Claiming TPD Through Your Super Fund: What You Need to Know

If you have suffered an illness or injury that prevents you from returning to work, you may be eligible to make a Total and Permanent Disability (TPD) claim through your superannuation fund.

This process can be complex and overwhelming, particularly when you are also dealing with serious health challenges.

Understanding how the process works, the TPD claim timeline, and what to expect after submission can make a significant difference in securing the financial support you deserve.

This article provides a comprehensive overview of how to lodge a TPD claim through your superannuation fund, with specific reference to Queensland law. 

What is TPD Insurance? 

TPD insurance is a type of cover typically held within your superannuation account. It provides a lump sum payment if you become totally and permanently disabled and are unable to work again in your usual occupation or any other suitable employment. 

Most super funds offer TPD insurance as part of their default cover, although the level of cover and specific terms vary between funds. It’s essential to review your policy documents or speak with your fund to understand the exact eligibility criteria. 

TPD Through Super: How It Works

When you hold TPD insurance through your super, your fund acts as the policyholder. This means you must submit your claim to the super fund, which will then liaise with the insurer. If your claim is approved, the insurer pays the benefit to the super fund, which then releases it to you, usually as a lump sum. 

Key Points: 

• The claim is made to your super fund, not directly to the insurer. 

• Approval depends on meeting both the insurance policy definition and the fund’s release conditions under superannuation law. 

• You may also be able to access other components of your super account, including any existing account balance. 

The Super Fund Claim Process 

The super fund claim process typically involves several stages: 

Initial Enquiry and Forms: 

Contact your super fund to notify them of your intention to lodge a TPD claim. They will provide you with claim forms and information about the required documentation. 

Gathering Evidence: 

This includes medical reports, employment history, education and training documents, and potentially Centrelink records. The goal is to demonstrate that your condition meets the TPD definition under the policy. 

Submission: 

Once all required documentation is completed, you lodge your claim with the super fund. 

Assessment by the Insurer: 

The insurer will review your claim and may request additional information. They may also ask for independent medical examinations. 

Decision: 

If the claim is approved, the insurer pays the benefit to the super fund. The fund then determines if it can legally release the funds to you. 

Release of Funds: 

If both the insurer and super fund agree that you meet the conditions, you receive the benefit. 

The process can take several months and requires patience and persistence. 

Understanding the TPD Claim Timeline 

The TPD claim timeline can vary significantly depending on several factors, including the complexity of your case, the responsiveness of medical practitioners, and the efficiency of your super fund and insurer.

On average, a straightforward claim may take between 3 to 6 months. More complicated claims may extend to 12 months or more. 

Typical Timeline:

 

• Week 1–4: Request forms, gather documentation, and submit claim. 

• Month 2–4: Insurer assesses the claim, may request further documents or arrange medical assessments. 

• Month 5–6: Decision made by insurer and super fund. 

• Month 6+: If approved, payment is processed. If denied, internal reviews or appeals may follow. 

Delays are common, especially if documents are incomplete or if your condition is not straightforward. Legal assistance can help streamline this process and reduce unnecessary delays. 

After You Submit Your TPD Claim 

Once your TPD claim is submitted, it enters the assessment phase. Here’s what you can expect: 

Regular Communication: 

You should receive updates from your super fund or insurer, although the frequency and detail can vary. 

Independent Medical Exams: 

The insurer may request that you attend one or more examinations by doctors they appoint. 

Request for Further Information: 

Be prepared to provide additional medical reports or clarification about your work history. 

Claim Outcome: 

If successful, you will receive a lump sum payment which can be used for living expenses, medical treatment, or to pay off debts. 

Review or Appeal if Rejected: 

If your claim is denied, you have the right to seek a review. This can be through internal dispute resolution processes or by lodging a complaint with the Australian Financial Complaints Authority (AFCA). 

Common Pitfalls to Avoid

Incomplete Documentation: 

Missing or inaccurate information can cause significant delays or result in a denied claim. 

Not Meeting Policy Definitions: 

Each policy has its own definition of TPD. You must provide evidence that matches this definition precisely. 

Delays in Medical Reports: 

Treating doctors may take time to complete reports, especially if they are unfamiliar with the specific requirements of a TPD claim. 

Failure to Get Legal Advice: 

A lawyer experienced in TPD claims can assist in compiling the correct documents, meeting deadlines, and dealing with the insurer. 

Why You Should Consider Legal Assistance 

Lodging a TPD claim is not just a paperwork exercise. It requires a thorough understanding of the insurance definitions, superannuation law, and how to present your medical and vocational evidence effectively. 

A TPD lawyer can: 

• Help you understand your policy terms. 

• Ensure you provide the right documentation. 

• Communicate with the insurer and super fund on your behalf. 

• Prepare appeal submissions if the claim is denied. 

If you are based in Queensland, particularly in regional areas like Townsville, it’s important to engage local expertise.

TPD through super claims are subject to specific legal and procedural requirements, and having a local team that understands the nuances of Queensland law can be a distinct advantage. 

Final Thoughts 

Claiming TPD through your super fund can be a lifeline if you're unable to return to work due to a permanent disability.

However, it’s not always straightforward. Understanding the super fund claim process, preparing for the TPD claim timeline, and knowing what happens after submission can make the journey smoother and less stressful.

Whether you're just starting your claim or have been delayed or denied, professional guidance can make a significant difference. 

Need Help With Your TPD Claim? 

Contact Sarinas Legal today for expert legal advice on TPD claims. Our experienced team is here to help you navigate your super fund claim and secure the benefits you’re entitled to under Queensland law.