The importance of superannuation insurance for those with a chronic illness

For countless Australians, chronic illness is a reality of life. By definition, these illnesses last for a very long time – sometimes indefinitely. In many cases, they can’t be cured. And for a lot of people, they can impact their ability to work.

Many people living with a chronic illness may be forced to take time off or leave their job to effectively manage their condition. While you can request to access your superannuation early, you might also be entitled to a lump sum payment through total and permanent disability (TPD) cover as well as payments through income protection cover.

What TPD cover means for you

Under Australian law, industry super funds are required to include TPD insurance. It aims to protect those who are forced out of work because of illness or injury – but many people with a chronic condition are unaware of it or that they're entitled to a benefit.

A common hurdle faced by those with a chronic illness is that many insurers ask you to disclose pre-existing conditions when you apply for insurance. This means you could pay a far higher premium or fall under an exclusion that makes you ineligible to make an insurance claim under a stand-alone policy.

However, many super funds offer TPD cover as long as your condition doesn't affect your ability to work when you first open the account. This means that if your condition gets worse and you're unable to continue working, you may still be entitled to receive a lump sum.

How TPD cover changed Robert Carrs life

Robert Carr, was a proud builder for most of his working life. He loved building houses for a living. When he started dropping his tools on a regular basis, it seemed strange. Then he started losing his balance and slurring his speech.

After Robert's mum Heather became aware of the deterioration in Robert's motor function, she took him to a neurologist who diagnosed him with multiple sclerosis (MS).

Dealing with the diagnosis and learning to manage the symptoms of such a puzzling disease were challenging enough for Robert and Heather, but they also faced the issue of how to cope financially. Over a period of two years, Heather contacted Robert’s three super funds about his account balances without realising he was entitled to TPD insurance. Each one of the insurers failed to notified Heather of Rob’s insurance entitlements.

When Heather reached out to Maurice Blackburn, we found that Robert was in fact entitled to receive a benefit. By letting us fight and win the case on his behalf, Heather and Robert were able to focus on managing his condition. The lump sum he received went towards making their home wheelchair-friendly, dramatically improving Robert’s quality of life.

Why you should seek legal advice early

As with any insurance policy, TPD and income protection cover can be complicated. By seeking legal advice early, you put yourself in the best possible position for your claim to be accepted.

Super funds have specific criteria for disability claims. For example, some funds have a stricter definition of TPD for those who are working fewer hours per week. This means that if you reduce your workload from 30 to 10 hours per week before you stop work entirely, you could unknowingly make yourself ineligible for the benefit or reduce your monthly income protection benefit entitlement.

Another common pitfall is when your insurer contacts you and asks for information. Questions you answer over the phone can be taken out of context and used against you, whereas a prepared statement backed by legal advice helps protect your claim.

We offer our services on a no win, no fee basis

Whether the chronic illness in question is arthritis, MS, chronic fatigue, fibromyalgia or another condition, it takes time and energy to manage the symptoms. This only makes it harder to find out whether you’re covered, how to make a claim and what to do if you hit any roadblocks.

We keep a close eye over the entire process, seeking additional evidence where necessary and pressuring the insurer when they drop the ball. If your claim is unfairly rejected, we will continue to fight until you receive what you're entitled to.

Don’t let the stress of tackling a TPD or income protection claim on your own take a toll on your health. Find out what super insurance you're entitled to.

TOPIC: Superannuation
RELATED LEGAL SERVICES: Superannuation claims

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Kelly Ozuna

Maurice Blackburn Melbourne
Kelly Ozuna is a superannuation, insurance and financial advice lawyer, practising in Maurice Blackburn’s Melbourne office. While living in her native Texas, Kelly was drawn to the law by her desire to stand up for everyday people. She holds a Bachelor of Arts and Juris Doctor from the University of Texas, where she qualified to practice law before to moving to Australia and joining Maurice Blackburn in 2010. She has a strong Australian background in superannuation and insurance compensation claims, representing people against large institutions and government departments. Kelly works with clients in Victoria, South Australia and Western Australia. She has five years’ experience in the industry, and is driven by the unfairness her clients have faced in dealing with insurance companies and negligent financial advisors. “The most rewarding part of my work is in helping those in need to get the entitlements they deserve. Working with our clients and winning, in what can be really challenging situations and against big companies, gives me a huge amount of satisfaction. It’s a large part of why I went into law,” says Kelly. Memberships & accreditations Law Institute of Victoria member Texas Bar Association member ...

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