Am I entitled to permanent disability benefits under an insurance policy?

Published 06 Nov 2014

Total and permanent disabilities can cause various problems for employees and their families, particularly when it comes to finances.

Even short periods away from the workplace can result in individuals struggling to pay bills, but the issue is exacerbated for people with a disability, as they are unlikely to ever work again.

However, there are benefits available in these circumstances that will help to alleviate some of the financial strain. But how do you know if you're entitled to these benefits?

Making a TPD claim

The definition of TPD typically varies between superannuation funds and individual insurance policies. However, those who are entitled could receive a lump sum payment from anywhere between $10,000 and $1 million if their claim is successful.

There are several criteria an individual must meet before consideration for a TPD claim. These include:

  • An inability to work - due to illness or injury - in a role that the person is otherwise reasonably qualified to perform in terms of education, experience or training
  • Gainful employment has stopped because of this ailment
  • The injured person is under 65 years of age when active employment ceased
  • A valid insurance policy covered the individual on the date they stopped working

It is possible for people to be declared totally and permanently disabled if they suffer a serious problem that prevents them from working for a continuous period of six months or more. The claimant must then prove they are unable to perform their job, which will require a doctor's report.

What disabilities are covered?

Anyone considering a TPD claim should also be aware that the disability can be physical or psychological, so conditions such as chronic fatigue syndrome, mental illnesses and cancer are all included.

If the disability is due to an injury or accident, it does not matter whether this was suffered while at work or at a location outside of the employment site.   

Furthermore, individuals who have attempted to re-enter the workforce at any point may still have the opportunity of making a TPD claim in circumstances where the rehabilitation was unsuccessful.

However, there may be a time limit on lodging a claim, so if you feel that you might be eligible for compensation, it is recommended you speak to an expert legal team.

A no-win, no-fees superannuation lawyer can help you with all the complexities involved when making insurance claims, ensuring you have the best chance of success.

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