Whether you qualify for a TPD claim comes down to two things: whether you hold the cover, and whether your injury or illness stops you working in the way the policy describes.
This guide explains the test super funds apply, the cover most people do not realise they hold, the waiting period, and the signs a claim is worth exploring. For what a claim can be worth, see how much a TPD payout is worth, and for where the cover sits, see claiming TPD through your super.
Article at a glance
- Two questions: do you hold TPD cover, and does your condition meet the policy’s definition.
- Most people are covered: TPD cover is often held by default inside super, sometimes in more than one fund.
- The test is about suitable work: usually whether you can return to any job you are suited to, not any job at all.
- A waiting period applies: often three to six months off work before a claim can be assessed.
Do you hold TPD cover?
Most working Australians hold some TPD cover inside their super without arranging it, because it is often included by default. The first step is to check your super, or to ask us to help you work out what cover you hold and when it applied.
You can often claim against cover you held in the past, even if you have since changed funds or stopped working, and you may hold cover in more than one fund and be able to claim on each. That is why it is worth checking rather than assuming you are not covered.
The test: any occupation, own occupation, or daily living
A TPD claim is assessed against your policy’s definition of total and permanent disability. Most super cover uses one of three tests:
- Any occupation: you are unlikely ever to return to work you are reasonably suited to by your education, training and experience. This is the most common default, and the broadest test to meet.
- Own occupation: you cannot return to your specific job. This is a more generous test, usually only available outside super or as an upgrade.
- Activities of daily living: you cannot do basic self-care tasks without help. This is the hardest test and the least common.
The wording matters. An any occupation test does not ask whether you can do literally any job, and it does not require that you never work again at all. Your policy’s product disclosure statement is the final word on which test applies to you.
The waiting period
Most policies have a waiting period before a claim can be assessed, often three to six months off work from when you became unable to work. Your cover also needs to have been in place, with premiums up to date, at the relevant time. These timing rules vary between funds, which is one more reason to check your own policy rather than assume.
Signs you may qualify for a TPD claim
You may have a claim worth looking at if any of these apply:
- You have stopped work, or reduced it significantly, because of injury or illness
- Your treating doctors do not expect you to return to your usual work
- Your condition is likely to be permanent
- You held TPD cover through super at the time you stopped
None of these is a guarantee on its own, but together they are a strong sign it is worth a conversation.
What can get in the way
Eligibility is not always clear cut. Waiting periods, the exact wording of your definition, gaps in cover, exclusions for pre-existing conditions, and the strength of your medical evidence can all affect the outcome. A claim that looks borderline is often the one where how it is prepared makes the biggest difference.
Frequently asked questions
Do I need to be unable to do any job at all?
No. The usual any occupation test asks whether you can return to work you are reasonably suited to by your education, training and experience, not whether you can do any job that exists.
I have more than one super fund, does that matter?
It can help. You may hold TPD cover in more than one fund, and in some cases you can claim against more than one policy. It is worth checking all of them.
How do I find out what cover I have?
Your super statements or fund will show whether you hold TPD cover, and the product disclosure statement sets out the test that applies. If it is unclear, our expert team can help you work it out.
Not sure if you qualify? Take the 2 minute check
Answer a few quick questions about your cover and your situation, and we will point you to the right next step. It is free, confidential, and there is no obligation.
Could you have a TPD claim?
Total and Permanent Disability cover is held inside most super funds. Answer a few quick questions to see if you may be able to claim. This is a guide only, not a determination.
This is a general guide only, not an assessment of your policy or eligibility. TPD outcomes depend on your individual super fund or insurance policy terms. This does not constitute legal, financial or medical advice. Book a free consultation for a personalised assessment.
Thinking about a TPD claim?
Our expert team is veteran run. A first conversation is free, and we will tell you honestly whether a claim is worth pursuing before you decide.