Understanding eligibility
TPD claim eligibility in Queensland depends on your policy and individual circumstances. An “any occupation” definition generally considers whether you are unable ever to work again in a job suited to your education, training or experience. Other policies may use an “own occupation” or activities of daily living definition.
Being unable to return to your usual job may therefore be important without necessarily satisfying every policy definition.
A diagnosis alone does not establish eligibility. Your illness or injury also does not necessarily need to be work-related, but the applicable definition, exclusions and other policy requirements still need to be met.
Queensland workers compensation is a separate system. WorkCover Queensland states that workers compensation applies where a person is injured or becomes ill because of work, with work needing to be a significant contributing factor. A workers compensation outcome should therefore not be treated as determining your separate TPD insurance claim.
Find the cover and relevant dates
Gather current and previous super statements and any insurance documents you hold outside super. Ask your fund or insurer for your insurance history and the policy documents applying to the relevant period.
TPD cover can be affected by circumstances including changes in employment and an inactive superannuation account. The applicable policy should be checked rather than assuming your current cover is the same as cover you previously held.
Before cancelling insurance, changing funds or closing a super account, check how that decision may affect your existing cover.
Prepare clear evidence
Medical evidence should address the disability definition that applies to your claim. Depending on the policy, that may involve your capacity for your own occupation, work suited to your education, training or experience, or specified activities of daily living.
Your work history can also help explain your actual duties and experience, particularly where your hours or duties changed or you attempted to return to work.
For TPD insurance held through superannuation, also check the rules that apply to accessing the benefit and how any withdrawal may be taxed. The amount ultimately received may therefore differ from the amount of insurance cover.
Speak with our team
Book a free consultation about TPD claims in Queensland. KSC Law can review the documents you have, identify the relevant policy requirements and explain the evidence that may be needed.
We will also explain the proposed process and costs before you decide whether to proceed, without promising a particular claim outcome..
Related reading: TPD claims lawyers · Do I qualify for a TPD claim
TPD guides and next steps
KSC supports TPD clients across Brisbane, Townsville, Gold Coast. Consultations are available by phone and online.