If you’re considering making a Total and Permanent Disability (TPD) claim, you might be pondering the following: “Why do I need a lawyer? Can’t I do the claim myself?”
The answer of course is that you don’t need a lawyer, but there is a reason lawyers exist and a reason superannuation funds and insurance companies have their own lawyers to act against you when you lodge a TPD claim.
The reality is that many people face challenges because they don’t get the right advice early on, or they simply don’t have the knowledge and experience. Many of our clients come to us after lodging a claim feeling confused, overwhelmed, and unsure of their next steps in the claim’s process.
In this article, we’ll explore why TPD claims often feel difficult, the common pitfalls to avoid, and how you can improve your chances of a successful outcome.
Why Do TPD Claims Feel So Difficult?
Many people find TPD claims challenging, especially when they try to handle the process on their own. A claim rejection or an insurer making unreasonable or unnecessary requets can make the process unnecessarily complicated, leaving claimants feeling defeated.
One common issue is that people tend to accept the insurer’s first response, which might state that they’re not eligible to claim, don’t have cover, or don’t meet the policy’s definition of disability. However, this advice can often be incorrect.
Another challenge is understanding what evidence is required. Many people are unsure which medical records are relevant, what reports they need, or how their employment history impacts their eligibility.
Additionally, the legal and insurance jargon used by insurers can be intimidating. This technical language often leaves claimants confused and unsure about how to respond to the insurer, out of fear of making a mistake. While the process can feel overwhelming, the right guidance can make it much more manageable.
Why TPD Claims Get Rejected or Delayed
There can be several reasons a claim will be rejected. Often, we will see similar types of issues that arise repeatedly with claims delayed or rejected due to minor errors, missing documents, or incorrect forms.
But we also see poor or blatantly incorrect advice given to clients about their eligibility to claim, including people being wrongly told they don’t have insurance or weren’t working enough hours to qualify.
Another major problem is that many claimants don’t fully understand their rights. Insurers are not always forthcoming about what they are required to consider, leaving claimants at a disadvantage.
What Makes a TPD Claim Likely to Succeed?
With almost 30 years of experience, we can often tell early on whether a TPD claim has reasonable prospects of success.
Most claims, like life itself, aren’t straightforward. When medical evidence is unclear or employment histories are messy, while often an excuse for an insurer to reject the claim, the claim can still succeed with the right approach. We’ve proven time and time again that even complex claims can succeed when handled strategically.
A Real-Life Example
One client came to us after their insurer denied their claim, stating they didn’t qualify for cover. Upon reviewing the policy, we noticed ambiguous wording that the insurer was interpreting in their favour. We built a strong legal argument, demonstrated that the client met the policy’s definition, and challenged the insurer’s position. The result? The client received their full payout.
This kind of situation happens more often than people realise, and it highlights the importance of having experienced legal support.
How We Simplify the Process
Many people don’t know where to start when gathering evidence for a TPD claim. That’s where we step in. We explain exactly what documents are needed, help clients request records from doctors, employers, and super funds, and liaise with specialists to ensure reports meet the policy’s requirements.
We also review everything before it’s submitted to the insurer, ensuring the application tells the full story in a way that demands the claim be taken seriously. This approach leads to faster decisions and better outcomes for our clients.
Common Misconceptions About Medical Evidence
Many people think they need a specific doctor, a particular type of report, or a precise diagnosis to succeed in a TPD claim. However, it’s not as much about the label of the condition as it is how the condition impacts your ability to work. A TPD superannuation lawyer helps clients understand what’s relevant and translate policy definitions into plain English, so they know exactly what’s required.
Why Having a Lawyer Helps
TPD claims can be long, technical, and emotionally draining. Many clients come to us after trying to deal with insurers on their own, only to feel pushed around and overwhelmed.
Having a TPD superannuation lawyer just makes sense. We know how to push back professionally and effectively, ensuring insurers meet their obligations and don’t act unreasonably. We protect our clients’ rights from day one, staying calm and strategic even when the process becomes challenging.
Our Fees
We understand that financial stress is a significant concern for our clients, which is why we offer a “no win, no fee” arrangement and fixed fees upon successful completion. There are no surprises, no upfront costs, and no added stress.
So, Is It Hard to Get a TPD Payout?
For those trying to navigate the process alone, it can be confusing, slow, and intimidating. But with the right support, the process becomes much easier and far more likely to succeed.
Our approach is simple: we provide friendly, plain English advice, maintain constant communication, and offer personalised guidance and our results (and reviews) speak for themselves. Put simply, we win.
There is, of course, plenty to know that is not covered here, and as the usual legal disclaimer goes, the information here is of a general nature because legal advice always depends on your circumstances.
Contact
You can call us at (03) 9969 7077 or via email at info@leonardwelch.au.
Leonard & Welch – the original (and the best) super lawyers!
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