We have seen people suffer injuries, including catastrophic ones, who have no idea that they even have a TPD insurance policy, let alone a TPD claim.
Senior Lawyer at our Port Macquarie office, Christine Neufeld discusses five things you should know about TPD insurance claims.
- You may have TPD insurance and not even know it. Often, people call our firm, who have been injured at work in a vehicle, or as a result of negligence. Some have suffered a life-changing or debilitating illness. Surprisingly, many people contact us to see if they can sue someone, but are completely unaware that they have TPD insurance. A TPD insurance policy can be worth hundreds of thousands of dollars. This amount of money can be life-changing for people who have suffered a permanent disability.
- TPD insurance covers both mental and physical illness or injury. The injury or illness does not need to be work-related. Though there are various definitions under differing insurance policies, generally, it is determined by whether you can return to an occupation of work for which you are reasonably qualified. It is generally the case that it does not matter if the injury arose out of a physical or a mental injury, or illness, or a combination of these. By way of example, if someone was working as a mechanic, and they began to suffer from a mental illness, which was not work-related, they may still be eligible for a TPD benefit, if they can establish that they are unlikely to return to any occupation for which they are reasonably qualified.
- TPD has got nothing to do with proving fault or negligence. With a TPD claim, you do not need to prove that your injury or illness was anybody’s fault. You simply need to prove that your injury or illness has caused an incapacity for work, to the extent that you are totally and permanently disabled, within the meaning of the policy.
- Your occupation and qualifications matter. The question that needs to be determined in a TPD claim is whether you are fit to perform your work, or any work for which you are reasonably qualified. It is advisable to have a TPD lawyer review the TPD insurance policies and trust deeds to determine your eligibility, as the precise preconditions which need to be met vary. For instance, TPD definitions could include own-, or any-occupation clauses. An any-occupation clause means that a claimant needs to prove that they are unfit to perform any occupation for which they are suited by education, training or experience. It is not enough to prove you simply could not perform your own occupation. An own-occupation definition is far easier to satisfy. You would only need to prove that you would likely be unfit to perform your own occupation. What this means is that the last occupation you performed, prior to your illness or injury, is critical, as is your full work history, and other qualifications. For instance, it is generally easier to prove that someone who has been engaged in manual labor all their life will be totally and permanently disabled if they have suffered a significant physical injury than it would be for an office worker.
- You may want to consider a retail policy, and should consider advice if you are looking to consolidate your superannuation. Sometimes, people may also have arranged insurances through a financial planner or insurance broker. Such professionals may have already set up a retail TPD policy on your behalf. This would often be done, for example, if you set up life insurance. It is generally the case that retail policies are usually for much larger lump sums, which can exceed millions of dollars. If you need to make a claim on a retail policy, you should certainly consult a TPD lawyer. If you haven’t got a retail policy in place, you may wish to consult a financial advisor or insurance broker. If something goes wrong in your life, and you’re unable to return to work, having an adequate TPD policy with a reasonable lump sum can provide great financial security for you and your family.