TPD Claims
A total and permanent disability claim can provide a significant lump sum payment when illness or injury has permanently ended your ability to work. It is one of the most valuable entitlements many Australians have, and one of the least understood.
Total and permanent disability, or TPD, insurance is held by most Australians through their superannuation fund, often without them realising it. If you have suffered a serious injury or illness that has permanently affected your capacity to work, a TPD claim may entitle you to a lump sum payment that can provide financial security for you and your family when you need it most. The challenge is that TPD claims are complex, the definitions are technical, and insurers dispute them regularly.
Who Can Claim
You may be eligible to make a TPD claim if you have suffered a serious injury or illness that has permanently affected your ability to work, including through:
- A serious physical injury sustained at work, on the road, or elsewhere
- A degenerative condition such as severe arthritis, spinal disease, or neurological illness
- A psychological condition including severe depression, PTSD, or anxiety disorder
- A terminal diagnosis that has ended your working life
- Any other condition that has permanently prevented you from working in your usual occupation or any occupation for which you are reasonably qualified
Most people with superannuation have some level of TPD cover. The amount varies significantly between funds and cover levels.
How a Claim Works in NSW
TPD claims are governed by the Superannuation Industry Supervision Act 1993, the terms of your fund’s trust deed, and the specific insurance policy your fund holds on your behalf.
- Identify all superannuation accounts you hold, as you may have TPD cover across multiple funds.
- Request your certificate of cover and product disclosure statement from each fund to understand the definition of TPD that applies and the benefit amount available.
- Obtain comprehensive medical evidence from your treating doctors and any relevant specialists.
- Lodge your claim with the fund’s trustee and insurer.
- If the claim is denied or the benefit offered is inadequate, dispute resolution options are available through the Australian Financial Complaints Authority (AFCA) or the courts.
Why You Might Want a Specialist Lawyer
TPD claims are routinely denied on technical grounds related to the definition of disability, the claimant’s work history, or gaps in medical evidence. Insurers and fund trustees have experienced claims teams and the resources to defend disputes at length.
We help you:
- Identify every fund and policy under which you may have TPD cover
- Ensure your claim is supported by thorough and strategically prepared medical evidence
- Challenge denials that misapply the policy definition or rely on inadequate evidence
- Pursue your claim through AFCA or the courts where the insurer’s position is not justified
What Compensation Could You Receive?
Depending on your level of cover and fund, you may be entitled to:
- A lump sum TPD benefit, which can range from a modest amount to several hundred thousand dollars depending on your cover level and fund
- Early release of your superannuation balance on grounds of permanent incapacity
- Separate income protection benefits if your fund also holds this cover on your behalf
FAQ
What is the difference between own occupation and any occupation TPD cover?
Own occupation cover pays out if you are unable to ever return to your specific occupation. Any occupation cover pays out only if you are unable to work in any occupation for which you are reasonably qualified by education, training, or experience. Any occupation is the more common definition in superannuation policies and is significantly harder to satisfy. We can explain which definition applies to your policy and what it means for your claim.
My TPD claim was denied years ago. Is it too late to challenge the decision?
Not necessarily. Limitation periods for superannuation disputes can be complex and depend on the specific circumstances of your claim and denial. It is worth getting advice before assuming the window has closed.
I am still receiving some medical treatment. Do I need to wait until I have fully stabilised before claiming?
Not always. Some funds allow claims to be lodged while treatment is ongoing, provided the evidence supports a conclusion that the disability is likely to be permanent. Early legal advice can help you determine the right time to lodge.
