What is the time limit for making a TPD claim?

Quick answer

There are generally no time limits for making a TPD claim. The only exception is if your TPD policy clearly states a time limit that applies to your claim.

Even if no time limits apply to you, we strongly suggest filing your claim as soon as your condition stabilises. Over time, it can be more difficult to compile sufficient evidence: medical records may be lost, witnesses’ memories fade, and your injury or illness might have changed. Plus, in our experience, super funds and insurers are more likely to reject older claims.

Below, we discuss time limits in more detail, including what may be included in your policy, how long you have to appeal a decision, and what to do if you’re already outside the time limit.

In depth answer

To make a successful TPD claim, you must meet all the terms and conditions of your policy. This includes any time limit requirements. While most TPD policies do not specify a time limit, there are some that include strict limits.

How do I know if my policy has a time limit? 

Checking your TPD policy is the easiest way to find any time limits. However, your policy is a complex legal contract, so it can sometimes be difficult to know exactly what time limits apply to you.

If you need help understanding your policy, speak to one of our expert TPD lawyers today. In a free consultation, we will breakdown the terms of your policy (including any time limits) and outline the best strategy for securing your full TPD benefit.

Types of time limits 

Your policy may include the following types of time limits:

  • Prejudice clause: This means you’ll need to make your claim within a set period to avoid missing out on your entitlements. This is usually 12 months from the date you were injured, or 12 months from when you discovered your injury or illness.
  • Employment clause: Some super funds or insurers may require you to file a claim before ending your employment. On the other hand, some may allow you to file a claim as long as your policy was active when the illness or injury occurred.

These are just some of the time limits you might find in your TPD policy. To learn which time limits apply to you, consult your individual policy.

Do time limits apply to appeals? 

Yes, strict time limits apply to appeals.

If your TPD claim has been rejected, you have the right to appeal the super fund or insurer’s decision. Each stage of the appeals process has its own time limits, and it’s crucial that you meet these limits. Failing to do so could result in your appeal being denied.

  1. Lodge an appeal with your super fund or insurer: This is the first stage of the appeals process. You generally have 21 days to lodge your appeal. After this, a super fund has 45 days to review the decision and either uphold or overturn it. If you’re appealing to an insurer, they only have 30 days.
  2. Lodge a complaint with AFCA: If you’re unhappy with your fund or insurer’s internal review, you have 28 days to take your complaint to the Australian Financial Complaints Authority (AFCA).
  3. Go to court: If you don’t accept AFCA’s decision, you can take your claim to court. You must begin proceedings within 6 years of your TPD claim being rejected.

Appealing a rejected TPD claim can be a complex process, so it’s vital to get specialist legal advice before starting. 

What if I’m already outside the time limit?

If you’re already outside the time limit, you still have options — just ensure you get legal advice as soon as possible. Our TPD lawyers can apply for a time limit extension on your behalf. There are many reasons the court may allow your claim outside the time limit, including:

  • Reason for the delay: if there are special circumstances that prevented you from claiming within the time limit.
  • Extent of the delay: if your claim is only just outside the time limit.
  • No ‘prejudice’: this means that accepting your claim after the time limit does not negatively affect the super fund or insurer.
  • Degree of disadvantage: if not allowing the TPD claim would severely disadvantage you. This is more of an additional consideration; you’re unlikely to get a time limit extension for this reason alone. 

How we can help

TPD is a complex area of law, and without an expert lawyer you may not receive the benefit you deserve. Our lawyers specialise in reading and interpreting TPD policies, and will ensure your claim meets all super fund or insurer requirements. This includes time limits, evidence, documentation and minimum wait periods.

If your claim has been rejected, we will help you appeal the decision. This means we’ll ensure you meet all time limits and evidence requirements, as well as handling negotiations every step of the way.

Speak to us today for free, comprehensive advice on your TPD claim.

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