Total & Permanent Disablement
Making an insurance claim can be a difficult task, we’re here to help guide you through what to expect if you have suffered an illness or injury that has left you unable to work and you need to make a claim on your Total & Permanent Disablement (TPD) insurance.
Making a TPD claim
Contact legalsuper
If you believe you could be eligible to apply for a TPD payment, call us on 1800 060 312 or email claims@legalsuper.com.au You’ll need to provide the date you last worked and the date of injury or diagnosis of your condition.
Starting your claim
Once we’ve confirmed your eligibility to start the claims process you will be offered a choice of how you would like to provide your initial information. If you prefer to provide this information online we will send you a link so you can apply online. However, if you prefer to complete your initial information via paper forms we’ll get some paperwork to you and ask for supporting documentation and other important information to help the process run smoothly.
We will need the following information:
- Your full name and date of birth
- Your member number would be helpful but it's not required
- Details about your injury or illness
- The date on which your injury first occurred or your illness first presented itself
- Details and the date of your diagnosis
- Details about your work status
- The date you last worked
- The number of hours you worked per week leading up to your injury or illness
and sometimes personal questions.
There is no set time frame for how long an insurance claim takes.
Submit your application
Depending on the process you have chosen to follow (online or paper based) the process will follow slightly different paths.
Online
Once you have completed the initial application online our insurer will contact you to request further information so that they can progress assessment of your claim.
The information requested may include reports to be completed by your general practitioner, treating specialist/s, certified identification, medical authorities, information from your employer amongst other things.
The information requested may depend on your particular circumstances.
They will provide you with the contact details of a dedicated Claims Consultant who will be able to assist you throughout your claim.
Paper
Complete the forms we send you and return them along with all of the necessary supporting documents. When we receive your initial forms we will send them to the insurer for initial assessment.
The insurer will contact you to request further information so that they can progress your claim. The information requested may include reports to be completed by your general practitioner, treating specialist/s, certified identification, medical authorities, information from your employer amongst other things.
The information requested may depend on your particular circumstances.
They will provide you with the contact details of a dedicated Claims Consultant who will be able to assist you throughout your claim.
The information you provide will be assessed to determine whether you’re eligible to apply for either:
- a TPD payment – made up of both your insured amount plus your account balance; or
- a Permanent Incapacity payment made up of your account balance only.
The Insurer will assess your application
The Insurer will use the information you provided when making an assessment. The insurer may also request relevant information from other sources, such as independent experts and insurers you’ve had other claims with. You will be informed of any such steps taken to assess your claim. You may also be asked to provide further information such as:
- Tax return and assessment notices
- Specialist medical reports
- Independent medical reports
- Clinical records
- Worker’s compensation records
- Pharmaceutical Benefits Scheme (PBS)/Medicare records
- Reports from your doctor(s),
- Information from your employer,
- And you may be asked to attend medical examinations.
The Insurer’s decision
Once your application has been assessed you’ll be advised whether it has been successful.
If your application is declined
If your application is declined, this generally means that the Insurer has not formed the opinion, based on all the evidence provided, that you meet the conditions for a TPD payment. The insurer will explain its reasons for the decision and your application will be referred to the legalsuper Trustee. The Trustee has a responsibility to review the Insurer’s decisions, to ensure they are reasonable and meet the conditions set out in the legalsuper Trust Deed and insurance policy.
You have the right to request the legalsuper Trustee or the insurer to reconsider any decision to decline your claim, and this request can be accompanied with new evidence or further submissions as to why you consider you meet the conditions for payment of a TPD benefit.
If your application is accepted
You will be required to give us instruction as to how to make payment to you.
