Ultimate Guide – How to Make a Successful Superannuation TPD Claim

You can make a TPD claim through your superannuation fund when an injury or illness stops you from working in your usual occupation.
An open book that is a guide to successful TPD claims
How to Claim TPD Insurance Through Super

    In Australia, when you can’t work again in your usual occupation because of an injury or illness, you can make a total and permanent disability (TPD) claim through your superannuation fund. Generally, any medical condition that stops you from working can qualify as TPD, regardless of whether you have a mental illness or an unexpected illness or injury.

    Our ultimate guide covers every aspect of making successful superannuation TPD insurance claims, helping you secure your financial future during tough times.

    About Superannuation TPD Claims

    TPD cover is designed to provide financial support through a lump sum payment, known as a TPD benefit, for Australians who can’t work due to an injury or illness. Many workers don’t realise they have TPD insurance cover included in their superannuation fund. You can access this valuable insurance benefit when you can’t earn an income.

    But how do you know the eligibility criteria for a TPD superannuation claim, and how do you work through the often-complex TPD claims process? We will explore the fundamentals of making a TPD claim and how they interact with your superannuation.

    Do I have a valid claim? >

    A man with broken leg on his bed viewing a tpd insurance policy on an ipad

    What is TPD Insurance?

    In Australia, TPD insurance pays a lump sum amount when you meet the definition of being ‘totally and permanently disabled’. As a result, you may have a successful TPD claim if an illness or injury prevents you from working in your primary occupation or any other job for which you are qualified due to your education, training, or experience. And it’s not just for physical injuries. Mental health conditions and psychological illnesses that disrupt your work capacity also qualify for a TPD claim.

    Once you have an accepted claim, you receive a one-time lump sum payment that helps replace lost income and cover your medical expenses.

    Free online claim check >

    About TPD Coverage

    Every insurance company and super fund insurer has a different definition of total and permanent disability, but three main categories generally exist.

    1. Own occupation: You can’t work again in the role you were doing before your disability. This TPD coverage typically costs more and is unavailable through a superannuation provider.
    2. Any occupation: You can’t work again in any role suited to your training, education, or experience. This cover is usually cheaper but more complicated to claim.
    3. Activities of daily living: This definition is not based on your job. Rather, it assesses your capacity to care for yourself and lead an independent life.

    Each category has distinct criteria; therefore, grasping your insurance policy’s specific TPD definition and satisfying these criteria is the key to winning a TPD insurance benefit.

    A lawyer meeting a client outdoors explaining super TPD policy requirements with a laptop

    Am I Eligible to Make a TPD Claim?

    To be eligible to make a TPD superannuation claim, first, you need total and permanent disability (TPD) insurance included with your superannuation policy (or a stand-alone insurance policy) on the day you stopped working (or when your permanent disability rendered you unable to do your role or one for which you have training or experience).

    Thankfully, our specialist superannuation lawyers will investigate your disability insurance cover for free and help you know your options (including if you can make multiple TPD claims) Call Now – 1300 873 252

    How To Lodge a TPD Claim

    Many Australians question, “How does a TPD claim work?” To start the TPD claim process, you’ll need to follow these steps:

    1. Locate all your super insurance TPD policies and check the eligibility clauses.
    2. Verify if they were current at the time of your illness or injury
    3. Contact the superannuation fund and request the relevant TPD claim form.
    4. Fill out the forms with information about your medical condition, employment history, and other relevant details. Provide honest, accurate, and thorough details, as errors or omissions could delay your case or cause a claim denial.
    5. Attach a supporting letter explaining why you should have an approved insurance claim.
    6. Actively pursue the insurer to confirm they have all the information required to make a decision.
    7. Contact a TPD lawyer for help with the dispute process if your claim is denied.

    Can I Make Multiple TPD Claims?

    You can make multiple TPD claims when you have insurance with multiple super funds. Some fortunate Aussies have contributed to more than one superannuation fund and, hence, have multiple disability policies. Therefore, you can claim separately against each superannuation insurance policy for the same permanent disability.

    Please be aware that each insurer’s terms and conditions will differ, including their Total and Permanent Disability definitions. Winning each claim depends on meeting the requirements of each insurance company. For this reason, the support of a qualified TPD lawyer will likely provide the best chance of a winning outcome.

    Know if you can make multiple claims and their value by calling 1300 873 252

    Next, we take a closer look at TPD eligibility requirements.

    Assessing Your Policy’s TPD Definition

    Before making a TPD claim, it’s crucial to understand the TPD definition in your insurance policy, as it determines your eligibility for a disability payout. The TPD definition varies among policies, with some covering you if you can’t return to your pre-injury occupation, while others apply if you can’t perform any kind of work. Recognising these differences will help you create the necessary supporting information and evidence to support your claim.

    Reasonable Retraining

    The “retraining clause” is another crucial aspect of the TPD definition. Under the TPD definition of most Australian superannuation funds, you must be unable to find employment in your usual (or any) occupation for which you are reasonably qualified by experience, education, or training, allowing for the restrictions caused by your injury or illness.

    The reasonable retaining clause states that even if you receive reasonable retraining that takes your disability into account, you still won’t be able to return to work. For this reason, insurance companies will ask for detailed information about your current job description, work history, and past vocational training.

    How Hard is it to Prove TPD?

    When claiming TPD through your superannuation provider, you are responsible for proving you have a total and permanent disability, which is not the same as proving you have a permanent disability when claiming NDIS or Centrelink benefits. Typically, the superannuation trustee communicates with the insurance company and confirms a satisfactory resolution.

    If the trustee disagrees with a decision, they should help with the dispute. However, there are significant differences in the behaviour of superannuation trustees, which is why a skilled TPD litigation lawyer can assist in getting the best outcome.

    TPD Claims Process Timeline

    TPD claim process infographic

    Super TPD Claim Process

    It can be challenging to make a TPD claim successfully, but with expert legal support, it can be less stressful. Here is the step-by-step TPD claims process for winning insurance benefits:

    Consult With a TPD Lawyer

    Hiring a TPD lawyer can significantly improve your chances of a successful claim. That’s because specialist TPD lawyers have substantial expertise when:

    • Locating old superannuation funds & insurance policies
    • Checking for TPD coverage
    • Negotiating settlements with large insurers
    • Championing your rights if you have a rejected claim

    With their expertise and support, you’ll be better equipped to navigate the TPD claim process and maximise your payout.

    Remember, when selecting TPD lawyers, discuss legal fees before proceeding so there are no nasty surprises. Aussie Injury Lawyers work on a 100% No Win, No Fee basis, which means you pay legal fees when you win and zero if you lose. Plus, we will give you an upfront, capped, or fixed price before we start work on your case. Get a quote now >

    Collate Medical Evidence

    Substantiating TPD insurance claims requires compelling medical evidence documenting how your injury or illness impacts your work capacity. This evidence typically includes medical records and reports, assessments, and other documents demonstrating how your illness or injury satisfies your insurance policy’s terms.

    Furthermore, regular consultations with medical professionals, like general practitioners, psychologists, or psychiatrists, will help support your case when making mental illness TPD claims.

    Lodge Your Claim

    After submitting your claim forms, your superannuation fund will assess your documentation to determine if you qualify for a TPD payment. The claims process can take several months, so it’s important to be patient and follow up with your super fund to ensure they have all the necessary information.

    TPD Payout or Denial

    Once approved, a lump-sum payout will be deposited into your superannuation account, substantially boosting your retirement funds. The decision to withdraw, transfer, or postpone withdrawal is then yours. If you have a rejected claim, your lawyer will work with you to challenge the outcome and reverse the insurer’s decision.

    More about denied insurance claims >

    A picture of a client shaking hands with a TPD lawyer after hiring them for a disability superannuation claim

    Common Types of TPD Claims

    You can make a total and permanent disability claim for many medical concerns. Generally, any physical injury, illness, or psychological disorder that stops you from working in your regular job can qualify for a successful TPD insurance claim. These are some of the most common kinds of TPD claims in Australia.

    Some physical injuries
    that qualify for TPD
    Chronic back pain
    Spinal cord injuries
    Head and brain trauma
    Loss of Vision, Hearing or Speech
    Shoulder injuries
    Lower limb damage
    Loss of limb
    Paraplegia and Quadriplegia
    Injury from a motor vehicle accident
    Mental health conditions
    qualifying for mental illness TPD claims
    Depression
    Anxiety
    PTSD
    Schizophrenia
    Bipolar Disorder
    Borderline Personal Disorder
    Any other recognised and diagnosable
    psychological disorder
    Some illnesses and diseases
    that qualify for TPD
    Most Types of Cancer
    Multiple Sclerosis
    Dementia
    Motor Neurone Disease
    Muscular Dystrophy
    Alzheimer’s and Parkinson’s disease
    Chronic lung conditions
    Severe Arthritis
    Heart Attack and Stroke
    Table of common TPD medical conditions

    The list above serves as a general reference. Please check your TPD policy terms or contact our friendly insurance experts to find out if you have an eligible claim. It’s free to understand your circumstances.

    More about the common types of TPD insurance claims >

    Examples of Common TPD Claim Situations

    The following are some frequent situations that may result in a successful TPD claim.

    Permanent Injury or IllnessWhen a permanent injury or illness results in an inability to work, you could claim TPD entitlements. This includes physical injuries like limb loss, spinal injuries including paralysis, and recognised mental illnesses like depression and anxiety.
    Work AccidentsWhen the unexpected happens, and you are seriously injured in a work accident, you may be entitled to workers’ compensation and permanent disability benefits. Typical workplace incidents include slips, trips, falls, industrial accidents, or work-related illnesses.
    Serious IllnessIf you suffer from a terminal or debilitating illness, you can make a successful TPD claim. Chronic conditions include fibromyalgia, cancer, multiple sclerosis, and other severe medical conditions.
    Hospital IsolationYou can win your TPD payout if you are hospitalised due to a long-term illness or injury that stops you from working.
    Table of common situations leading to a TPD claim

    Tips for Maximising Your TPD Claim

    When seeking to maximise your TPD claim, remember a few essential tips.

    1. Please provide as much evidence as possible to support your case. This would include your medical records and any other documentation that can help prove your case.
    2. Be honest and transparent, ensuring your claim is accurate and consistent to increase your chance of receiving compensation benefits.
    3. Seek professional assistance from a lawyer or TPD specialist. Your legal team will provide valuable guidance and support, ensuring you have the best chance of success.
    4. Be patient and persistent. Claiming TPD benefits can be a lengthy process, but with the right approach and mindset, you will increase your chance of successfully receiving your deserved compensation.

    Superannuation TPD Claim Payouts

    Once you have an approved claim, a once-off TPD payout will be deposited into your super account on top of your existing balance. But how much will you receive, and how can you access your funds?

    More about TPD payouts >

    Typical TPD Payout Ranges

    The amount of money you are entitled to for a TPD payout depends on the value of your superannuation insurance policy. Based on our many years of experience with successful claims, you could receive between $30,000 and $500,000. Some fortunate people who are eligible for multiple TPD payouts receive millions.

    What Can Delay a Total and Permanent Disability Payout?

    Several factors can delay a permanent disability TPD payout, such as an insufficient medical history or failure to provide proper evidence of your disability. Accurately presenting the extent of your impairment is critical to winning a claim. Other common reasons for delays include inaccurate policy information or incomplete paperwork.

    To ensure a quick and fair claim, you must have an experienced disability claim lawyer supporting you. They will guide you through the claims process and provide professional advice, ensuring you are fully prepared for unexpected challenges.

    Successful TPD claim icon

    Successful TPD Claim Case Studies

    QSuper Denied Claim Reversal

    Emma had initially submitted a TPD claim for bipolar disorder with QSuper. This leading Australian super provider had taken six months to assess her case before rejecting the claim, causing significant emotional distress. Emma then had an unsuccessful appeal with the Australian Financial Complaints Authority.  Aussie Injury Lawyers then took over her matter (on a 100% no win, no fee basis) and arranged an independent medical examination. Based on these medical reports, we submitted a formal complaint to the insurance provider, had the decision overturned, and Emma received a payout of $500,000.

    Successful PTSD TPD Payout

    Jim, a school teacher in Tasmania, witnessed the horrific jumping castle accident on 16th December 2021 and suffered PTSD as a result. Consequently, he struggled to work as he felt his life had been “stolen from him”. Jim agreed to work with our skilled compensation legal team in March 2023, and in August, he received TPD compensation of more than $388,000.

    Brain Injury TPD Settlement

    Steve, a security worker, was born with hydrocephalus, which is a medical condition causing excess fluid buildup in the brain.  Sadly, his medical condition meant he could no longer work by the time he was 46 years old. Aussie Injury Lawyers prepared and lodged his claim in August 2023, and six weeks later, he received a payout of over $230,000.

    The Impact of TPD Superannuation Claims on Taxes and Benefits

    While a TPD payment is generally tax-free, a lump-sum withdrawal from your super fund will have tax implications. However, if you leave funds in your superannuation account until retirement, you will likely pay no tax on your TPD lump sum.

    We recommend consulting with an accountant or financial advisor before deciding how to spend your insurance benefit to minimise your tax liability.

    Centrelink and Other Government Benefits

    A TPD payout generally won’t impact your Centrelink payments if the funds are held within your super. However, if you choose to withdraw, it could affect your Centrelink benefits and other government financial assistance. If this is your situation, please seek expert legal advice to understand the potential impacts on your Centrelink disability support pension or other benefits. Reporting any changes to your financial situation, such as receiving a TPD payout, is crucial to ensuring you receive Centrelink funds correctly.

    A female insurance lawyer providing TPD insurance claim advice to an elderly couple

    How TPD Lawyers Help Win a TPD Insurance Claim

    Hiring the best TPD lawyers for your super TPD claim is essential for a winning outcome. When seeking legal representation, please choose a law firm with experience handling similar cases and a winning track record.

    Be assured that when you choose Aussie Injury Lawyers for your TPD claim, you are accessing more than 100 years of combined insurance litigation experience with a 99% win rate. Our expertise is your guarantee of a positive outcome. Furthermore, all our insurance claim legal services have 100% No Win, No Fee legal funding, which means you owe us nothing until we win your case, and nothing if you lose. Hence, you are free of financial risk with AIL. Get free advice now by, Calling 1300 873 252

    Total and permanent disability icon

    TPD Compensation Claims FAQs

    How long do TPD insurance claims take?

    On average, the period for a successful TPD claim ranges from 6 months to a year. However, this timeframe can vary depending on how quickly your insurance provider processes your paperwork and if they require additional information. Generally, your best strategy for success is fast, expert legal intervention to increase the likelihood of a positive outcome.

    What is the average TPD payout?

    The average TPD payout is between $30,000 and $500,000, with some making multiple claims worth millions.

    How does TPD insurance work in super?

    TPD insurance through superannuation is a type of disability insurance cover that pays you a benefit if you suffer an extended injury or illness and become permanently disabled, making it unlikely for you to work again. Before claiming a TPD benefit, you must check your terms and conditions to understand the requirements for meeting your disability definition.

    How do you successfully claim TPD?

    To successfully claim TPD, you must understand your policy terms, gather medical evidence, accurately complete the form, submit the claim and wait for approval. If accepted, you will receive a lump sum payout that could ease the financial burden of your injury or illness.

    How long do you have to be off work to claim TPD?

    You typically need to be off work for three to six months before you can make a TPD claim. This ‘waiting period’ will change depending on your policy terms, but once it expires, you can make a claim at any time.

    What do lawyers charge for TPD Claims?

    How much lawyers charge for TPD claims depends on their pricing structure. Aussie Injury Lawyers is a 100% no win, no fee law firm, which means you pay costs when you win and zero if you lose. Plus, we give you a fixed or capped price before we start work on your case. Get a free quote now >

    Can I go back to work after a TPD Claim?

    You can return to work after a successful TPD claim in specific circumstances, depending on your insurance policy’s terms and conditions and other variables. There are generally two main categories of TPD policy terms:

    1. You can’t return to work in your own occupation
    2. You can’t return to work in any occupation

    The first type means you can’t do your regular job but could train to work in a different industry. The second type is more difficult because it means you can’t work in any occupation. The one exception is when innovative therapy aids your recovery to the point where you can resume employment, in which case you could return to work and keep your TPD benefit payout.

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