TPD Insurance Claims: Who is Covered?
TPD insurance claims can be made by those who have a policy in place and who suffer a serious illness or injury that renders them unbale to ever return to work. TPD insurance is often held through superannuation, where the lump sum payable from a successful claim will be distributed to the fund before being distributed to the life insured. The money you get from your insurance makes it easier for you to manage financially given your inability to return to work and earn money due to your injury or illness.
What Does TPD Insurance Cover?
Simply, TPD insurance provides a benefit in the event that you become Totally and Permanently Disabled. Totally and Permanently Disabled can mean a number of different things and it is ultimately dictated by the terms of your particular policy. TPD Insurance provided by super funds will generally cover you in the event that you are unable to return to work in ANY occupation for which you are suited by way of training, education or experience. These policies will generally have clauses that result in this definition changing should you take extended leave from work, move overseas or reduce to casual hours. More comprehensive policies can cover you in the event that you are unable to return to work in the occupation you were in immediately prior to disablement, which removes any scope for the insurer to trawl through your education and employment history with a view to finding an occupation for which you might be suited. With a wide variety of policy definitions available in the Australian market, it is crucial to understand exactly how your cover works and when it will pay out.
Making a TPD Claim through Your Super
While superannuation funds do vary in terms of the quality of cover that they offer, most do include TPD insurance to some degree. However, the level of cover varies from one policy to another, so it is crucial that you keep abreast of the amount that you have in place as well as how this will change over time. If you need to make a TPD claim through your superannuation fund, it may be of significant benefit to get assistance from a claims adviser with experience and expertise in this matter. This is because the process of TPD claims can be a lengthy and complex one for those who are unfamiliar with making this type of claim. An additional complexity arises when making a super TPD claim as there is an additional ‘layer’ of legislation involved. TPD super claims need to be released by the trustee of the fund and approved by the insurer underwriting the fund. Unfortunately this tends to delay the process. A TPD claims advisor can take you through the process step by step, which makes things a lot less stressful because you have access to expert claims advice.
In order to successfully make a superannuation TPD claim, you will typically need to demonstrate that you, as a result of injury or illness, are unable to return to your work or any other work you are suited to by way of training, education or experience. If a medical condition has stopped you from working for a period of around six months, and if unlikely to be able to do that type of work again for the same reasons, you may be able to make a successful TPD claim. The above applies to an ‘Any Occupation TPD’ policy, that which is most commonly found through super. Outside of Super you may well have an ‘Own Occupation’ TPD policy which only requires you to be unable to ever work again in the occupation you were in immediately prior to disablement. As you can see, there are many things to consider and speaking to an expert TPD advisor will enable you to better determine the likelihood of success as well as providing you with information on what you need in order to make a TPD claim.