Many of us have Disability Insurance Cover under our Superannuation Schemes and sometimes we have it as part of holding a credit card. Likewise, many of us have private disability insurance.
Disability Insurance can include:
- Total and Permanent Disability (TPD).
- Income Protection/Salary Continuance.
- Trauma Insurance.
- Death Insurance/Life Insurance.
Due to injury or illness, you may be entitled to make a claim under your Disability Insurance Cover.
If you are lodging a disability claim because you were injured at work, in a car accident, in a public place or due to medical treatment, you may also have rights to bring a claim for compensation under the laws that apply to those situations. Please refer to those sections on this webpage for more information or phone us on 02 9252 8824 for further information.
Do I have a Total and Permanent Disability Claim?
Whether you are entitled to a Total and Permanent Disability (TPD) Claim depends on your insurance policy and whether your injury or illness meets the definition within the policy to entitle you to a payment.
Generally, to qualify for a TPD claim you must have been so seriously injured or ill that you are unlikely ever to work again in your usual job/occupation, or any other occupation for which you could reasonably be considered qualified based on your education, training and experience.
Most policies have a waiting period of 6 months. That is, you will need to provide evidence that you have been unable to work for 6 consecutive months, due to your injury or illness.
If you think you have such an entitlement, we are happy to review your Total and Permanent Disability Policy and advise you of your potential entitlements under this policy.
How do I bring a TPD claim?
Generally, a claim form is lodged with your superannuation fund to bring a TPD claim.
The insurance company will provide you with the claim form. Part of the form must be completed by your doctor. The insurer will also require your employer to provide information regarding your work situation.
Check your policy in relation to the time allowed to lodge the claim as different policies can have different time requirements.
If the insurer accepts your claim, the insured amount will generally be paid out to you within a few months once all paperwork is lodged with the insurer.
If the superannuation fund does not accept your claim you can lodge your claim with the Court for a determination by the Court as to your entitlements under your policy.
Court proceedings have to be lodged with the Court within 6 years of your claim being rejected by the superannuation fund.
What compensation can I claim?
The payment you receive will be a fixed amount determined under the policy.
What legal costs do I have to pay?
The superannuation fund does not have to pay any of your legal costs if your case is finalised without the need to lodge the claim with the Court.
Our legal costs at this stage only become payable once you receive a payout under your TPD policy. If your claim is rejected and you do not proceed to Court, we will not charge you for the work done on your case.
If you do proceed to Court and you are successful, the Court will order the superannuation fund to pay about 60 to 70% of your legal costs.
Income Protection Insurance or Salary Continuance Insurance
If you have Income Protection Insurance (also known as Salary Continuance Insurance) and, if due to illness or injury you are unable to work, you should make a claim under your Income Protection Policy.
The amount you are entitled to claim will be determined by the insurance policy. The policy will set out the terms and conditions in relation to the percentage of your salary the insurer will pay and for how long the payment will be made for.
If the insurer does not accept your claim, please contact us for advice on 02 9252 8824.
The insurer may, for example, reject the claim on the basis that you did not advise them of a particular medical condition.
Trauma Insurance
Trauma Insurance pays a once off lump sum on the diagnosis of a specific medical condition that is covered under your policy. If the medical condition you are diagnosed with is not covered in the policy, you will not be entitled to a payment under the policy.
The payment of the lump sum is made on the diagnosis of the medical condition.
If the insurer does not accept the claim, please contact us for advice on 02 9252 8824.
Death Cover/Life Cover
Death Cover, also known as Life Cover, pays a set amount of money to the person nominated as the beneficiary in the insurance policy, upon the death of the policyholder.
If the insurer does not accept the claim, please contact us for advice on 02 9252 8824.
