Worrying about the impact of permanent disability is normal, as it can happen to anyone.
Besides the emotional and psychological effects, worrying about medical expenses and how to survive financially can take a toll on the patients.
However, claiming TPD benefits mitigates the financial anxiety associated with permanent injury and disability.
TPD stands for “Total and Permanent Disability.” It is a claim made by an individual who has suffered a significant injury leading to total and permanent disability. TPD claim is often associated with superannuation funds (Retirement savings).
Therefore, if someone is unable to work due to permanent disability, injury, or illness, they can make a TPD claim to receive a lump sum payment from their insurance policy.
This article reveals how long it takes to claim a TPD, discusses the TPD claim process, and examines factors that may impact claiming TPD benefits.
How long would it take to claim your Total and Permanent Disability (TPD)?
You will typically receive the TPD lump sum payment from your insurer within 3 to 12 months of making a claim. Once your insurance company receives the case, it will likely take a six-month assessment period to provide your TPD benefits.
Some claims may take longer, depending on the complexity of your case. However, you can take specific steps to ensure you receive your payout sooner, including seeking legal advice.
Average TPD claim timeline
On average, the TPD claim time frame is about 3 months to 12 months. Generally, the time frame depends on the superannuation fund and insurer you use, as each insurance company has unique requirements.
What to know about the waiting period after your TPD claim has been approved
You must have stopped working for an extended period to earn a TPD claim. This shows your inability to work, making you eligible for the TPD claim. The waiting time usually takes about three to six months.
Once you have submitted your claim forms to your insurers, within 6 to 12 months, again, the time limits vary based on your insurance company and the complexity of your claim.
The TPD insurance claim lodgment process
The steps to a TPD claim vary among insurers, law firms, and superannuation funds. However, here is a typical step-by-step guide for a TPD insurance lodgment process:
- Step #1: Contact your insurer or superannuation fund for the TPD policy
- Step #2: Request all the documentation necessary for eligibility. This may include medical records, payslips, and employer correspondence.
- Step #3: Compare the policy’s criteria with the evidence provided to determine the compensation amount
- Step #4: Compare the evidence against the TPD policies
- Step #5: Complete the claim forms required by your insurer and submit your claim
- Step #6: Your insurer will access your claim and may request additional information or proof
- Step #7: Your insurance company will make a decision on your claim
In addition, your insurer may organise a medical specialist to be eligible for a permanent disability claim.
You can find out more about the TPD claims process with our guide.
Factors that Affect The Timeline of Your TPD Insurance Claim
Here are some factors that determine how long your total and permanent disability insurance takes:
Your claim type
The specifics of your claim can influence how long it takes to review it. This is because various types of TPD claims require varying levels of complexity. For example, a physical disability claim’s processing time may differ from a mental illness disability claim. Therefore, check in with your insurer to know the specifics of your claim type.
The severity of your disability
The severity of your disability may impact the waiting period. For instance, claims with more severe disabilities may require extensive assessment and documentation, prolonging the entire process. Severe disability cases may also require your insurer to gather detailed information to determine the extent of your disability and how it affects your ability to work.
How much medical evidence is available
The amount of medical evidence you provide can determine how quickly you will obtain your TPD payouts. Providing detailed medical reports, specialist reports, and other relevant documentation can facilitate the claim process. However, limited medical evidence or inconsistency in your report may prolong the process as the insurer may seek additional evidence.
The complexity of your claim
The complexity of your claim may influence the process timeline. Complex claims may require extensive documentation, and evaluation, lengthening the process. Conversely, claims with minimal complexities may require minimal complexities and lower in-depth evaluation.
Your employer or insurer’s cooperation
The level of cooperation between your employer and insurer determines your TPD claim’s time frame. For instance, if your employer promptly provides the documentation required by your insurer, it can streamline the process and expedite the timeline.
Common Delays When it Comes to TPD Insurance Claims
Several factors may delay your TPD claim process. They include:
Insurance companies
An insurance company may contribute to delays in the claims process due to a high number of claims, insufficient staffing and resources, and administrative inconsistencies. There may be errors in the paperwork, and data entry, delaying the process. The insurer may also be dealing with a large number of claims within a specific timeframe, leading to delays.
Incomplete documentation
The process may also be delayed if the claimant provides insufficient information and documentation. Missing medical records, payment history, medical practitioner assessment, and more may also extend the process. Cases like these often require follow-ups and additional information, extending the waiting period.
Disputes and investigations
Investigations may ensue if there are disputes over a claim, perhaps eligibility issues or an extended claim process. There may be a delay if this occurs, as the parties involved may try to resolve the issue, leading to further investigations or legal proceedings.
The evidence you need for your TPD claim assessment
A successful TPD claim relies on the claimant’s ability to provide adequate evidence for your super fund policy. They include:
- Medical evidence: Medical evidence allows you to prove your claim for total and permanent disability insurance. A medical practitioner must provide you with all the reports and certificates that affirm you have a physical or mental illness that prevents you from performing your job.
- Evidence of ongoing medical care: A TPD payout will require providing evidence showing that you are unable to do your job due to ongoing medical treatment or rehabilitation.
- Work history and TPD claim: You must meet your super fund policy requirements of minimum work history to qualify for a TPD payout. In most cases, you must show you were able to work for a minimum of 3 months before your injury. You can show evidence for this claim through work contracts and payment history.
- Inability to perform tasks: You may need to provide proof that shows your inability to carry out daily tasks without assistance. You can prove this by showing you have a carer or family member supporting you in performing your daily activities.
The inability to provide the above pieces of evidence may delay your TPD payout. Therefore, contact your insurer for the specific levels of evidence required to meet their unique eligibility requirements.
What to Do if Your Claim Gets Denied
You can file an appeal if your TPD claim gets rejected. To do this, request the rejection letter from your insurer and review it carefully to identify the reason for the denial. If you do not support the reason, lodge a complaint with your insurance company or superannuation fund. You can also seek legal advice for an informed decision.
How You Can Fast-track Your TPD Claim with Curo
Claiming a TPD payout can be challenging, especially when you do not know how to go about it. At Curo financial services, we understand how overwhelming this process can be and are here to help. Whether you want to make a claim for the first time or your claim has been rejected, we ensure your claim is handled efficiently, fairly, and professionally.
Contact our team of TPD specialists today, and let us take charge of your TPD claim while you focus on your health.
Frequently asked questions
How long does it take to get your TPD payout?
It takes about 6 to 12 months to finalise a TPD payout. However, the timeline may vary based on various factors, including the complexity of your claim and your insurance company.
Why does a TPD claim take so long?
Obtaining a TPD payout takes time due to the various activities involved. This includes a thorough assessment, complex review processes, unavailability of the required medical records, dispute resolution, and more.
What is the average payout for TPD?
The amount of TPD payout depends on the specifics of your insurance policy and your super fund. However, lump sum payment usually ranges from $30,000 to $450 000.
What is the success rate of TPD claims?
According to SuperRatings Research, 30% of insurers approved about 91% to 100% of TPD claims.
What if my claim is denied?
If your claim is denied, request a rejection letter to know the reason for the denial. If you disagree with the reason, seek legal advice for the next steps.
General Advice Disclaimer: The advice provided is general advice only and in preparing it we did not take into account your investment objectives, financial situation or particular needs. Before making an investment decision on the basis of this advice, you should consider how appropriate the advice is to your particular investment needs, and objectives. You should also consider the relevant Product Disclosure Statement before making any decision relating to a financial product.