Total and Permanent Disablement (TPD)

How do I claim for compensation

What does TPD mean for me?

If you are suffering from a disability, sickness and/or an injury and you have been employed in your lifetime you may have a successful disability claim. A superannuation fund/trustee will almost always hold TPD insurance for their members under a group life policy entered into directly with the trustee

How do I claim TPD?

Firstly, it is prudent to determine whether or not you hold Total and Permanent Disablement Insurance. Then, an assessment should take place of the Total and Permanent Disablement definition within the trust deed and policy. The person making the application must supply supportive material and particulars in support of the claim to establish a right of claim. The fundamental evidence needed to make an application to claim your Total and Permanent Disablement benefit is:

  1. Proof of evidence or Statement including particulars of employment; and
  2. Medical opinion from treating doctors and specialist; and
  3. Expert medical opinion
  4. Vocational assessment 
  5. GP and other records

Or…. Give me a call and I’ll guide you through it. 

Why Nathan believes Total and Permanent Disablement Insurance is a life saver or life line?

I have legally represented many people who have suffered immeasurably not by way of their own doing but by unpredictable misfortune such as injury, illness, sickness or life circumstances. Often these people will have children, mortgage/s and other debts. In other words, people are relying on them financially.  

Depending on what has happened and how it is happened there maybe be other forms of compensation available to them such as workers compensation, third party claims, civil liability act claims and/or common law. However, over the last decade compensation rights and entitlements have been reduced and minimised for injured and sick people compared to what was historically in place. Therefore, in order to assist my clients we turn to and look at Total and Permanent Disablement insurance. 

As a real-life example, I acted for a forty one year old male named Richard. He was married with two young children working as a truck driver with a $900,000 mortgage (this was 7 years ago). He was diagnosed with Motor Neuron Disease (MND) and given 18 months to live. He had no workers compensation rights and entitlement as the neurological condition was not acquired at work and his Total and Permanent Disablement insurance with his current employer was only $18,000.

The family was looking at not only losing their father but their family home and then his wife experiencing significant financial strain. He told me in his initial conference he worked as a mechanic prior to his prior to his current job as a truck driver. We conducted our due search and discoverability and found another superannuation policy he forgotten about that was active and had a Total and Permanent Disablement of $750,000.  

We lodged the claim and within 4-5 weeks it was released. A true-life saver for his family and peace of mind for Richard in the later stages of his life. 

Why TPD insurance is often over looked?

The majority of applications for Total and Permanent Disablement insurance are made by Personal Injury Lawyers. That has occurred because these lawyers deal with injured people on a daily basis. In fact, Total and Permanent Disablement insurance claims are contractual claims and therefore you must retain a lawyer with specific expertise dealing with these types of claims. 

A superannuation fund is erected by way of a trust fund. A trustee usually has disability insurance for paying members under a policy. There is a contract with a member which is you (employee) and the trustee and one between the trustee and the insurer. 

Often lawyers apply a common sense meaning to Total and Permanent Disablement claims, but this is usually the incorrect approach. Total and Permanent Disablement is governed by the definitions in the policy and trust deed. Those definitions must be considered carefully. There are common form definitions and individual disability definitions. The total and permanent disablement definition in the trust deed and policy will form the basis of any determination of disablement. 

How long do I have to make a Total Disablement Claim?

Like most things in life nothing lasts forever and if you don’t bring your cause of action within certain time frames you may be precluded altogether. For example, the limitation period for claims against trustees varies from 12 years to 15 years depending on the state and territory and what is provided specifically under the contract. 

A contract of insurance (with the insurer) shares the same limitation period as a simple contract namely 6 years subject to agreed extension or variation. Rarely, a shorter period may be provided under the contract. 

Be careful, read, read, read and re-read the deed and policy or simply pick up the mobile and give me a call or drop me an email. 

In practical day to day advice to Total Permanent clients the above comments have limited application because they visit my rooms immediately or shortly following their injury, illness or life changing event. A cause of action on a trust deed accrues at the time of the breach. This could mean:

  1. Until a superannuation fund and/or trustee makes a decision declining the claim the cause of action doesn’t arise; or
  2. The current court cases suggest the cause of action under an insurance policy will not arise until a rejection after the expiration.

However, there are unusual cases where the date of disablement was the commencement giving rise to the cause of action. 

Your best bet is start the claim as soon as possible.  Call me.