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 need to make a claim on your Total & Permanent Disablement insurance.
Starting your claim
To start an insurance claim, you’ll need to speak to us. We have a dedicated team who will help you through the claims process, it’s good to be prepared to answer some difficult and sometimes personal questions. Once we’ve confirmed your eligibility to start the claims process, we’ll get some paperwork to you and ask for supporting documentation and other important information to help the process run smoothly.
There is no set time frame for how long an insurance claim takes.
If you believe you could be eligible to apply for a TPD payment, call us on 1800 060 312. You’ll need to provide the date you last worked and the date of injury or diagnosis of your condition.
Submit your application
Complete the forms we send you and return them along with all of the necessary supporting documents. These include, but aren’t limited to, forms to be completed by your treating doctor and specialists describing the nature and extent of your disability or illness, certified identification, information from your employer and medical reports and medical evidence that may support your application. Your eligibility to submit a claim will be assessed.
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 reports from your doctor(s), information from your employer and you may be asked to attend independent 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.
You have the right to request that the legalsuper Trustee or the insurer to reconsider any decision to decline their claim, and this request can be accompanied with new evidence or further submissions as to why 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.