Do you have to make a claim on your insurance policy? If you have a total and permanent disability insurance claim, you need to follow a guide on what to do and what not to do in order to file a claim. Whenever you’re making a claim on your TPD insurance, it is vital that you understand the conditions which lead to the claim in your state. The procedure in which you can submit a claim to obtain the benefit payment can often be a tedious one and more so when you don’t follow the required steps.
The main three things that you require considering while making a TPD claim are:
- Ensure that you understand the reasons behind why you should dispute a TPD claim
- Determine whether or not you are eligible for making the claim
- Follow the steps that you need to take to file a claim, depending on whether or not the TPD is included within your super fund or whether it is a standalone policy
What are the reasons behind disputes of TPD claims?
So, what are the reasons behind TPD claims being disputed? Here are few reasons that can be considered.
- Various definitions between insurers: There isn’t any particular definition of TPD and TPD disputes are the main kind of dispute for the definitions.
- Extended waiting period: There are few policies which need waiting periods of around 3 months before you make a payment.
- Continuous requirements: There are few TPD policies which demand the claimant to follow few ongoing advice of a specialist or some special rehabilitation program.
- Exclusions: TPD payouts will have exclusions for the medical conditions which are already pre-existing.
Criteria used to decide your eligibility to make a TPD claim
#1: Extent of disability: There are few insurers who will check the extent of disability before allowing you to make a claim. They will also consider the chances of recovering from the disability.
#2: Whether the cover is included in super: A TPD policy which is inside a superannuation will let you cover only Any Occupation disability. When it’s any occupation disability, you will be unlikely to engage in a job which suits your experience and education and for own occupation disability, you’re unlikely to return to full-time work in your past job.
#3: Waiting periods: There is definitely a minimum waiting period from the time when you file a claim till the time you’re paid. As long as waiting periods are concerned, the ones that are concerned are 3 months of constant absence from work, 6 months of absence from work and no waiting period for some condition like in case of a major trauma.
So, the insurer will take into consideration the above mentioned factors while deciding whether or not they will allow you to file a claim on your TPD policy. In case of any doubt, make sure you get in touch with a financial advisor.