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TPD Claims

If illness or injury has stopped you working — maybe for good — you may be entitled to a lump-sum total and permanent disability (TPD) payout. Most Australians have this cover inside their super and never realise it. Call the free hotline now to find out whether you're covered, how to claim, and what to do if your insurer has already said no.

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If your TPD claim has been declined, the clock matters. After your insurer or super fund gives you its final internal response, you generally have two years to take the dispute to the Australian Financial Complaints Authority (AFCA). Don't let a "no" be the end of it — get advice early, while the evidence is fresh and your options are open.

TPD Claims at a glance

What it is

Insurance that pays a lump sum if illness or injury leaves you permanently unable to work

Where the cover usually is

Built into your superannuation — most funds add it automatically for members aged 25 and over

The test

Whether you meet the policy's definition of "total and permanent disablement" — most often an "any occupation" test (you can't return to any job suited to your training)

You may have more than one

If you've had several jobs, you may hold TPD cover across multiple super accounts — each one can be claimed

If your claim is declined

You can dispute it — first through the fund or insurer, then through AFCA, which is free for consumers

Separate from workers comp

TPD is not workers compensation — in some cases you can pursue both

How urgent

Call any time — get your cover checked early and don't let a declined claim sit

What a TPD payout actually is

Total and permanent disability — TPD — cover pays a single lump sum if an illness or injury leaves you permanently unable to work. It's a type of insurance, not a government benefit, and it exists to give you something to live on when your earning capacity is gone.

The crucial thing most people don't know is where it lives. The great majority of working Australians hold TPD cover inside their superannuation, usually added automatically by the fund. You may never have signed up for it, never noticed the premiums coming out, and have no idea it's there — but it can be worth a very large amount when you most need it.

Because it's insurance, what you can claim isn't decided by how unwell you feel. It's decided by the wording of your particular policy. That's why the first move is always the same: find out exactly what cover you have and what its definitions say. Talk it through with a lawyer now →

Check every super fund — you may have more than you think

Most super funds automatically give members aged 25 and over default TPD cover once their balance reaches a certain level. So if you've been working and paying into super, the odds are good that you have some.

Here's the part that catches people out: if you've changed jobs over the years, you may have several super accounts — and each one can carry its own separate TPD policy. That can mean more than one claim, and a much larger total payout than you'd expect from a single fund.

You can find out what you hold by logging into each super account, reading your annual statement and product disclosure statement, or simply calling the fund. If that feels like a lot to untangle on your own, it's exactly the kind of thing we can point you through on the call — at no cost. Talk it through with a lawyer now →

The test that decides your claim

Whether you get paid comes down to one question: do you meet your policy's definition of "total and permanent disablement"? Every policy spells this out, and the wording varies, so two people with the same condition can get different answers from different funds.

The most common definition in super is the "any occupation" test — you must be unable to ever work again in any job suited to your education, training or experience. That's a high bar, and it's deliberately tougher than the alternative. Some policies (more often those held outside super) use an "own occupation" test, which only asks whether you can return to the specific job you were doing. A smaller number turn on "activities of daily living" — whether you can manage basic self-care without help.

Reading these definitions correctly, and matching your medical evidence to them, is where claims are won or lost. A lawyer who does this regularly can tell you quickly which test applies to you and whether you're likely to meet it. Talk it through with a lawyer now →

Declined? That is often the start, not the end

TPD claims are knocked back all the time — sometimes for thin reasons, sometimes because the medical evidence wasn't put together to answer the precise test in the policy. A first "no" does not mean you have no claim.

You have a clear path to challenge a decision. First, you raise it through the fund's or insurer's internal complaints process (called internal dispute resolution, or IDR), which generally must give you a response within a set time. If you're still not satisfied, you can take the matter to the Australian Financial Complaints Authority (AFCA) — an independent body that reviews these disputes, is free for consumers, and can make a decision the insurer must follow if you accept it.

Importantly, you generally have two years from the date of the fund's or insurer's final internal response to bring the dispute to AFCA. That window is one of the main reasons not to sit on a declined claim. Get advice while you still have all your options. Talk it through with a lawyer now →

TPD vs workers compensation — you might claim both

People often assume that if they've made a workers compensation claim, that's all they're entitled to. Not so. TPD is a completely separate type of cover, paid by your super fund's insurer rather than a workplace scheme, and it turns on whether you can work at all — not on whether you were hurt at work.

That means your injury or illness doesn't have to be work-related to claim TPD, and in some situations you can pursue a TPD payout as well as workers compensation. They run on different rules and can sit alongside each other.

Working out what you may be entitled to across both is worth doing properly. A short, free call can map out which claims are open to you before you commit to any one of them. Talk it through with a lawyer now →

Mistakes that cost people their payout

• Not realising you have cover at all — and never checking your super.
• Looking at only one super account when you actually have cover across several.
• Accepting a declined claim as final, instead of disputing it.
• Letting the time limit to take a dispute to AFCA quietly run out.
• Sending in medical reports that don't speak to the exact "total and permanent disablement" test in your policy.
• Assuming a workers compensation claim rules out a TPD claim — when both may be available. Talk it through with a lawyer now →

How Legal Hotline helps — right now

Being unable to work because of illness or injury is hard enough without fighting an insurer on top of it. Legal Hotline is a free service you can call any time, day or night. In a single call we'll help you work out whether you're likely to have TPD cover, which policy test applies, and what to do if a claim has already been declined.

If you need a lawyer, we'll connect you with one experienced in TPD and insurance claims who can act for you — anywhere in Australia, usually within the hour. There's no cost to call and no obligation. If illness or injury has stopped you working, the smartest first step is simply to pick up the phone. Talk it through with a lawyer now →

How a TPD claim works, step by step

Find your coverCheck every super fund you've ever had. We can help you identify which accounts carry TPD cover, how much, and which definition each policy uses.

Lodge the claimYou — or your lawyer — submit the claim to the fund and its insurer, with medical and work-history evidence built to answer the policy's exact test.

The insurer assessesThe insurer reviews your medical evidence against the definition of total and permanent disablement and decides whether to accept, decline, or ask for more information.

Dispute if declinedIf the claim is knocked back, you challenge it through the fund's internal complaints process — and, if needed, escalate to AFCA, which is free and independent.

TPD Claims — your questions answered

What is a TPD claim?

It's a claim for a lump-sum payout under total and permanent disability insurance, which pays out if an illness or injury leaves you permanently unable to work. Most Australians hold this cover inside their superannuation. Call the free hotline to check whether you have it.

How do I know if I have TPD cover?

The easiest way is to check each super fund you've had — log in online, read your annual statement and product disclosure statement, or call the fund. Many people have cover they didn't know about, sometimes across several accounts. We can help you work through it on the call.

My TPD claim was declined — can I do anything?

Yes. A declined claim is often not the end. You can dispute it through the fund's or insurer's internal complaints process, and if that doesn't resolve it, take it to the Australian Financial Complaints Authority (AFCA), which is free for consumers and independent. Get advice early — there are time limits.

What does "total and permanent disablement" mean?

It's defined in your specific policy, and the wording matters. The most common test in super is "any occupation" — being unable to ever return to any job suited to your training and experience. Some policies use an "own occupation" test or focus on basic daily-living activities. The right test for you depends on your policy.

Can I claim TPD and workers compensation?

Often, yes. TPD is separate from workers compensation — it's paid through your super fund's insurer and doesn't require your condition to be work-related. In some situations you can pursue both. It's worth getting advice on what's open to you before deciding.

Do I need a lawyer for a TPD claim?

You're not required to, but these claims turn on matching medical evidence to precise policy wording, and insurers assess them closely. A lawyer who handles TPD claims regularly can give you a realistic read on your prospects and handle a dispute if your claim is declined. Calling the hotline to get connected costs nothing.

Is calling Legal Hotline really free?

Yes. The information line is free and open 24 hours a day, 7 days a week. Call any time to understand where you stand — no cost, no obligation.