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Super Claims

TPD Claims

What is TPD

TPD (commonly known as Total & Permanent Disability or Total & Permanent Disablement) is an insurance benefit available under a superannuation fund. This is available in addition to the contributions (account balance) made by the employer/fund member.

Who can claim TPD?

You can make a claim for TPD, if:

  • If you have ceased your employment and/or duties as a result of an illness and/or injury (please note that this does not mean your employment must be formally terminated); AND
  • You are unlikely to return to your employment/duties as a result of this illness/injury; AND
  • You were under the age of 65 years when you ceased this employment; AND
  • You were a member of a Superannuation Fund at the time you ceased your employment and had TPD Insurance at the time you became unwell.
How do I know if I have TPD insurance?

You will need to have a look at your current Superannuation Statement. If you are covered for TPD, it will normally be located near the Death Benefit including the amount you are insured for.

An example of this is shown below:

What are my rights?

Any rights that you have are governed under your policy document. We will need to review the Superannuation Fund Policy Document carefully before we are able to advise you in relation to your rights.

How do I lodge a claim?

This is generally a two step process.

First, your Superannuation Fund needs to be contacted either by writing or by telephone to obtain the claim forms, a copy of the policy document and to confirm the amount you are insured for.

The second step requires completing the claim forms (these generally consist of a lengthy Application Form, Employer Declaration Form and Treating Doctor’s Report/Certificate) and lodging them together with copies of medical records, reports and any other information that may be relevant to your claim with the Superannuation Fund.

What do I need to give to my lawyer?
You will need to bring the following information and/or documentation to the meeting:
  • Superannuation Policy Number
  • Latest Superannuation Statement
  • Superannuation Policy Disclosure document, if you have it in your possession;
  • A list of your qualifications, trades and education;
  • A list of all employers you have worked for including job descriptions. If it is easier for you please just bring your resume;
  • A list of all your injuries and illnesses;
  • A list of all your medical practitioners including your current treating practitioner;
  • The details of your employer when you became unwell and the date you last worked.
Do I need to resign or be terminated from my employment before making a claim?

You do not need to resign from your employment or be terminated from your employment before a claim can be made. Most funds require that you be absent from your employment for a continual period of at least 6 months before lodging a claim.

What can I expect in the claim process?

The TPD Claim process can be quite lengthy and complex. An investigation with your superannuation fund will need to be undertaken to confirm your TPD cover and obtain the policy document.

A detailed statement will need to be obtained from you in relation to your vocation, work experience/qualifications, injury and illnesses and work history.

Further, all medical evidence by way of a medico-legal report from an independent specialist (this means you will need to attend at an appointment for examination); medical records from your treating practitioners and any other material.

The Claim form together with submissions will then be prepared on your behalf for lodgement with the superannuation fund.

The fund will then make a determination as to whether they accept or reject your claim.
The information provided above is a short run down on the process. It is difficult to determine the length of time for the process as we are dealing with third parties to obtain information.

How much do I get?

How much you will get is dependent upon how much you are insured for, the policy which governs your TPD insurance and whether you decide to take a lump sum amount or a weekly benefit.

Do I pay tax on any benefit that I receive?

Yes you are required to pay tax on any benefit you receive for TPD as it is considered income. Tax is paid on a portion of the amount payable to you and is taxed at a discounted rate. It will need to be declared to the Australian Taxation Office.

The superannuation fund will automatically calculate the amount payable on your behalf and forward this amount directly to the Australian Taxation Office.

We recommend that you seek advice from an accountant or financial planner in relation to this.

Who offers TPD cover?

Most Superannuation Funds offer TPD cover or you can organise your own cover either through a superannuation fund or other insurer.

Is there a time limit to make a claim?
There are no time limits in lodging a claim against your Superannuation Fund for TPD claims if your employment has not been formally terminated..

However, most funds require you to be absent from work for a continual period of at least 6 months before you will qualify to make a claim for TPD.

In the instance that your employment has been formally terminated then you must lodge the claim for TPD within two years of this date. Example: If your employment was formally terminated on 28 January 2010 then you have until 28 January 2012 to lodge your claim with the superannuation fund.

If your claim is rejected by the fund after lodgement, you will have six years from the date the claim is rejected to file proceedings in the court, if necessary.

What happens if my claim is refused?

If your claim is refused by the Insurer you have several options. These options include:

  1. Taking no further action;
  2. Lodging a request for consideration with further material to support your claim;
  3. Lodging a complaint with either the Superannuation Complaints Tribunal or Financial Ombudsman Service. Please note that you will need to seek authorisation from the SCT or FOS for a lawyer to represent you as there is not an automatic right.
  4. Start proceedings in a court to challenge the decision made by the fund.
Can I access some of superannuation account balance now?

Yes, you are able to access some of your superannuation account balance now.  The options are as follows:

  • If you are over 55 years old, you may be eligible to automatically have some of your account balance released;
  • You may have some of your account balance released on the basis of permanent incapacity.  You will be required to obtain to medical reports (as provided by the superannuation fund) stating you are permanently incapacitated;
  • The other option is to have your account balanace released on the basis of financial hardship.  You will need to have been on Centrelink benefits for at least 6 months before you are able to access your superannuation under this category.

Please note that a minimum balance is required to be left in the account so as not to affect your insurance claim.