TPD & Superannuation Claims

Superannuation, disability insurance and death benefit claims can be difficult and stressful to deal with. The process involved is often unfamiliar, complex and frustrating. Lime Lawyers can help you cut through the red tape of the claim process. Access to these insurances may mean you are entitled to receive benefits for total and permanent disablement (TPD), income protection, total and temporary disablement (TTD) or a lump sum payment for a defined medical condition or ailment (Trauma). You may also be entitled to seek an early release of your superannuation balance if you are experiencing dire financial hardship.

Disability and Superannuation Claims

People are often completely unaware that they may have insurance coverage that they are entitled to access if they are unable to work due to injury or illness.

This insurance coverage is usually automatically included as standard in most superannuation fund policies or is a policy that you have taken out yourself or your employer has set up for you. Surprisingly though it can also be attached to mortgage or other loan insurance.

In the event that a person dies, that person’s spouse and children may also be entitled to access a lump sum amount if there is a life insurance policy in force, or may be able to access this through a person’s superannuation fund or other insurance policies.

If you or your loved ones are entitled to access superannuation, disability insurance or death benefits, it does not matter who was at fault.

The experienced Lime Lawyers team is available to help you, listen to what has happened to you or your loved one, and to see whether you are entitled to access superannuation, disability insurance or death benefits. If we can, we will manage your claim for you dealing directly with your superannuation fund or insurance provider. We do this with the aim of assisting you to get your entitlements paid as soon as possible.

Where do I find details of whether I am entitled to bring a claim?

Check your most recent super fund statement which should include not only details of your super balance but whether you have coverage for TPD insurance, income protection or death benefits and the amount of each insurance.

If you have any other private insurance policies, you should check for any recent statements you have received which should list the amount of any insurance you have.

If you need any help or don’t know where to begin, call us on 1800 LIMELAW or complete our online enquiry form and we will guide you to find the information you need.

How do I know if I meet the criteria to bring a claim?

You should be eligible to bring a TPD claim if you are able to demonstrate that you cannot perform your usual job as well as cannot perform any other jobs for which you have experience, skills or qualifications. There can be slightly different criteria depending on which fund you are with so seek assistance if you are not sure.

To be eligible for income protection or a TTD claim you need to demonstrate that you are medically certified as being unable to do your usual job and that you are not working elsewhere earning a wage or income. You will usually be paid up to 75% of your usual wage or salary.

Trauma insurance lump sum benefits are paid when the defined medical condition (eg. Cancer, heart attack, stroke) is confirmed.

Death benefits will usually be paid to a deceased’s spouse, de-facto (including same-sex) partner, children, financial dependents or a representative of the deceased’s estate.

Death benefits can also be claimed by the person with the insurance policy prior to them passing away. This can occur only if two doctors certify that the person has a terminal illness with less than one year to live.

As the eligibility criteria for claiming benefits for the different types of disability insurance differ from fund to fund and from policy to policy you should seek assistance sooner rather than later.

I have multiple super funds or insurance policies. Can I still bring a claim?

Yes. You can lodge multiple TPD claims if you have more than one active super fund.

Lime Lawyers helps you to identify all insurance policies you hold to ensure that all of your potential entitlements are identified and give you advice about what claims you can pursue.

Can you tell me more about the different types of insurance?

  • TPD Insurance –

This is insurance designed to provide a lump sum benefit to a person in the event of a medically diagnosed condition, illness or injury that causes the person to be unable to work.

There are three main types: own occupation TPD, any occupation TPD or non-occupational TPD.

  • Income Protection / TTD Insurance –

This usually provides a person with monthly income payments who become temporarily unable to work due to illness or injury.

There is often a waiting period during which a person has to be medically unable to work (eg. 30, 60 or 90 days) and benefits will only continue for a specific period (eg. 2 years or until age 65).

  • Trauma Insurance –

Also known as critical illness insurance, this is designed to provide lump sum payments for defined medical events or conditions. Some policies also offer partial payments if a medical condition does not fully meet all requirements for a total payment.

  • Life Insurance / Death Benefits –

A lump sum benefit payable to the spouse, children, financial dependents or legal representative of the deceased person which can incorporate the superannuation balance and a policy specific lump sum amount.

It can be offered by super funds or taken out as a private insurance policy.

  • Financial Hardship –

There are circumstances where you may be able to access your superannuation early. If you find yourself in severe financial need and are unable to pay your mortgage, medical expenses or other expenses you may be able to seek a release of part of your superannuation to meet those expenses.

I have lodged a claim and it has been rejected. What can I do now?

You can appeal the decision by a super fund or insurer to reject your claim. This usually involves the super fund or insurer undertaking a formal review of the merits of your claim. If necessary, you can also appeal the decision to reject your claim in court.

If you feel you have been unfairly treated or are unhappy with the conduct of the super fund or insurer you can also lodge a complaint with the Superannuation Complaints Tribunal or Financial Ombudsman.

It is important to speak to a lawyer if you find yourself in one of the above situations.

How long does a claim take and what time limits are there?

As a general proposition most claims are finalised between 6 to 12 months after lodgment with the super fund or insurer, although income protection and death benefit claims are usually finalized much sooner.

Because each claim is different we will provide you with a realistic timeframe specific to your circumstances so you are aware of how long your claim may take to be finalized.

Time limits for lodgment of a claim can vary from each insurer and super fund so it is important to seek legal assistance to ensure you are aware of the time limits relevant to your claim.

If your claim is rejected by a super fund or insurer you have a six (6) year time limit to commence court proceedings. You should seek legal advice to ensure the correct time limit is known and can be protected so you don’t risk losing your legal rights.

How much will it cost to involve Lime Lawyers?

Lime Lawyers help people on a ‘No Win, No Fee’ basis. This means that if your claim isn’t accepted then you don’t have to pay our legal fees and disbursements.

Do I pay tax on any benefits or lump sum I receive?

Benefits paid under TPD, income protection and life insurance policies or from a super fund are treated differently for taxation purposes and can depend on the specific circumstances of the individual involved.

It is crucial to obtain financial and taxation advice specific to your circumstances so you are fully aware of whether or not you will have to pay tax and also get an idea of how much tax you may have to pay.

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