Total and Permanent Disablement Insurance (TPD) is designed to provide a lump sum benefit to the claimant in the event of a medically diagnosed event that renders them unable to work again.
The purpose of TPD is to help take the financial pressure off the claimant if they suffer an illness or injury that leaves them permanently disabled. Someone claiming TPD will be paid a lump sum benefit to eliminate debts, pay for medical expenses or fund permanent lifestyle changes, such as moving home to a more accessible location for their condition.
Having a claim for TPD approval can be a difficult process for the claimant. Most TPD insurance policies are provided by superannuation funds. TPD superannuation funds will require that the claimant has been off work for a period of 3 - 6 months before they will even consider a claim. After this period has been satisfied, the claimant will need to provide evidence that two of their treating medical practitioners have certified that the claimant will be unable to ever return to work in any occupation for which they are suited by way of education, training and experience. The process of determining this involves seeking professional advice from lawyers and financial advisors.
The general definition of TPD is qualified by the insurer. The insurer’s definition will often be similar to these three main definitions:
The reason it is important to understand the definitions of TPD is that the main cause of the dispute for TPD is over the standard definition of TPD. Some policies will need the claimant to follow specific ongoing advice of a specialist or even a rehabilitation program. Some policies require waiting periods of up to 3 months before a payment is made. Moreover, TPD payments will often have exclusions for pre-existing medical conditions.
In summary, there are six main criteria used to assess the claimant’s eligibility. That being:
If you have further questions about TPD contact Nathanael Coles at ncoles@franklaw.com.au.
This is not legal advice.
Image by Steve Buissinne from Pixabay.