Successful TPD Insurance Claims: 3 Steps You Must Take When Claiming

Should you need to claim on your total permanent disability (TPD) insurance, then it’s crucial that you fully comprehend the conditions that apply. For successful TPD claims, it’s vital that claimants meet the exact eligibility criteria required by their particular policies. While all insurance and superannuation policies will have different requirements, case studies show some of the more common reasons claimants fail the eligibility tests include:

• Failing to meet the required disability level
• Failing to satisfy minimum wait times
• Failing to fulfil requirements around work history

The best advice is to read your policy carefully, and if you have any questions about your total and permanent disability superannuation claim, contact your provider or a law firm’s Superannuation experts. The process can be long and arduous unless you take the necessary steps.

For over 38 years, the PK Simpson law firm has been helping the people of Australia win the TPD payout to which they are entitled.
PK Simpson lawyers have the skills and experience to make sure you are successful in your TPD claim.

Consider These 3 Points Before Making a TPD Claim

1. Ensure that you fully understand the reasons why TPD claims can be disputed.
2. Check your policy or have an expert check it to make sure you’re eligible to make a claim.
3. Follow the right steps to claim. This will be dependent upon whether your TPD is a standalone policy or is included in your Superannuation fund.

If you are going through the difficulties that come after the death or total and permanent disability of a member of your family, Superannuation and disability insurance benefits may help to ease your financial burden. At PK Simpson, our TPD Claim lawyers can help to make sure you win the maximum lump sum payout under your benefit.

Understand Why Your TPD Claim Might Be Disputed

One of the primary reasons many TPD claims are disputed stems from the fact that the definitions between the different insurers are so varied. Also, there is no standard definition of TPD. Examples of variations include:

• Long wait times
  Before you receive any payments, your policy might require you to wait for up to three months.
• Further requirements
  Your policy might specify that you receive ongoing advice from a specialist or that you have a rehabilitation program in place.
• Exclusions
  Your policy could exclude you from receiving a TPD payout if you have pre-existing medical problems.

Check if You’re Eligible to Claim

Being crystal clear about what your policy requires is of the utmost importance for a successful TPD claim. You also need to be clear about the definition under which you policy falls, so there are no disappointments or nasty surprises after you claim. Providing you satisfy the conditions set out in the policy you have with your insurer or your Superannuation fund you can make a TPD claim. This will typically involve proving you can no longer work. Insurers will usually rely on the following criteria when they assess a TPD claim. Remember, the requirements set by the different insurers usually varies greatly.

• Level of Disablement: You will most likely need to prove you suffer from a minimum degree of disablement which will often consider your ability to go back to your previous job, or ever to work again.
• Your Superannuation Fund: Whether you can lodge a claim will depend on whether TPD cover is part of your Superannuation policy.
• Wait Times: Before you lodge a TPD claim, there will possibly be a stipulation in your policy that you wait for a certain period after your injury so your symptoms can stabilise and the full extent of damage can be ascertained.
• Your Employment History – Before you are eligible to claim a TPD payout your policy could require that you have had a minimum level of work in the form of weekly hours or total length of employment.

Follow the Appropriate Steps to Claim TPD

Making a claim from a standalone TPD insurance policy is similar to claiming TPD from your Superannuation; however, there are some differences in the claim processes. While every claim process will be different, depending on your insurer and the type of claim, it is generally the case that the following steps should be taken:

• Call Your Insurer’s Claims Department: You will need to get the proper forms, and it’s advisable to let your lawyer help you to fill them out correctly.
• Prepare the Documentation: This includes the completed claim forms, a statement from a certified doctor or specialist to verify your injury or illness, whether physical or mental, details of other health claims, plus your bank details for your benefits to be deposited.
• Submit Claim Forms and Documents: Makes certain you have every document and all the information required by your insurer to avoid any unnecessary delays.

PK Simpson prides itself on being a firm that takes on any case relating to compensation, including TPD, whether it’s big or small. Call us today on 1300 757 467 or enquire online now so we can help you.