Many superannuation funds – including those into which benefits are paid by employers for their staff – provide members with generous insurance for death and disability. Qualification for benefits depends on the extent of injury and varies from fund to fund. Payments are often in the discretion of the funds’ trustees and incorporate medical obstacles and other hurdles.
WHAT IS TPD AND CAN I CLAIM?
What is TPD?
TPD is a total and personal disability payout, which is available as a lump sum upon an injury or illness that renders a person unable to return to work in their original capacity. The payment is available under insurance that super fund members have as a benefit of membership.
Can I claim for TPD?
Although eligibility depends upon the specific insurance policy that is provided by your super fund, the fund’s trustees have significant discretion in deciding eligibility.
Many trustees apply the following criteria:
- Level of disability
All insurers will require a minimum level of disability and may assess your claim according to the likelihood of you recovering from that disability.
- Education, Training & Experience
To be eligible for TPD, you must be prevented or significantly impaired in carrying out any employment within your education, training & experience. This is called the ETE test.
- Waiting periods
Many insurers will impose a minimum waiting period before assessing claims. This serves to allow the injury to settle, so that it may be accurately assessed.
- Minimum work history
Some insurers may require you satisfy a minimum level of employment before eligible for TPD.
- Subsequent work history
Under many policies, applicants will be disqualified if they have returned to full time or near full time employment following the original injury.
- Your age
Many policies reduce the insured amount as your age advances. This is determined as at the date of application for the insurance benefit.
- Your ability to perform daily activities
In assessing TPD, some policies may require that you are unable to perform functions of daily life including; eating, drinking, dressing and showering. This is called the Activities of Daily Living test.
- Ongoing medical care
Your eligibility for a TPD claim may – under some policies – be established by your condition requiring ongoing medical attention.
How to make your TPD claim
You should instruct a lawyer to contact your Superannuation Fund because fund managers are not obliged to assist you and may even lead you in to making a claim that can be easily disqualified.
The actions required to lodge a claim will depend upon your specific policy. The lawyer can examine the policy (there may be several that need to be considered, depending on how long after the injury your claim is being made), and confirm the amount for which you are insured.
Your lawyer will then obtain the medical evidence and complete a submission and application and medical records for your Superannuation Fund to assess.
If you are unsure of your eligibility or would like further advice on TPD claims, please call us on 07 3210 3437.
Bank related insurers have recently been exposed for having pressured doctors into changing opinions and diagnoses of policy holders in order to deny claims.
Some have also been found to use customized medical definitions to deny claims, and that medical files are deliberately removed from internal filing systems to frustrate the claims process.
Register now for recovery of policy entitlements and exemplary damages for dishonest denial of your income protection, disability or superannuation related claim.