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      Mario wins large TPD payout for psychological condition despite strict policy definition

      Mario wins large TPD payout for psychological condition despite strict policy definition

      Mario

      After Mario stopped working due to psychological illness, his insurer attempted to deny his Total and Permanent Disability (TPD) claim, arguing that he could eventually return to work. We used compelling expert evidence to prove that he was entitled to a TPD payout.

      Mario was diagnosed with several psychological conditions, including psychosis, major depressive disorder, anxiety disorder, and panic disorder. These conditions were so severe that he struggled to continue his work as an IT administrator, eventually stopping work altogether at just 35 years old.

      When Mario approached us for assistance, we quickly discovered that his super policy had a very strict definition of TPD. To qualify, Mario would need to meet one of the following criteria: lose two limbs, have at least 25% Whole Person Impairment, have one of 18 specified medical conditions, or be unable to perform Activities of Daily Living (ADLs). ADLs include essential tasks such as walking, eating, dressing, and personal hygiene.

      This strict definition made Mario’s claim challenging to prove, but our TPD team was determined to help. We obtained detailed medical reports from a psychiatrist, psychologist, and GP, each addressing the specific clauses and definitions in his policy.

      Given Mario’s relative youth and transferrable skills, the insurer argued that he could potentially return to work in the future. However, our compelling arguments and thorough medical evidence ultimately secured Mario a $1 million TPD payout within two months of taking on his claim.

      Compensation received

      $1 million

      Claim type

      Total and Permanent Disability

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