What to Expect After Submitting Your TPD Claim

If you have recently submitted a Total and Permanent Disability (TPD) claim, you may be feeling a mixture of hope, anxiety, and confusion about what happens next.

The post-submission phase of a TPD claim can be just as challenging as preparing and lodging the claim itself.

Understanding the typical process, expected timeframes, and how to handle delays can help ease some of the stress and ensure you remain proactive throughout the journey. 

This guide is designed to walk you through the post-submission stage of your TPD claim, with insights tailored to Queensland law and practices. 

Understanding the TPD Claim Process Post-Submission 

Once your TPD claim is submitted to your superannuation fund or insurer, it enters the assessment phase. During this time, the insurer or trustee evaluates the medical and employment evidence you provided to determine whether you meet the definition of being totally and permanently disabled under your policy.

Each policy may have different definitions of TPD, but generally, it requires that you are permanently unable to work in your usual occupation or any other work for which you are reasonably qualified by education, training or experience.

Your superannuation trustee or the insurance company will: 

• Review your application and supporting documents 

• Contact your medical providers for clarification if needed 

• Seek further information from your employer 

• Possibly arrange for you to undergo an independent medical examination 

• Engage occupational or vocational experts to assess your capacity to return to work 

This process is comprehensive, which is why patience and follow-up are key. 

How to Check Your TPD Claim Status

After submitting your TPD claim, it’s natural to want to know how things are progressing. Staying informed about your TPD claim status is important and can prevent unnecessary delays. 

Here are a few ways you can check your claim status: 

1. Contact the Super Fund or Insurer Directly: Reach out to the claims team via phone or email and request an update. Keep a record of your communications. 

2. Request a Claims Progress Report: Some insurers or funds can provide a written report outlining the current status of your claim, any outstanding documentation, and estimated timeframes. 

3. Use Online Portals: If your superannuation fund offers an online portal, it may allow you to track the progress of your claim. 

4. Speak to Your Legal Representative: If you have engaged a TPD lawyer, they can communicate with the fund or insurer on your behalf and push for timely updates. 

Remember, consistent and polite follow-up helps reinforce that you are actively monitoring your claim and won’t accept unnecessary delays. 

Expected Timelines After Submitting a TPD Claim

There is no legally binding timeframe for how quickly a TPD claim must be assessed in Queensland.

However, the Australian Securities and Investments Commission (ASIC) recommends that super funds and insurers aim to decide TPD claims within six months of receiving all necessary documentation. 

Here is a general timeline of what to expect:

• Weeks 1-4: Confirmation of receipt and initial document review. You may be asked to provide additional information. 

• Weeks 5-12: Assessment of medical records, employer reports, and any vocational assessments. The insurer may request further documents or schedule independent evaluations. 

• Weeks 13-24: Completion of assessments and final decision made. You should be notified of the outcome. 

If everything goes smoothly, a well-prepared TPD claim could be resolved within three to six months. However, if complications arise, such as disputes over medical evidence or policy definitions, the process can extend to 12 months or more. 

What to Do if Your Insurer Is Not Responding

It can be incredibly frustrating when your insurer is not responding or providing vague updates. Silence or stalling tactics can leave claimants feeling helpless, especially when they are already dealing with the emotional and financial strain of being permanently unable to work. 

Here are practical steps to take:

1. Send a Formal Follow-Up: Draft a formal letter or email requesting an update. Reference dates and any prior communications. 

2. Escalate the Matter: Ask to speak with a senior case manager or the internal complaints team. Make it clear that you expect timely communication and transparency. 

3. Lodge a Complaint with AFCA: The Australian Financial Complaints Authority (AFCA) allows individuals to lodge a complaint against insurers or super funds if a claim is being delayed unreasonably. 

4. Seek Legal Assistance: Engaging experienced TPD lawyers in Townsville can make a significant difference. Lawyers can formally request updates, push for faster resolutions, and take legal action if necessary. 

Common Reasons for Delays in TPD Claims 

Understanding why TPD claims get delayed can help you avoid or address common pitfalls. Reasons include: 

• Incomplete or inconsistent medical documentation 

• Disagreement between your treating doctors and independent medical examiners 

• Vague employment history or gaps in vocational evidence 

• Complexity of the policy wording or outdated policy definitions 

• Administrative backlogs or internal staff shortages at the insurer 

Staying proactive, organised, and ensuring that all your supporting documents are detailed and consistent can help minimise these delays. 

What Happens After a Decision is Made? 

Once a decision has been made on your TPD claim, you will receive formal written notice. 

If your claim is approved: 

• You will be advised of the benefit amount 

• The payment will usually be made into your superannuation account 

• You may be able to access the funds as a lump sum or in instalments, depending on your circumstances 

If your claim is declined: 

• The insurer must provide reasons for the decision 

• You have the right to request internal review 

• If that fails, you can lodge a complaint with AFCA or pursue legal action 

Legal support is crucial at this stage to review the reasons for rejection and determine the best course of action. 

Tips to Stay Proactive During the Waiting Period 

While you wait for a decision on your TPD claim, here are some proactive measures you can take: 

• Keep a Claims Diary: Record all correspondence and updates, including phone calls and emails. 

• Organise Your Documents: Make sure all reports, assessments, and letters are filed and easy to access. 

• Follow Up Regularly: Contact the insurer or your legal representative every 2-4 weeks for updates. 

• Prioritise Your Health: Continue receiving medical treatment and keep your health records updated. 

• Review Other Entitlements: You may also be eligible for Centrelink payments or workers’ compensation. 

Final Thoughts: You Don’t Have to Navigate This Alone 

Navigating a TPD claim in Queensland can be overwhelming, particularly after submitting your application and entering the often slow and opaque assessment phase. Knowing what to expect, understanding your rights, and seeking support when needed can empower you to take control of the process. 

Whether you’re waiting on a claim decision or facing an unresponsive insurer, remember that help is available. Delays are not something you simply have to accept – and with the right legal advice, you can advocate for the fair treatment and support you deserve. 

Need Help With Your TPD Claim? 

If your TPD claim is delayed or denied, or you’re unsure what to do next, contact Sarinas Legal.

Our experienced team of Queensland-based TPD lawyers can help you stay informed, fight unfair delays, and secure the compensation you’re entitled to. 

Call Sarinas Legal today for expert support with your TPD claim.