Operating Since 1983
Operating Since 1983
There is no single timeframe for a Total and Permanent Disability (TPD) claim. How long a TPD claim takes can depend on the terms of your TPD insurance policy, any applicable waiting period, the medical and employment evidence required, and how long the insurer and, where relevant, your superannuation fund trustee need to assess the claim.
For insurers that subscribe to the Life Insurance Code, a decision on a lump-sum claim will generally be made within six months of the claim being received or the end of the policy waiting period, whichever is later, unless circumstances beyond the insurer’s control cause further delays.
Your individual TPD claim time frame may therefore be shorter or longer depending on your circumstances, and where you are within the TPD claims process.
Try our free 30 second claim checker or please contact us for a free assessment.
Several stages of the TPD claim process can affect the overall timeframe.
Some TPD insurance policies include an initial waiting period before the relevant total and permanent disability definition can be assessed. The length of the waiting period depends on the terms of your policy.
A waiting period is separate from the time the insurer may need to assess your claim once the required information has been provided.
Medical evidence is a key part of most TPD claims. This may include medical records and medical reports from treating doctors addressing your diagnosis, treatment, prognosis and capacity for work.
Depending on the policy, information about your employment history, education, training and experience may also be required. Gathering complete and relevant documents before you lodge a TPD claim can help reduce avoidable delays during assessment.
Where TPD cover is held through a superannuation fund, both the insurer and the superannuation fund trustee may have roles in the claims process.
The insurer or insurance company may also request further information before making its decision, particularly where additional medical or employment evidence is needed to assess the relevant eligibility criteria.
Complex claims can require more detailed assessment. This may occur where the medical evidence is extensive, several health conditions affect a person’s capacity for work, or further information is needed to assess the relevant policy definition.
If you have TPD cover through multiple superannuation funds or insurance policies, you may also be able to make multiple claims. Each Total and Permanent Disability claim is generally assessed against the terms of the relevant policy, so one claim may progress faster than another.
Not necessarily. TPD claims involving mental health conditions are assessed against the requirements of the relevant insurance policy in the same way as other claims.
However, mental illness claims may involve medical evidence addressing symptoms over time, treatment history, prognosis and how the condition affects a person’s capacity for work. In some cases, gathering and assessing this information can take additional time.
The same can apply to physical disability claims where the medical position is still developing or further reports are required.
Not every delay can be avoided, but providing complete and relevant information from the outset can help the claims process move more smoothly.
This may include:
Legal advice can also help identify what evidence is likely to be relevant before an official claim is lodged.
If your TPD claim appears to have stalled, you can ask the insurer or super fund for an update, confirm whether any further information is outstanding and request an explanation for the delay.
Where an insurer subscribing to the Life Insurance Code expects a lump-sum claim to extend beyond the usual assessment timeframe because of circumstances beyond its control, it must explain the delay and provide progress updates.
If the delay cannot be resolved directly, the insurer or superannuation fund may also have an internal complaints process. Depending on the circumstances, a complaint may later be taken to the Australian Financial Complaints Authority (AFCA).
If an insurer has already made a decision to reject your claim, different review and dispute options may apply.
Having a TPD claim approved and receiving the TPD benefit are not always the same step.
After a successful TPD claim, where the insurance is held through superannuation, the insurer may pay the benefit to the superannuation fund trustee before the funds can be released to you. Additional superannuation, tax or release requirements may therefore affect when you can access the money.
The amount available and how a TPD payout is handled will depend on your policy, super fund and individual circumstances.
An experienced TPD lawyer can help you understand the terms of your cover, identify the information required for your claim and deal with the insurer or superannuation fund throughout the assessment process. The Personal Injury Lawyers can also help review requests for further information, follow up delays and advise you on your options if an insurer’s decision is disputed. Contact our TPD lawyers for an obligation-free discussion about your circumstances.
It can. If you have TPD insurance through multiple super funds or policies, each claim may need to be lodged and assessed separately against its own eligibility criteria. This means one claim may be decided before another.
Yes. An insurer may request further medical evidence where the existing information does not adequately address the relevant TPD policy definition. This could include medical records or reports from your treating doctors.
Providing complete and relevant medical evidence that directly addresses the policy requirements can help reduce unnecessary back-and-forth during the assessment.
If the insurer needs additional medical reports, records or information from your treating doctors, the assessment may take longer. This can occur where the existing evidence does not fully address your condition, prognosis or capacity for work under the relevant TPD policy.
Providing the requested information as early as possible can help reduce unnecessary delays, although the overall timeframe will still depend on the circumstances of the claim.
This depends on how your TPD insurance is structured. If the cover is held through super, the insurance benefit may first be paid to the superannuation fund trustee before it can be released to you.
The timing can therefore depend on the fund’s requirements and your circumstances.
There is no single time limit that applies to every TPD insurance claim. Relevant timeframes can depend on the policy, when your disability occurred, when the cover was in place and whether you are challenging an insurer or trustee decision.
Because different deadlines can apply at different stages, it is worth seeking legal advice if you are unsure whether a time limit affects your claim.
A TPD claim is separate from a workers’ compensation claim. Receiving workers’ compensation payouts does not automatically determine whether a TPD claim will succeed or how quickly it will be assessed.
However, information from a workers’ compensation claim, including medical or employment records, may also be relevant to the insurer’s assessment of your TPD claim. Each claim is considered under its own requirements.
Not sure whether you may be able to make a TPD claim? Our quick TPD claim checker can help you understand whether you may have a potential claim based on your circumstances. It takes around 30 seconds to complete, or you can contact our team if you would prefer to discuss your situation directly.
The Personal Injury Lawyers are long-term members of several professional legal organisations and are also listed across recognised legal directories, including the Australian Lawyers Alliance, Gold Coast District Law Association, Queensland Law Society, LawConnect and Doyle’s Guide.
Try our free 30 second claim checker or please contact us for a free assessment.
