Total and Permanent Disability (TPD) claims can be a lifeline for those who find themselves unable to work due to illness or injury. However, the process of claiming TPD benefits is often fraught with complexities and challenges. While it’s possible to lodge a claim without legal representation, having an experienced TPD lawyer by your side can significantly increase your chances of a successful outcome.
Let’s take a look into the key situations where legal assistance is crucial and explore the numerous benefits of working with a TPD claim lawyer.
Why Are TPD Claims Often Complicated?
TPD claims can be intricate due to several factors. Different insurance policies and superannuation funds may have distinct definitions of disability, making it challenging to determine if you meet the criteria for a claim. Each policy typically has specific criteria that must be met to qualify for a payout, and these criteria can be complex and open to interpretation. Insurance companies often examine claims with a fine-tooth comb, looking for reasons to deny or reduce payouts. This level of scrutiny can be intimidating for claimants.
Gathering and presenting appropriate medical evidence can be challenging, especially if you’re dealing with multiple health issues. Insurance policies are often filled with legal and medical terminology that can be difficult for the average person to understand fully. A lawyer who specialises in TPD claims can help interpret policy language, gather appropriate evidence, and present your case in the most compelling manner, navigating these complexities on your behalf.
When Should You Consider Hiring a TPD Lawyer?
There are several scenarios where having a TPD lawyer becomes essential:
- Your claim has been denied or rejected
- You’re unsure if you have a viable case
- Your disability is based on a psychological injury (which often has a higher rejection rate)
- Your case involves complex medical or occupational issues
- You’re uncomfortable negotiating with large insurance companies
In these situations, a lawyer’s expertise can be invaluable in navigating the claims process and advocating for your rights.
How Can a Lawyer Improve Your Chances of a Successful Claim?
TPD lawyers bring several advantages to your claim. They have expertise in claim preparation, ensuring all required information is provided and the application is submitted correctly, reducing the risk of delays or rejections due to technicalities. Lawyers manage complex interactions and paperwork on your behalf, presenting your case in the most favourable light. They can interpret and explain complex policy language, ensuring you fully understand your rights and obligations.
If your claim is initially rejected, a lawyer can guide you through the appeals process, which may involve internal reviews, complaints to external dispute resolution bodies, or court action. Lawyers stay up-to-date with recent court decisions that may affect how TPD claims are assessed and can use this knowledge to strengthen your case. They can develop a comprehensive strategy for your claim, anticipating potential issues and addressing them proactively. Experienced lawyers can negotiate effectively with insurers to achieve the best possible outcome for you.
What Do The Numbers Say About TPD Claims?
The Australian Securities and Investments Commission (ASIC) has provided valuable insights into Total and Permanent Disability (TPD) insurance claims through its comprehensive reviews.
Key findings include:
- TPD cover is held by approximately nine million Australians, with 86% holding it through their superannuation fund.
- The Activities of Daily Living (ADL) test, used in 4% of all TPD claims, has a significantly higher declined rate of 60% compared to the 12% average for other TPD claims.
- At the group policy level, the 10 highest ADL declined rates ranged from 45% to 87%.
ASIC’s 2021 review of individual disability income insurance (IDII) claims revealed:
- Non-disclosure investigations were conducted in about 5% of claims.
- Physical surveillance was used in around 1% of claims.
- 40% of non-disclosure investigations related to mental health non-disclosure.
- In cases where physical surveillance was used more broadly in TPD claims, the insurer ultimately admitted the claim in over 60% of instances.
These statistics highlight the complexities and challenges in the TPD claims process, particularly for claims assessed under the ADL test, and underscore the importance of transparency and fair practices in the insurance industry.
What Services Do TPD Lawyers Typically Provide?
Our TPD lawyers offer comprehensive support throughout the claims process. They start with an initial assessment, evaluating your eligibility for a TPD claim based on your medical condition and policy terms. They assist in collecting and organising medical evidence, including obtaining specialist reports if necessary.
Our Lawyers then prepare and submit all required claim documents, ensuring they are complete and compelling.
Throughout the process, we handle all communications with insurers and superannuation funds, protecting your interests. We negotiate settlement offers, striving to secure the maximum possible payout for you. If your claim is denied, we can manage the appeals process, including preparing for and representing you at any hearings. In cases that go to court, we provide full legal representation to argue your case.
How Do You Choose the Right TPD Lawyer?
When selecting a TPD lawyer, consider the following factors:
- Experience and expertise in TPD claims
- Track record of successful outcomes
- Communication skills and responsiveness
- Fee structure (many work on a no-win, no-fee basis)
- Client testimonials and reviews
Reach Out To Us Today
Don’t risk your financial future by handling a TPD claim alone. Our experienced TPD lawyers are ready to fight for the compensation you deserve. Take the first step towards securing your future today. If you are totally unfit to work and are in need of accessing TPD benefits in your superannuation, get in touch with our friendly insurance claim lawyers at McDonnell Schroder.
Contact us today or drop into one of our offices in Blacktown and Schofields to receive an obligation-free first consultation on your TPD claim or any other legal service that you require.
