A total and permanent disability can have a severe impact on your life, which is why it is important to maximise your chances of success with your claim and receive the compensation you need to support yourself into the future. A few key ways you can do this include:
Confirm that you are eligible to claim TPD compensation
TPD insurance claims are intended for people who have sustained a severe injury or illness resulting in permanent impairment to their body. This means that in order to be eligible for TPD compensation you need to be able to prove that:
- You have a valid TPD insurance policy, often through your superannuation.
- You have a total and permanent disability. A total and permanent disability is generally defined as a loss of a quarter of your ‘whole person function’. This could be illness, paralysis, loss of a limb, part of a limb, sight or hearing.
- You have to show that the injury has severely affected your daily life and stopped you from engaging in activities such as self care, communication, physical activity, sensory function or hand function.
Ensure you have fulfilled the required waiting period
Depending on your insurance policy and the severity of your injury you may be required to wait 3 to 6 months before you can lodge your application. This is important because the waiting period is intended to give your condition the time it needs to stabilise and show that it has become a permanent impairment. If your condition does not stabilise within this time you may be required to wait even longer. If the insurer does not wait for your condition to stabilise before making a decision their decision can be disputed.
Comply with medical advice and care
One of the important factors when assessing eligibility for a TPD insurance claim is whether the claimant has complied with medical care and advice. Therefore, it is important to follow your doctor's orders and be able to prove that you have actively been complying with their directives. If you have not done so it may be more difficult to argue your case and minimise your chances of success.
Obtain written reasons for the insurer's decisions
Whether your claim was rejected, accepted or the compensation less than you thought reasonable, it is always important to receive a written response outlining the insurer's decision. In this response, you will be able to identify the reasoning behind the outcome. This is important because if the response is less than you believe you are entitled to or if the claim has been rejected outright, you will have a clear outline of their thought process and have the chance to determine whether the assessment was a reasonable one. If you believe that it was not reasonable you may be able to dispute the decision.
Seek professional advice
TPD compensation claims are complex and require significant work to gather the required evidence and present it in the correct format to the insurer. First, if you are suffering from a serious illness or injury this may be a difficult task to do on your own and second, there may be specific factors that you are unaware of that may significantly change the outcome of the claim. Thus, professional advice from a certified TPD lawyer, can both make the task easier, as well as maximise your chances of success.