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TOTAL AND PERMANENT DISABILITY CLAIMS
TOTAL AND PERMANENT DISABILITY CLAIMS
“We’re often able to obtain large lump sum payments from insurance policies which clients didn’t even know they had! Anyone who isn’t working due to illness or injury should just call us to discuss”
– David King, Senior Lawyer
If you’re injured or sick and can’t work for any reason then there’s a really good chance an insurance company owes you money. You see, most of us have insurance cover called Total Permanent Disability (TPD) built into our Superannuation. You may have even taken out your own additional TPD insurance through financial advisors or other institutions, for instance, when you signed up for an Income Protection policy.
TPD insurance can often pay hundreds of thousands of dollars – and in some cases much more. If you have had to stop work as a result of an illness or injury, then you may be entitled to claim this lump sum TPD insurance.
Super funds use a variety of funds to take out insurance for their members. Because of this, if you have TPD insurance, the criteria for making a claim can vary. However, you can generally claim a TPD payment if you’re not able to perform your usual job due to injury or illness and can’t return to any other work for which you are reasonably qualified by education training or experience. This means that much of the time you don’t have to be completely unfit for all work – just work that you are suited to due to your past experiences. So if you can do some work but will require retraining then you may still be entitled to the payment. Your disability does not have to be work related. For instance, you may still be entitled to claim TPD if you have a fall at home, a heart condition, disease or mental illness which prevents you from working.
By way of example, Mr Jones was 34 years of age. He left school at the end of year 10 and qualified as a roof plumber. He worked as a roof plumber until 2002, when he injured his back. After medical treatment he was able to go back to roof plumbing but he still had problems with his back from time to time. In 2011, he injured his back again and this time he couldn’t return to work as a roof plumber.
At the time he stopped work all of Mr Jones’s work experience had been in manual labour.
Mr Jones made a claim for $100,000 in TPD insurance under his superannuation fund.
The insurer declined his claim and said that Mr Jones could work (without retraining) as a:
- Retail Sales Assistant (Hardware)
- Courier/Delivery Driver;
- Console Operator; or
- Customer Service Advisor/Telemarketer.
Mr Jones had to take his case to Court. The Judge found that as Mr Jones’s education, training and experience was in manual labour he was not suited to the jobs identified by the insurer. The Judge ordered the insurer to pay Mr Jones the $100,000, plus interest, and pay his legal costs.
Although Mr Jones’s case needed to go to court, it is often the case that a TPD claim will be paid out quickly – without the need for Court proceedings.
Let us find out if you’re covered. We frequently find policies of insurance that people have been completely unaware of. It may also be the case that you have multiple policies through different superannuation accounts. TPD insurance can be claimed in addition to a Workers Compensation payment, Motor Accident compensation and other kinds of compensation.
By engaging Schofield King Lawyers, you are often able to get your claim paid out quickly, and often without a fight from the insurer. However, the fact is that insurance companies reject many of the claims that they should be paying. That’s why we’re here: to help you get what’s yours — to make insurance pay.
We offer ‘No Win, No Fee’ and fixed fee costing arrangements. For more about our Cost promise, click here.
If you feel you may have a TPD claim, or you just want to make sure you’re not missing out on something you may be entitled to, please contact us for a no obligation consultation. Alternatively, begin the process now by using our virtual lawyer questionnaire (coming soon) to begin a case assessment. This can be done in under 2 minutes.
What can you expect from Schofield King Lawyers?
To get the ball rolling, we can perform all investigations necessary to determine any TPD or other insurance entitlements you may have. After advising you of your options, we then use our automated technological platform to gather all the evidence we require for your TPD claim (such as evidence from your doctor and the completion of claim forms) in order to give your claim the best chance of success. We create a detailed statement for you setting out your education training and experience. We then review all of the evidence and make submissions on your behalf as to why the insurer should pay the claim.
Once everything is provided, the insurer will determine your claim. It may be that the insurer accepts the claim and payment can be made. If not, we can advise you further as to potential action that can be undertake which could include:
- Seeking a review;
- Providing further evidence;
- Requesting an informal settlement conference; and/or
- Commencing court action.
Let us do our best to make insurance pay.