It is crucial that all TPD Insurance policyholders and anyone looking to take out TPD cover to have a clear understanding on the conditions around claiming TPD in Australia. The process of submitting a claim to actually receiving a benefit can take months and be complicated. An understanding of this process can ensure the policyholder takes the right steps and a successful claim can be achieved.
This article will outline the claims process for TPD insurance that is held within a superannuation fund and for cover that is held outside a superannuation fund. In doing so it will offer key advice to policyholders on how to best prepare for the event of a claim to ensure the process runs smoothly and that there is no delay in payment.
Requirements for a Successful TPD Claim
Most providers will also require the claimant to be unable to perform the duties of their occupation for at least three months before turning the age of 65.
Conditions of the TPD cover are also often subject to the occupation category of the policyholder.
When Can you file a TPD Insurance Claim?
A TPD claim benefit is usually received when the policyholder has satisfied the definitions of TPD as defined by the insurance company or Super Fund in which their cover is held. It is extremely important for policyholders to be clear on what definition their policy falls under to avoid any surprises in the event of disablement. Generally, TPD is considered under either “Own Occupation” or “Any Occupation”
- Own Occupation: The policyholder has become disabled and is unlikely to ever return to full time work in the position of which they are employed for.
- Any Occupation: The policyholder has become disabled and is unlikely to be able to engage in any form of regular paid work for which they may be suited to by education, experience or training.
TPD Claims Key Facts
- It is possible to claim TPD for mental health conditions.
- TPD claims within super must be approved by the fund trustee.