Unfortunately, making a Total and Permanent Disability (TPD) insurance claim and receiving your benefits may not be a quick and simple process. Insurers and super funds often decline TPD claims and try to avoid paying the benefits. TPD is usually the injured or ill person’s lifeline, and after going through the ordeal of making a claim to then have it rejected can be a shattering experience. But it need not end there.
If you’ve recently tried to access your TPD insurance after suffering an injury or illness that has prevented you from returning to work in the same capacity and your insurer has denied your claim, call us immediately at PK Simpson so we can sort it out for you as soon as possible.
Some ask “can you claim TPD more than once?” The answer is yes, you can have multiple TPD claims, providing your separate funds are independent of each other.
Are you no longer able to work due to injury or illness? The good news is your superannuation fund probably owes you a lump sum payment. Call us today at PK Simpson so we can get the ball rolling and get you the TPD Insurance benefits you deserve.
Why Are Some TPD Insurance Claims Rejected?
At PK Simpson, we have a high success rate and our properly prepared TPD claims are accepted by superannuation fund insurance. However, it’s now increasingly common for insurers to decline a claim the first time round, only to accept it later on review. This is why you ought to challenge an insurance company if they have denied your TPD claim.
While every insurance and superannuation policy has a different requirement, TPD claims are commonly declined because the insurer:
- Decides you don’t satisfy the TPD policy definitions
- Has medical evidence that denies your injury or illness
- Believes you can carry out some form of work
- You failed to meet the working requirements before you were injured or ill (e.g you worked 30 hours a week rather than full time)
- Your TPD insurance policy is no longer active
- You haven’t satisfied minimum waiting periods
- There’s a dispute with your insurer regarding evidence
For more than 38 years, our injury compensation lawyers at PK Simpson have helped our valued clients receive the TPD benefits they deserve.
We’ve successfully dealt with over 25,000 claims and helped thousands of people get their lives back on track.
That is our speciality!
If Your TPD insurance Claim is Denied – Don’t Give Up
If your TPD claim is declined, denied or rejected outright, don’t despair and think you’ve lost and that’s the end of the matter. Don’t let anyone tell you there’s nothing more you can do and that no further action is worth it or even possible.
Once you fully comprehend why your insurer declined your TPD claim, you have plenty of options available to you. Seek urgent legal advice from PK Simpson injury compensation lawyers to discuss your next step and find out how you can lodge a review of your insurer’s decision. We can help you:
- Lodge both a personal and official complaint to your superannuation insurance provider
- Submit an official complaint to the insurer’s internal dispute resolution office
- Submit a complaint to the Financial Ombudsman Service
Why Should I Try to Challenge the Insurer’s Decision?
No matter what reasons your TPD insurance provider has given for declining your claim, you ought to seek urgent legal advice to find out about your options. At PK Simpson we may be able to also do the following:
- Refer your super fund insurer’s the decision to the Australian Financial Complaints Authority (AFCA)
- Begin court proceedings so your claim can be determined by a judge who may overturn the insurance company decision.
The importance of seeking legal advice cannot be overstated when it comes to TPD claims. The best advice is to let PK Simpson handle your case from day one of your injury or illness. Insurance companies have been known to reject TPD claims for little or no reason.
Some simply do a brief review of a file and then decide not to pay the TPD claim. Where the insurer does get medical or expert reports, they may fail to use the right professional, don’t ask the right questions or address TPD insurance policy definitions.
Call us at PK Simpson if your TPD claim has been declined and you want to know if you should challenge the decision made by your superannuation fund insurer. Phone 1300 757 467, fax (02) 92624497, email email@example.com. You can also fill in the convenient online form and we’ll get back to you pronto!