TPD & Superannuation Claims

At our firm, TPD insurance provides a lump sum payment if you become totally and permanently disabled and are unable to work in your usual occupation or any occupation for which you are reasonably suited by education, training, or experience. Most Australian superannuation funds include automatic TPD cover, though the specific definition varies between funds. Some policies use an own occupation definition (easier to satisfy), while others use an any occupation definition (harder). TPD claims are assessed by the superannuation fund trustee in consultation with the insurer. The lump sum can range from $50,000 to $1,000,000 or more depending on your cover level.

At our firm, to make a TPD claim, you must lodge a claim with your superannuation fund trustee, providing comprehensive medical evidence demonstrating that your condition meets the policy definition of total and permanent disability. This includes reports from treating doctors, specialists, and allied health professionals, along with evidence of your inability to work in your usual occupation or any suitable occupation. The fund will also require proof of your employment history, qualifications, and skills. Claims can take 3 to 12 months to process, depending on the complexity and the quality of evidence provided.

At our firm, a successful TPD claim requires compelling medical evidence including detailed reports from your treating general practitioner and relevant specialists, diagnostic test results (MRI, CT scans, X-rays), and assessments from allied health professionals (physiotherapists, occupational therapists, psychologists). You also need employment evidence demonstrating your pre-injury duties and qualifications, and evidence of the functional impact of your condition on your ability to work. Independent medical examinations may be required by the insurer. The key is to demonstrate that your condition prevents you from performing the core duties of your occupation.

If your TPD claim is declined, our team helps you through the review process. You first request an internal review by the insurer, which must be conducted within 45 days. If the internal review upholds the decline, you can lodge a complaint with the Australian Financial Complaints Authority (AFCA), which provides free external dispute resolution. AFCA can award compensation up to $1,065,000 (2025 limit) for superannuation complaints and can make binding determinations. If the claim value exceeds AFCA's limits or involves complex legal issues, you may consider court proceedings. We handle all stages of the appeals process.

Yes, we can help you claim both TPD benefits through your superannuation fund and workers compensation through WorkCover Queensland simultaneously, but the payments interact. TPD benefits are generally paid as a lump sum and are not reduced by workers compensation payments, though some TPD policies exclude or reduce benefits if workers compensation is being received. Income protection benefits through superannuation may be reduced by any weekly workers compensation payments you receive. It is important to review the specific policy wording and seek legal advice about how the two claims interact to maximise your total entitlements.