide a substantial lump sum payout. The best part? It’s often automatically included in your super policy, meaning you might be covered without even knowing it.
Unfortunately, a successful claim requires more than just filing paperwork with your super fund or insurer. You must meet all your policy’s requirements and provide solid medical evidence of your condition and its impact on your life. Without this, your claim could be denied, and you might miss out on your benefit. That’s why we strongly suggest getting legal advice from a specialist TPD lawyer before starting your claim.
Below, we explore how legal advice can help you navigate the complex claims process and secure your full TPD benefit — fast.
Understanding Total and Permanent Disability
Despite the name, you don’t have to be bedridden or confined to a wheelchair to make a TPD claim. You just need to meet the definition of TPD in your policy.
Generally, there are two types of TPD policies: ‘any occupation’ and ‘own occupation.’
- ‘Any occupation’ policies require you to be permanently unable to work in any job. This means your condition is so severe that doctors believe you won’t recover enough to work again.
- ‘Own occupation’ policies are a bit more flexible. You may only need to show that you can’t perform your specific job or any job related to your education, training, and experience. With this type, you might be able to claim TPD and still retrain for a new career.
Your entitlement to a TPD benefit depends on the terms of your policy, so it’s crucial to understand them fully. Policies can be complex and are open to interpretation, so getting legal advice is essential. Don’t just rely on the super fund or insurer’s interpretation of your policy — consult with a specialist lawyer to get the benefits you’re entitled to.
7 ways legal advice can help with your claim
An experienced superannuation and TPD lawyer provides invaluable guidance and representation in TPD claims. Their legal advice can assist in every aspect of your claim, including:
- Understanding your policy: just like any contract, your TPD policy can be interpreted in different ways. That’s why it’s crucial to have a lawyer experienced in policy interpretation on your side. For instance, the term ‘permanently disabled’ can have various definitions depending on your policy — some are stricter, while others are more lenient. An experienced TPD lawyer will unpick these details and build a case that aligns with the specific definition in your policy.
- Meeting policy requirements: each TPD policy has its own set of requirements, and you’ll need to meet these specific conditions to make a successful claim. This often includes serving waiting periods and providing sufficient medical evidence. A lawyer can help you understand the exact requirements of your policy and ensure you meet them all.
- Gathering strong evidence: your lawyer can assist in collecting comprehensive medical reports, expert testimony and other crucial evidence to support your claim. They’ll also challenge any conflicting evidence provided by the fund or insurer’s experts, giving them less opportunity to deny your claim.
- Covering out-of-pocket expenses: it’s no secret that making a claim can be expensive, with costs for medical assessments and expert evidence adding up quickly. However, if you choose a No Win No Fee lawyer, they’ll cover these upfront costs for you.
- Avoiding delays: super funds and insurers sometimes use tactics to unfairly delay claims, especially if your TPD benefit is substantial. A skilled lawyer is familiar with these tactics and can help you navigate around them, helping to speed up your claim.
- Handling disputes: if your claim is denied or disputed, a lawyer can negotiate with the super fund or challenge their decision. If necessary, they can take your case to court to help you secure the benefit you deserve.
- Maximising your payout: a lawyer can identify additional entitlements beyond your TPD claim, such as income protection, workers compensation, and common law damages. This ensures you receive the maximum compensation for your injuries.
Common challenges in TPD claims
Making a TPD claim can come with several challenges, each of which requires careful navigation and legal expertise. These include:
- Proof of permanent disability: to support your claim, you’ll need detailed medical evidence showing both the severity and permanence of your disability. Unfortunately, super funds and insurers frequently challenge this evidence and may argue that you can retrain for another job. A lawyer will help you gather the necessary medical documentation and ensure it clearly demonstrates the long-term nature of your disability.
- Policy exclusions: some policies have exclusions or specific conditions that can impact your claim. For instance, certain policies might exclude coverage for pre-existing conditions. A lawyer can clarify these exclusions and guide you on what you’re entitled to based on your policy.
- Dealing with multiple policies: if you have more than one TPD insurance policy, you may have multiple claims. While this can significantly increase your overall compensation, it can also complicate the process — since each policy has its own requirements and coverage details. A lawyer can help you navigate these complexities and ensure you meet all the specific requirements for each policy.
To tackle these challenges head-on, it’s essential to seek professional legal advice from the start. A skilled TPD lawyer can help you understand your entitlements and the specific requirements of your policy. They can also assist with uncovering any additional claims you might be eligible for, such as multiple TPD claims or work injury claims. With an experienced lawyer by your side, you can avoid unnecessary delays and ensure a smooth, speedy resolution of your TPD claim.
To sum up
Navigating TPD claims is more than just knowing the law; it demands experience, strategy, and the ability to stand up to super funds and insurers. Whether you need help understanding your TPD policy, proving the permanence of your condition, or challenging a decision, a skilled lawyer provides crucial guidance and support.
Get in touch today to speak with a TPD lawyer. Our legal team are always ready to review your policy and offer free advice on your entitlements.
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