What is Total and Permanent Disability Insurance?
Are you suffering from a permanent disability due to injury or illness? Under challenging circumstances like these, it can be difficult to find out exactly what you are entitled to. Rest assured that there are insurance options available to help ease financial difficulties from loss of work.
Total and Permanent Disability (TPD) insurance provides financial protection if you become permanently disabled and are unable to work. It offers a lump sum payment to help cover medical costs, living expenses, and loss of income if you can no longer work due to illness or injury.
Read on for more information about making a TPD insurance claim.
What Does TPD Insurance Cover?
TPD insurance typically covers situations where you become permanently disabled and unable to work. If you are unable to work in your own occupation or any occupation for which you are reasonably suited based on your education, training or experience, TPD can apply to your situation.
Some common conditions that may be covered include:
- Spinal cord injuries resulting in paralysis
- Loss of limbs
- Severe burns
- Blindness
- Deafness
- Severe mental health conditions like depression or anxiety
- Chronic pain conditions
- Neurological disorders like multiple sclerosis
The exact conditions covered will depend on your specific policy. It's important to carefully review the policy terms to understand what is and isn't covered.
Where Do You Get TPD Insurance?
Did you know that most Australians have some level of TPD insurance through their superannuation fund? Many super funds include a basic level of TPD cover by default when you join the fund. You can often increase your level of cover through your super fund if desired.
TPD insurance is also available as a standalone policy outside of superannuation from insurance companies and financial advisers. These policies may offer more comprehensive coverage but tend to be more expensive.
How Much Cover Do TPD Policies Provide?
Like other insurance types, the amount of TPD cover can vary significantly depending on the policy. Default cover through superannuation may be around $100,000 to $300,000. Optional increased cover through super or standalone policies can provide up to $5 million or more in some cases.
The appropriate level of cover depends on your individual circumstances, including:
- Your income
- Debts and financial obligations
- Family situation
- Lifestyle and expenses
All of these factors will be considered when the insurer is assessing your claim. It's worth reviewing your level of cover periodically to ensure it remains adequate for your needs.
Types of TPD Policies
Note that there are two main types of TPD policies:
- Any occupation: Pays out if you're unable to work in any job suited to your education, training or experience. This is the most common type, especially for policies through superannuation.
- Own occupation: Pays out if you're unable to work in your own specific occupation. This provides broader coverage but is usually more expensive. It's more commonly available through standalone policies outside super.
Some policies may also offer a partial disability benefit if you can still work in a reduced capacity.
Can You Have Multiple TPD Policies?
Yes, it's possible to have multiple TPD policies. Many people have default cover through multiple superannuation accounts from different employers over the years. You can also have standalone policies in addition to cover through super.
Having multiple policies can provide additional protection. However, it's important to consider whether the total level of cover across all policies is appropriate for your needs and budget.
Typical Eligibility Criteria for TPD Claims
To be eligible for a TPD claim, you typically need to meet the following criteria:
- You have a medically diagnosed condition causing your disability
- Your condition prevents you from working in your own occupation or any occupation suited to your education, training or experience (depending on policy type)
- You have been unable to work for a specified waiting period (often 3-6 months)
- Your condition is considered permanent, with no reasonable prospect of improvement
- You have received appropriate medical treatment and rehabilitation
The exact eligibility criteria can vary between policies; it’s always best to carefully review your policy documents to understand the specific requirements.
How Legal Advice Can Help with TPD Claims
While it's possible to lodge a TPD claim on your own, seeking legal advice can significantly increase your chances of a successful claim. TPD claims can be complex, and insurers may look for reasons to deny claims.
An experienced TPD lawyer can help by:
- Reviewing your policy to determine your eligibility
- Gathering and presenting strong medical evidence to support your claim
- Ensuring all claim forms are completed correctly and comprehensively
- Challenging insurer decisions if your claim is initially denied
- Negotiating with insurers on your behalf
If you're considering making a TPD claim, it's worth consulting with a specialist TPD lawyer to understand your rights and options. Smith’s Lawyers are TPD claim experts offering risk-free claims with no upfront costs and free initial consultations.
