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      How long does a TPD claim take?

      Quick answer

      After your TPD claim is lodged, the insurer has 6–12 months to make an assessment. But with our experience and specialist skills, your claim could be resolved in as little as 3 months.

      The exact length depends on the circumstances of your case, as well as factors like wait periods, insurer delay tactics, ‘unexpected circumstances’ and requests for information.

      In depth answer

      Wait period

      You must be off work for a designated ‘wait period’ before starting your TPD claim. This is usually 3 or 6 months, depending on your super fund or insurer.

      Most funds and insurers will only allow you to lodge a claim once you’ve served the wait period. It’s essential to stop working entirely during your wait period. Even light work can impact your claim or result in it being rejected.

      Delay tactics

      Funds and insurers use many tactics to delay claims. In our experience, this includes taking unreasonably long to reach a decision or requesting unnecessary documents. A fund or insurer may also delay your claim with poor communication, long internal ‘processes’ or by moving your case between staff members.

      Most of these tactics are designed to discourage unrepresented people from pursuing their claims. A lawyer experienced with funds and insurers can help you evade delay tactics and resolve your claim faster.

      Unexpected circumstances

      There may also be ‘unexpected circumstances’ which prevent a speedy decision. Under the law, your fund or insurer is held to mandatory customer service standards. This includes the requirement that a decision must be reached within 6–12 months. The only exceptions are unexpected circumstances. These vary from case to case, but your insurer must always issue you an unexpected circumstances letter stating the reasons for the delay. The letter will also cover the next steps.

      Your lawyer will help you understand your rights and advise you on how to proceed. If you’re unrepresented and have received an unexpected circumstances letter, speak to us today. Our TPD specialists will outline your options for free.

      Requests for information

      When assessing your TPD claim, your super fund or insurer will commonly request additional information. This can include:

      • Employment information, e.g. employer statements, payslips and leave history.
      • Medicare and Pharmaceutical Benefits Scheme (PBS) history.
      • Tax and financial documents from the ATO.
      • Centrelink documents.
      • Medical records or reports from medical professionals.

      Gathering documents from companies, medical providers, experts, and government organisations can delay your claim. To speed up this process, your lawyer will first challenge the necessity of all requested documents. Insurers are known to use unnecessary requests to delay claims, so it’s essential to scrutinise each request.

      Your lawyer will then procure any necessary documents through multiple channels. They will also review all external reports before handing them over to the insurer, as any inaccuracies can slow down your claim.

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