Why are mental health disability claims more difficult to prove?

Published 19 Oct 2017

Total and permanent disabilities (TPDs) have a significant impact on the affected individual and their loved ones.

TPD claims mean permanently disabled people can receive a lump sum payment to help them support themselves and their families should unforeseen circumstances strike.

However, insurers don’t approve every claim they receive and individuals who suffer a mental health disability may find it more difficult to access benefits. But why are mental health problems sometimes treated differently?

Mental health claimants struggle to receive insurance

Insurers are often looking for ways to reject a claim, and some won’t provide cover to people with mental health issues at all.

Research from beyondblue and the Mental Health Council of Australia found that only 37 per cent of people with psychological illnesses received insurance without any exclusions or extra premiums. Twenty-two per cent were specifically declined because of their mental health history.

Even those who are accepted for cover may face problems if they eventually pursue a claim. One of the key reasons is that mental health disabilities are often more difficult to diagnose than physical ailments.

For example, the symptoms of depression, anxiety and post-traumatic stress disorder typically vary in severity over time. A lack of obvious physical injuries can also make it seem that claimants are able to return to the workplace in the future, even when this is not the case.

The additional strain of a rejected or delayed TPD claim can be particularly traumatic for people who are already suffering from severe mental health illnesses.

The stress of pursuing a claim

Insurers regularly conduct extensive surveillance of policyholders in an attempt to disprove an individual’s claim. Some people may even abandon their TPD case because of the extra stress placed on them and their families.

ABC News recently reported that insurer AMP was facing legal action over delayed claims. One Queensland-based customer, Rebecca Ryan, has waited over five years for her TPD insurance settlement.

“Every time I think that I’m doing a bit mentally better they’ll want another doctor’s report or a new opinion or another psychologist’s report or opinion, and then I have to go through the last 10 years all over again,” she explained.

Ms Ryan eventually received her lump sum payment, but other customers aren’t so fortunate.

That’s why people who feel a legitimate claim has been rejected should contact an expert law firm such as Gerard Malouf & Partners Superannuation Lawyers.

Contact us today to see how we can help you gather evidence to support your TPD insurance claim.

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