Partial Disablement Claims

  • Overview & Examples
  • What You Need To Know
  • Specialising Lawyers
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Overview

Retail Policy Claims

Total and Permanent Disability (TPD) insurance is an essential safeguard for those facing severe health challenges. Not all TPD and income protection policies are obtained through your superannuation fund. You can also purchase your own insurance policy through an insurance company directly, or a professional financial advisor may recommend a policy for you. This is often referred to as ‘retail’ insurance. These are policies purchased directly, providing TPD insurance cover outside of superannuation. This section will discuss the importance of understanding the nuances between retail and superannuation-based TPD insurance claims. 

The Nature of Total and Permanent Disability Claims in Retail Policies 

Total and Permanent Disability (TPD) claims in retail policies are designed to provide a safety net for individuals whose circumstances fall outside the scope of their superannuation fund's coverage. These retail policies specifically cater to the needs of those suffering from total and permanent disability, ensuring they have financial support when unable to work.

To make a TPD claim under a retail policy, claimants must meet specific eligibility criteria. These often include proving the permanency and severity of their disability, often through comprehensive medical assessments. Successful claims can cover a range of financial needs, including ongoing medical expenses and loss of income. 

Financial Aspects of TPD Claims

Understanding the financial implications of TPD claims is crucial for claimants. The primary financial component of a TPD claim is the lump sum payment, calculated based on the policy's terms and the claimant's specific circumstances. This payment is intended to cover immediate and future financial needs arising from the claimant's disability.

Alongside the lump sum, claimants should consider the ongoing support for medical expenses and how these are factored into the benefit. Additionally, it's important to understand how a TPD insurance benefit might impact other financial supports, such as the Centrelink disability support pension.

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What You Need To Know

Expert Superannuation Lawyers and TPD Insurance Claim Lawyers

If you are unable to work at all as a result of an illness or injury, and held an active superannuation account or other personal disability policy at the time of your illness or injury, you may be covered for life benefits which would include Total and Permanent Disability benefits, Income Protection/Salary Continuance and Death Cover. You may also be entitled to benefits for medical expenses incurred to be incurred.  You must note however that the receipt of a TPD benefit may affect your eligibility for the Centrelink Disability Support Pension, an important consideration in the overall financial planning process.

You may also be entitled to make a claim for early release of your superannuation funds in circumstances where you are temporarily or permanently disabled from working in your usual occupation, or any other occupation for which you are reasonably suited by education, training or experience.

Brydens Lawyers are experts in interpreting the complex documentation and policies involved in TPD cover and claims. The thorough understanding and expertise of our lawyers will help guide you through this process and ensure your claim is a successful one. In the unlikely event that your claim is unsuccessful, Brydens Lawyers does not get paid due to our *”No Win – No Fee” policy. This policy means we are just as committed to the successful prosecution of your case as you are.  


How do I know if I have Total and Permanent Disablement Insurance?

Brydens Lawyers can make enquiries on your behalf with the Australian Taxation Office (ATO) to determine what superannuation accounts were held by you and for what period. Further, enquiries can be made of any active superannuation accounts to determine if there was total and permanent disablement insurance in place as at the date you last worked.


Are you eligible to make a claim?

TPD stands for Total and Permanent Disability. Some superannuation funds provide for default Total and Permanent Disability (TPD) insurance for its members. You may also have a TPD insurance policy that you applied for and purchased yourself. However, the existence of TPD insurance does not automatically mean that you are covered in all circumstances or that you can make a claim for any injury or illness.

Firstly, to ensure that you are covered, you must satisfy the specific eligibility requirements and exclusion clauses that are invariably contained in the fund’s TPD insurance policy. This will often depend upon your particular circumstances at the time the insurance policy was entered into by the fund.

Usually, factors that will be considered are:  

  • Whether your employer had made regular super contributions  

  • Whether you were actively working,  

  • Your age 

  • Pre-existing medical conditions  

 Secondly, to be entitled to make a TPD insurance claim, you will have to meet the definition of “Total and Permanent Disability” as explicitly defined in the particular insurance policy. The definition is usually intended to cover people who are unlikely ever to be able to work again because of permanent restrictions arising from their injury or illness.   Finally, the TPD benefit amount that you may be entitled to will depend upon the date of disablement, not necessarily how much your TPD insurance cover is provided for. This will also mean that, even if your superannuation fund informs you that you do not have TPD insurance today, you may have had TPD insurance at the date of your disablement and therefore would still be entitled to make a claim.   To be eligible to make a TPD insurance claim, you generally need to be under the age of 65 years at the date you ceased working on account of the injury or illness and held either an active superannuation account with insurance cover in place, or another personal disability insurance policy.   Generally, it does not matter if contributions had not been made into your superannuation account for a long time or even if you had closed your account after you stopped work. Brydens Lawyers are able to make investigations on your behalf which would include the identification of any superannuation accounts that may have been contributed to by you and/or your employer and determine from same whether or not you were in fact covered for insurance benefits under any of these accounts at the relevant time.


What are you able to claim? 

Depending upon the level and type of cover available at the date you ceased all work, you may be entitled to a one-off lump sum payment or monthly benefits for a specified period.  The amount of the TPD lump sum you receive or monthly benefit will vary from insurance policy to insurance policy. Brydens lawyers can assist you in navigating your TPD claim–contact us online or call 1800 848 848 today.


Why Are Brydens Lawyers The Right Representation For You?

The team of expert superannuation insurance claims lawyers at Brydens Lawyers are readily available to provide you with expert and concise legal advice to ensure that you achieve the best possible outcome for your superannuation and insurance claims.

Brydens Lawyers are the experts in the area of TPD and superannuation insurance claims with extensive experience in managing disability insurance claims from those arising out of default insurance arrangements with a superannuation fund, to more complex arrangements relating to individual contracts of insurance cover.

At Brydens Lawyers, we will assist by lodging all superannuation and disability insurance claims supported by detailed and lengthy submissions and often containing citations of legal precedent or authority to support the claim. It is this level of expertise supported by our experience that will often result in claims resolving without having to go to court.

We are also able to assist our clients by simplifying the claims process meaning that we can look after an insurance claim with a super fund from start to finish. This would involve the making of all the initial investigations to reviewing the applicable policy documents and providing advice on the policy definitions to ensure that you fall within the scope of the policy and are entitled to benefits.  Brydens Lawyers will also liaise with your doctors and other third parties to recover all the necessary and relevant evidence to support the claim.  Brydens Lawyers will communicate with the superannuation fund manager throughout the duration of the claim to ensure that the claim is prosecuted diligently and expeditiously.

The expert superannuation lawyers at Brydens Lawyers will assist you in locating accounts where superannuation funds may have lost contact with you, in order to ensure that all claims available to you under any superannuation policy are actively pursued.

When it comes to TPD and superannuation claims, strict time limits may apply. To find out more about any superannuation insurance claim that may be available to you, allow the team of experts at Brydens Lawyers the opportunity to advise in a free* initial consultation.  Contact Brydens Lawyers without delay on 1800 848 848 or at Brydens.com.au. *Conditions apply.


When Should You Consult A Lawyer About Making A Claim? 

Brydens Lawyers recommends that you seek legal advice once you have been off work for a consecutive period of three months.  Brydens Lawyers will then determine firstly whether you are a member of an active superannuation fund and secondly, whether there is TPD insurance cover available.  In the event that you have already been absent from work by reason of injury or illness for longer than three months then you should contact TPD lawyers at Brydens Lawyers as soon as possible.


What Is Your Next Step? 

If you have suffered an injury or have been diagnosed with an illness which has caused you to cease working, it is important that you seek appropriate medical treatment as soon as possible and continue to receive the treatment as recommended by your healthcare professionals.

When you have been off work for at least three months due to that illness or injury, you should collate your superannuation statements and/or any personal disability policy documents, and thereafter arrange to see one of the expert superannuation claims lawyers at Brydens Lawyers for a free* consultation. *Conditions apply. 


Testimonials

Unbelievable, I’m very happy with my TPD result. Honestly Lee and the team at Brydens Lawyers treat you like family. All my family and friends have had miracle results with Brydens.

Fred from Sydney

I have been a long-term client of Ashli’s- she has been great to deal with and has helped brighten my future with an excellent outcome.

A client of our Superannuation and TPD division

Meet the team that specialise in

TPD and Superannuation

Meet the Team
Bandeli (Lee) Hagipantelis
Bandeli (Lee) Hagipantelis

Principal

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Ashli Joudo
Ashli Joudo

Senior Associate - Practice Group Manager

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Isabel Sarcia
Isabel Sarcia

Senior Lawyer

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Jonny Aghayan
Jonny Aghayan

Lawyer

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Jose (Joshua) Avedillo
Jose (Joshua) Avedillo

Lawyer

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Abigail Hamilton
Abigail Hamilton

Lawyer

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Stavroula (Stephanie) Kokkolis
Stavroula (Stephanie) Kokkolis

Lawyer

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Xiangan (Natalie) Nie
Xiangan (Natalie) Nie

Lawyer

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Mario Rodriguez
Mario Rodriguez

Lawyer

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