My TPD Claim Has Been Rejected. What Do I Do Next?

Last updated on August 30th, 2023 at 02:47 pm

A Total and Permanent Disability (TPD) claim can be an injured or ill person’s second lease on life. As such, they should not have to go through the ordeal of making a claim, only to have it rejected.

If you have tried to make a TPD insurance claim after an injury or long-term illness, you might have had the dismaying experience of your provider denying your request. Insurers often try to decline the payments, and their reasons for doing so are sometimes unclear.

To shed some light on the matter, here are some things that you might be asking about TPD claims, and what you’ll need to know to move forward.

Are You Entitled to Multiple TPD Claims?

In a word, yes—if you have separate funds for each of your claims, that is. If you are unable to go to work due to an injury or an illness, then your superannuation fund might owe you a lump sum.

Obtain professional legal advice to help you determine if you have a chance to make multiple claims. Your insurance lawyer should be able to walk you through your policy and your entitlements.

What Are The Reasons Why Providers Reject Claims?

Every insurance company and superannuation policy is different. However, some common reasons why a provider might reject the claim often have to do with insufficient evidence of the necessity for it.

According to the company’s guidelines, this might mean that you do not satisfy the criteria for being granted a TPD. The company might have medical evidence that disproves your injury, or they might believe that you are capable of working in another role.

Some providers might even deny claims if you were working in part-time roles before you were injured, or if they find that you have an inactive insurance policy.

What Could I Do If My Provider Declines?

First, do not be discouraged. Understand why your insurer declined your claim and seek legal advice to find your next steps.

Why Should I Challenge My Provider’s Decision?

Some companies review files quickly and decide to reject TPD claims based on that initial cursory reading. Sometimes, they are more thorough, but merely get a medical expert who does not give a clearer picture of the worker’s illness or condition.

They might not ask the right questions about your claim or refer to the TPD policy definitions. As such, you have to be the first person to advocate for yourself. If they reject your application, you have to ask for the reasons why they did so and present your case on why they made the wrong assessment.

Conclusion

An insurer’s decision on a TPD insurance claim is not the last word on the matter. If a provider rejects your request, you must seek legal advice. A superannuation claim lawyer can help you explore your options and map out your next steps.

If you wish to lodge a TPD claim, get in touch with Seymour Furlong Lawyers. We work in the Brisbane area and specialise in compensation and insurance claims. Get in touch with us today and secure one of the best compensation lawyers in Queensland to help you with your case.