Complexity of TPD claims

TPD law is a complex area of law, and is constantly changing and being updated by court decisions. The current case law in this area is seeing an increased restriction in a claimant’s ability to successfully obtain a TPD benefit, and more hurdles that a claimant needs to jump through to establish that they are entitled to their TPD benefit. Often, a claimant must commence proceedings in either a Tribunal or Court to challenge an insurer or trustee’s decision to decline a claim, and obtain their benefit.

Common issues or themes in TPD claims

Unlike workers compensation, TPD claims are largely unregulated. As a result, we often see the handling, processing and management of TPD claims by trustees and insurers being problematic in a number of ways. A few notable examples include:

• Excessive delay in processing claims. In some of the cases we have previously dealt with, we have frequently seen delays in excess of 2 years, and often up to 4 – 5 years;
• Excessive, aggressive and/or illegal surveillance undertaken of the claimant. This is an issue particularly with psychiatric or psychological claims, as surveillance is usually unable to show how impaired a claimant is;
• A disregard shown by the trustee or insurer for medical evidence that supports the claim, and instead a preference for medical evidence that indicates that the claimant is not TPD.

Why you need an expert for your TPD claim

Contrary to popular belief, TPD claims cannot and should not be streamlined by a law firm. TPD claims require more than a vague or basic understanding of the case law. Whether a claimant is TPD requires a very detailed look at a claimant’s particular circumstances, including the evidence on hand, a consideration of whether that person is likely to currently satisfy the TPD definition with reference to current case law, and any procedural steps that should be undertaken to strengthen a particular case.

In our opinion, only a select number of claimants are ever capable of establishing that there is absolutely no real chance that they will return to the work force.

John Cox holds himself out to be an expert in the area of TPD law for claimants. To date, he has had significant success in obtaining TPD benefits for his clients. This includes successfully obtaining a benefit for a claimant, getting a trustee or insurer to overturn an original decision to decline a claim, obtaining favourable settlements for claimants, and obtaining judgments from the Supreme Court of NSW for TPD benefits to be paid by an insurer.

Superannuation benefits

You are usually unable to withdraw your superannuation benefits prior to retirement. However, if you are likely to satisfy the thresholds for TPD, we can approach your super fund on your behalf and request that you be able to access your superannuation early on the basis that you are suffering from a permanent incapacity. We are able to provide you with further information on this if you wish.

Fees

In respect of TPD claims, we offer a flexible range of fee agreements. For more information, please see our Legal Fees page, or simply get in touch with us. We are always upfront about the way we charge our clients.

Contact us

We would be happy to hear from you if you believe you have a TPD claim or if you are currently in the process of seeking a TPD claim. Further, if you have successfully obtained a TPD benefit, but believe there was significant delay on the part of the trustee or insurer, we are also able to look at whether you have any entitlement to interest, under the Insurance Contracts Act 1984 (Cth).

John also reviews declined TPD claims, and regularly requests trustees and insurers to review their decisions to decline claims with merit. John has had significant success in overturning declined claims. If you have been unsuccessful in your TPD claim but believe that the insurer’s decision is incorrect, please get in touch with us so that we can assist you.