There’s been a lot of bad press recently surrounding total and permanent disability (TPD) cover with some products offered by insurers less likely to bring payouts to sufferers. This is the case whether they have TPD injuries to their back, neck, or shoulders working as pickers or packers, or in warehouses; those with cleaning jobs, or who work in other areas. But delayed payouts have also been experienced by claimants, particularly those who have sustained an injury while working in jobs where they see traumas, such as the police, fire fighters, nurses and suffer from Post Traumatic Stress Disorder (PTSD) and other mental injuries and illnesses. Claimants have spoken out on television current affairs programs about the delays and battles they’ve had with insurers, with one insurance company using deliberate delaying tactics to drag out their process. Although this behaviour is totally unacceptable, unfortunately, it happens. So, how long does it take to get a TPD payout? More to the point, how long should it take?
At PK Simpson, we are experts in super and TPD claims – We help Australians nationwide claim their benefits – you’re in safe hands with us – We’re big on keeping our clients up to date and supported throughout their claims.
Any associated conditions caused by medicines including:
Sexual or social issues
These should be resolved within two to three months of your insurer receiving the forms along with the documented medical evidence. For anyone suffering a TPD, this can seem like a very long time if they have no income. However, if you find yourself in this situation, it’s best to try to be patient while your insurer assesses your claim. You should ask your insurer for an update if you haven’t received an answer after three months. Be sure to follow any instructions given to you in applying for TPD benefits because this will make the process faster. Should you fail to provide documents or make errors in your application, it could cause major hiccups, although many claimants who are diligent still encounter delays.
PK Simpson is the only superannuation law firm with a client services department who are dedicated, 100 per cent of the time, on making sure clients are happy.
How Can I Get a Quicker TPD Claim Benefit?
The first thing to do if your TPD claim is taking longer than three months (some claims can drag on for years) is to get in touch with PK Simpson lawyers. We specialise in TPD claims and can help expedite your case. You can also follow this course if your original application was rejected, and you don’t agree with the decision. At times, the mere threat of legal action can be enough of an incentive for the insurer to get on with accepting your claim without delay and providing the payout you deserve. If the insurer doesn’t budge, our experienced TPD claim lawyers can gather evidence for you and start court proceedings. A successful claim results in a lump sum payout and the insurer will likely have to pay your legal costs and interest.
If you’re unable to work due to an injury or illness, the friendly team of lawyers at PK Simpson will make sure you’re looked after, and every fund you’ve ever been a member of is looked into – You might have more than one TPD claim –
We maximise results by obtaining required specialist reports, and we pay for all medical reports
Why Do Insurers Often Delay TPD Claims?
Yes, it’s understandable that insurers need a reasonable time to make an assessment on a TPD claim, but some of them deliberately slow the process by asking for information bit by bit. Everyone knows insurers collect the highest premiums but pay out the lowest claims. This kind of unethical behaviour should be exposed, since insurers are obliged to treat claimants in good faith. Also, it’s against the law for insurers to frustrate or unreasonably delay a claim. Reasonable requests for information should be the norm, and insurers should send claimants for medical examinations as soon as possible. If your insurer fails to do this, they could be breaking the law which might entitle you to penalty interest. If you are in this category, do seek legal help because claimants who are not represented are usually the ones whose claims are delayed for years.
If you haven’t been able to work in your usual job for three to six months due to an injury or illness, you are likely to be classed as TPD.
Each superfund has their own TPD definition and this must be satisfied for the TPD claim to be approved. Common factors which are assessed in each claim are the members work history (education, training and experience), suitable jobs, and medical evidence.
Your TPD entitlements are set out in the contract (a.k.a. policy, or product disclosure document) you have with your insurer. Therefore, the definition of TPD will vary between policies and insurers.
Yes, you can have multiple TPD claims providing your insurance policies or super funds are independent of each other. Bear in mind that, unlike other personal injury claims, when you make a TPD claim, you do not have to prove that the illness or injury was work-related or caused by somebody else.
A successful TPD claim can never be 100 per cent guaranteed, but you are much more likely to win your claim if you contact a TPD specialist lawyer at PK Simpson to discuss your situation. There is a minimum level of evidence required to support your claim, which must be provided to your insurer and your super fund. This includes your claim form, a signed authority, certified ID, and two medical reports from your treating doctors showing that you can never return to work. These will need to be reviewed by a lawyer to ensure all the correct boxes are ticked, and that the evidence strongly supports your claim for TPD.
Often, terms and conditions specific to your policy need to be analysed in order to make sure the fund cannot decline your claim.
Superannuation funds will often require specialist reports. Superfunds do not pay for treatment throughout the claims process. However, PK Simpson pay for all medical reports needed to support your claim.
Yes, you can. People are now becoming more aware of depression and other mental illnesses, and while there’s a way to go before the stigma is lifted, we’re talking about it more often. Around one in four Australians suffer from a mental illness each year. However, insurers are wary of mental illness disability claims, and it can be quite hard to get cover. But what many people fail to recognise is that the automatic TPD insurance you have through your superannuation fund can pay out much-needed benefits and funds if you cannot work due to depression or any other mental illness.
Mental illness can often be a lingering side effect of a physical injury, even after full physical recovery.
Most claims are paid out and finalised within three to six months, but it all depends on how complicated the claim is, and how much good evidence you have about your injuries. There is also the matter of whether you fulfil all the criteria set by your insurer. This is why it’s crucial to have a specialist TPD team on your side when you make a claim for TPD for any reason.
As lawyers we will make sure your claim is assessed by the superfund in a timely manner. Delay tactics are deployed by funds to prolong and frustrate TPD claimants who are not legally represented.
Yes, you can. If you’re diagnosed with a serious cancer that has an impact on your ability to work, you may not realise you are entitled to claim insurance benefits through the insurance provided through your superannuation. These benefits may include income protection if your disablement is temporary, and TPD if your condition is long-term and serious. If your condition is terminal, you will be eligible for a terminal illness payment.
If you or anybody you know has ceased work due to illness or injury and they cannot return for at least six months they could be eligible to claim TPD benefits. Call PK Simpson specialist TPD lawyers today on 1300 358 057 or email firstname.lastname@example.org