If you are unable to return to work due to the injury or illness, then you might be wondering whether or not you are eligible to claim a benefit for total and permanent disability (TPD).
In this article, we will cover some key aspects of TPD claims, including examples of the most common claims and things to consider prior to filing them.
What is TPD Claim?
TPD benefit pays a lump sum if you become totally and permanently disabled as a result of injury or illness. Whilst the exact definition of TPD will vary from policy to policy, generally you will need to establish that you are unable to return to work as a result of your condition.
Types of TPD Claims
The type of TPD claim will vary depending on the applicable definition. In this article, we will explore the “Any Occupation”, “Own Occupation” and “Activities of Daily Living” (ADL) definitions applicable in these claims.
A person may claim against an Any Occupation TPD policy if they have sustained an injury or illness that prevents them from returning to work in any occupation that is suitable for them by way of their education, training and experience.
Own occupation TPD insurance covers a person who as a result of injury or illness, is unable to return to work in their usual occupation or field of work. A person with an Own Occupation policy, may be eligible to claim against their TPD insurance even if they can work in a different field.
The definitions of ADL will likewise vary, however, it will generally require that a person is unable to perform a number of activities of daily living, such as feeding, bathing, mobility or dressing. Generally, an ADL definition will be included in a policy as an alternative to an “Any Occupation” definition and it may apply when a claimant does not meet the pre-conditions of that clause; such as being in gainful employment in the period immediately prior to the date of disablement.
Benefits of TPD Claims
The primary benefit of a TPD claim is that it provides an individual with financial support in the form of a lump-sum payment if they are unable to work as a result of injury or illness. This insurance payment can provide important relief to individuals and assist them to cover medical expenses, ongoing care, and other costs. In some cases, TPD claims provide sufficient funds to cover mortgages and pay outstanding debts. This has the effect of reducing financial anxiety and helping individuals focus on their recovery and adaptation moving forward.
Most Common TPD Claims
Let’s also overview the most common reasons for TPD claims to understand the eligibility criteria better.
Terminal or Critical Illness
A terminal or critical illness such as cancer or MS are generally covered by TPD policies. In these circumstances, a TPD claim may be able to provide you with significant financial relief in an uncertain and challenging time.
Physical Injuries
There is no exhaustive list of physical injuries which may result in a person becoming eligible to bring a TPD claim. Some common examples of physical injuries, however, could include loss of limb or loss of senses, back injuries or other physical conditions. The key aspect to consider when considering eligibility is whether the injury has prevented you from returning to work, either in your own occupation, or one that you are trained for by way of your education, training and experience.
Mental Illnesses
Mental health illnesses or conditions can cause an individual to be unable to return to work. These conditions and diagnoses can include for example, depression, anxiety and/or PTSD.
Depression can cause a complete inability to do anything and totally diminish a person's capacity for work. In the case of anxiety, a person can suffer from associated physical symptoms such as an irregular heartbeat and breathing, which prevents them from functioning properly and being able to sustain their employment. Other mental illnesses can also result in an individual becoming eligible for a TPD claim. Contact professionals to discuss your particular circumstances and potential eligibility to claim.
TPD Claims Process
Typically, the TPD claim process takes between six and twelve months. This is because there is generally an initial waiting period of 3 to 6 months, which speaks to an individual’s inability to return to work. Following any applicable waiting period, the claim is prepared and lodged with the Insurer. The Insurer generally has 6-months to complete their initial assessment of the claim, after being provided with all the relevant documentation.
If the claim is accepted, you will receive the sum insured at the date of disability. If your case has been declined, we recommend that you speak to a professional without delay so that you can obtain comprehensive advice about your prospects of successfully appealing the decision.
How to Make Successful TPD Claims?
At Walker Law Group, we have a proven track record in securing successful outcomes for our client’s in TPD claims. When preparing a claim, we will gather, review and consider all relevant evidence to assist with the lodgment and assessment of your TPD claim.
Benefits of Getting Legal Assistance
When it comes to lodging a TPD claim, you may wish to consider engaging legal representation. A legal representative will ensure that the relevant paperwork and supportive evidence is lodged correctly and will pursue your claim through the assessment process so that you can focus on your recovery.
Expertise and Knowledge
Getting legal assistance means getting professionals to handle your case efficiently. At Walker Law Group, we practice exclusively in personal injury law and our team members have the required expertise and experience to successfully deal with TPD claims. Professionals understand legal requirements and have the skills to navigate any complexities of the claims process.
Cost-Effective
At Walker Law Group, we are able to conduct most TPD claims on a No-Win-No-Fee-Basis. Under the terms of this agreement, Walker Law Group would represent a person without charging any upfront fees and the fees charged would only become payable in the event of a successful outcome.
File and Win a TPD Claim with Walker Law Firm
At Walker Law Group, our team offers professional advice, assistance and representation in relation to TPD claims. Practicing exclusively in personal injury law, our team is here to assist you with your TPD compensation claim.
Contact us today so that we can discuss your unique circumstances and eligibility to claim.
