In Australia, any permanent injury or illness that prevents your continued ability to work can qualify as a Total and Permanent Disability (TPD). It doesn’t matter how you acquired your medical condition to have a successful TPD claim and receive a lump sum payment. However, in making a TPD claim it is important to remember that insurers will look closely at your medical history and other external factors leading to the injury or illness, when assessing eligibility.
This makes the disclosure of all relevant medical details during your application process incredibly important!
Luckily, at Aussie Injury Lawyers we’ve got everything you need to know to make a successful TPD Claim covered. In this article, we’ll answer all your questions about the definition of total permanent disability in Australia. If you qualify for a TPD insurance claim, speak with Aussie Injury Lawyers to get the TPD payout you deserve. It’s free to know if you can claim and the estimated value of your lump sum payment. Call 1300 873 252
“TPD” – What is Total and Permanent Disability?
A total and permanent disability is any injury or illness that makes it impossible or highly restricted for you to practically do your job. Anything that prevents you from working in your own occupation or one for which you are qualified by training, experience, or education could meet the TPD definition.
As you can imagine, a permanent illness or injury is generally serious, as it can restrict your ability to pay for living expenses. Typically, the benefit amount you may receive from a TPD claim depends on your policy and coverage level, and a TPD payout calculator can help estimate the potential benefit amount. Some insurance policies also include critical illness insurance, which provides financial support if you suffer a serious illness or injury.
Do I Have Permanent Disability TPD Insurance?
Most working Australians have TPD insurance as part of their life cover, often through a super fund. Many people are unaware they have TPD cover included when they open a superannuation account, and some have multiple insurance policies.
Thankfully, this insurance provides financial security for you and your family. When you have a successful TPD claim, it pays a TPD insurance benefit that pays for your medical expenses and rehabilitation costs.
Although insurance policies differ in their definitions of total and permanent disability, there is still a general understanding of what qualifies as a Total and Permanent Disablement.
What Qualifies as a Total and Permanent Disability?
Total permanent disability insurance pays out when you become totally and permanently disabled due to an injury or illness and can’t work. So, while losing your toe or finger is a severe accident, it may not qualify you for a TPD insurance claim, depending on your occupation.
Some insurers may require a medical examination as part of the TPD claims process, but others may not. Still, it is important to fully disclose your medical history when applying or making a claim.
Each insurer has a different definition of TPD, so check the relevant Product Disclosure Statement (PDS) to see what they define as a permanent disability. It is important to compare TPD insurance policies and provide honest answers during the application process to avoid issues with claims or policy cancellations. However, there are two main categories: an own occupation policy and any occupation.
Own Occupation Policies
You can successfully claim against an own occupation TPD policy when you can’t work again in your usual occupation. For this type of TPD insurance policy, you could later return to work in a different industry suited to your disability.
Any Occupation Policy
When you are unable to work in any job for which you are qualified by your education, training, or experience, and any occupation provides a lump sum payout.
Can I Claim Against a TPD Insurance Policy?
For free, Aussie Injury Lawyers will:
- Investigate your TPD insurance cover
- Advise if you qualify for a TPD claim
- Tell you the value of your TPD benefits
Our experienced insurance lawyers have a 99% success rate for claiming insurance benefits and can help you have a successful outcome. Though, if you are seeking a higher benefit amount or have complex insurance needs, it is worth considering consultation with a financial adviser for tailored advice.
You can get your claim process started by calling 1800 873 252.
Types of Total and Permanent Disability
Total and permanent disability can take many forms, affecting people in different ways. Here are some examples of injuries or illnesses that may be eligible for TPD cover.
What kinds of physical disability qualify for a TPD claim?
Physical disabilities often qualify for a TPD claim because they impact someone’s physical capacity to perform daily tasks or work. Examples include:
• Spinal cord injuries
• Amputations
• Severe burns
• Neurological disorders such as multiple sclerosis or Parkinson’s disease
• Chronic illnesses like cancer or heart disease
What kinds of mental health conditions qualify for TPD Claims?
Mental health disabilities are recognised psychological disorders that impact someone’s mental well-being, making it challenging for them to cope with daily life or work. Examples of mental illnesses include:
• Severe depression
• Anxiety disorders
• Post-traumatic stress disorder (PTSD)
• Schizophrenia
• Bipolar disorder
Some mental health conditions may also be classified as a critical illness under certain insurance policies, which can affect eligibility for a TPD claim.
Cognitive disabilities that qualify as a Total Permanent Disability
Cognitive disabilities qualify for TPD claims because they make it difficult for people to process information, learn, or remember. Examples include:
• Traumatic brain injuries
• Stroke or cerebral vasculature disorders
• Neurodegenerative diseases such as Alzheimer’s or dementia
• Learning disabilities like dyslexia or ADHD
Common Causes of Total and Permanent Disability
You can become totally and permanently disabled from many different accidents and illnesses, but work-related injuries are a common cause. If you become totally and permanently disabled due to any of these causes, you may be eligible for a permanent disability benefit or TPD cover through your insurance policy.
Work-Related Injuries
Work-related injuries are a common cause of total and permanent disability. These injuries often occur due to:
- Accidents at work
- Serious slips, trips and falls
- Exposure to hazardous materials or environments
- Poor workplace safety or ergonomics
Examples of work-related injuries that can lead to total and permanent disability include:
- Back injuries or spinal cord damage
- Head or brain injuries
- Amputations or severe limb damage
- Chronic illnesses like mesothelioma or asbestosis
If you suffer a work-related injury resulting in total and permanent disability, you may be eligible to receive a disability benefit from your insurance policy. You could also access WorkCover benefits with the support of an experienced workers’ compensation lawyer.
In Australia, if you have a permanent injury or illness, regardless of how it occurred, a TPD insurance claim helps cover medical and rehabilitation costs, giving you financial security during recovery. Whether by claiming against TPD cover in a life insurance policy or other means, having the right coverage can make a significant difference in managing the financial impact of a permanent disability.
TPD Insurance Benefits
TPD insurance provides several valuable benefits for anyone who is totally and permanently disabled. One of the key advantages is the lump sum payment received if your TPD insurance claim is approved. This lump sum can be used to cover:
- Medical expenses
- Ongoing rehabilitation costs
- Every day living expenses
- Accommodation costs for an immediate family member who needs to travel a long distance to support you during a serious illness or injury
Another key feature is the guaranteed future insurability benefit, which allows you to increase your TPD cover without needing to provide new health information when a significant life event occurs, such as getting married or having a childneeding to provide new health information when a significant life event occurs, such as getting married or having a child
How Much Does TPD Insurance Cost?
Several factors influence the cost of TPD insurance, including age, occupation, gender, and how much cover you need to pay for daily living expenses. Generally, buying TPD insurance through a super fund is cheaper, as it includes group coverage when you open a new account.
NOTE: Some life insurance providers may also set a maximum benefit amount for TPD coverage, which can be up to $3 million, depending on the policy. TPD insurance premiums are generally not tax deductible, but the lump sum benefit received is usually tax-free.
Stepped or Level Premiums
To calculate how much TPD cover you need, you should understand the gap between what you have and what you will need in the case of a total permanent disability. Then, the cost of TPD insurance premiums changes based on whether you choose stepped or level premiums.
When considering stepped or level premiums, it’s important to note that some insurers offer variable premiums and variable age stepped premiums, which can affect the cost of your policy over time.
• Stepped premiums increase annually based on your age
• While level premiums remain the same throughout the life of the policy• While level premiums remain the same throughout the life of the policy
How Much TPD Cover Do I Need?
When deciding how much cover you need in TPD insurance, you should first check:
- Where to buy TPD insurance as a standalone policy
- Whether you are already covered through existing superannuation policies.
The lump sum payout from permanent disability insurance covers many aspects of your life, including:
Medical treatment costs
A successful TPD insurance payout should cover all your medical expenses.
Your living expenses
You might be unable to pay for housing for you and your family when you can’t work. A TPD benefit should cover your daily living expenses so you can afford to stay in your home.
Debt repayments on a mortgage or credit card
If the income from your job enables you to pay off debts, a TPD insurance benefit will cover those debts for the period you are unable to work.
Boost your retirement savings
You can also have some money left from your lump sum payment to fund your retirement.
Long Distance Accommodation Benefit
Some insurers, such as TAL TPD Insurance, offer additional features like TAL Accelerated Protection and critical illness insurance, which offer extra support in the event of a serious illness or injury.
Certain policies also include a long-distance accommodation benefit, reimbursing accommodation costs for an immediate family member or a family member who needs to travel more than 100km to support the insured during a serious illness or injury.
How Much is a Lump Sum Payment?
In Australia, a TPD lump payment ranges between $50,000 and $500,000, depending on the value of your TPD coverage. However, some people can receive much more because they can claim TPD against multiple TPD policies.
- Some policies offer an advanced payment or advanced payment benefit, allowing you to access a portion of your benefit amount early if you suffer permanent loss of use of a limb or eyesight, subject to certain restrictions such as superannuation structuring or exclusions.
- Additionally, some policies include an inflation protection benefit, which increases your benefit amount annually to keep up with inflation.
Claiming a TPD Benefit with a TPD Lawyer
When you need to make a TPD claim due to a permanent illness or injury, an experienced TPD claim lawyer will significantly increase your chance of success. Disability insurance companies will look for any reason to deny your insurance benefits, so you need a well-prepared case and compelling medical evidence.
Our insurance claim specialists provide the best legal representation at Aussie Injury Lawyers. Furthermore, our 100% no-win, no-fee policy allows you to use our legal services without paying until we win your claim. Call now for your free claim investigation: 1300 873 252
