Claiming TPD benefits from multiple super funds

When multiple TPD claims may be possible

Multiple TPD claims are more likely where:

• you held more than one super account with active TPD insurance
• cover was in place when your illness or injury prevented you from working
• you meet the TPD definition under each policy

Timing of a claim may be particularly relevant where a medical condition develops over time or where someone initially hopes to return to work after a serious injury or illness, only to later discover that recovery is unlikely.

Situations where multiple claims may be limited

There are circumstances where making multiple TPD claims may be more complicated. For example:

• insurance cover may have lapsed
• a super account may have become inactive
• policy terms may affect how benefits are assessed
• some policies state that a benefit will not be paid if you have already received, or are eligible to receive, a benefit under another policy
• different insurers may apply different eligibility criteria

Many people are surprised to learn they no longer have insurance attached to an older super account. Others discover that policies they believed were similar contain very different terms and conditions.

Reviewing the details of each policy carefully can help identify what cover may have been available at the relevant time.

Why TPD definitions matter

One of the most important differences between TPD policies are the definitions used to determine entitlement to a benefit.

Some policies assess whether you can return to any occupation for which you are reasonably suited by your education, training, or experience. Others may use different and harsher wording or assessment criteria.

Because these definitions are not standard across the industry, two insurers may reach different conclusions based on the same medical condition and evidence.

Understanding the definition that applies to each policy can be an important part of assessing your entitlements.

Claiming TPD for mental health conditions

TPD claims are not limited to physical injuries. Conditions such as PTSD, depression, anxiety, and other psychological conditions may give rise to a TPD claim where that condition has a significant and lasting impact on a person's ability to work.

Mental health claims are often supported by evidence from treating doctors, psychologists, psychiatrists, and other medical specialists. A clear treatment history and consistent medical evidence can be particularly important.

Where claims are being made through multiple super funds, each insurer will assess the available evidence independently and apply its own policy requirements.

How multiple TPD claims are assessed

Each insurer will usually conduct its own assessment, even where the same medical information is provided across multiple claims. This process commonly involves reviewing:

• medical records
• treating doctor reports
• specialist opinions
• employment history
• vocational and functional evidence
• financial evidence, such as payslips and tax returns

Insurers may also request independent medical examinations or additional information before making a decision.

Because each claim progresses separately, it is not unusual for decisions to be made at different times.

Common challenges with multiple TPD claims

Managing multiple claims can feel overwhelming, particularly when you're already dealing with the effects of a serious illness or injury. Some common challenges include:

• conflicting medical opinions
• repeated requests for information
• delays in obtaining records or reports
• difficulties locating older super funds
• managing several claim processes at the same time

For many people, the administrative burden can be significant. Understanding the requirements of each claim early may help reduce some of that stress.

Changes to superannuation insurance cover

Insurance reforms in recent years have affected TPD cover held through inactive super accounts. As a result, some members may have lost insurance that would previously have remained in place automatically.

Older policies can sometimes provide different benefits or broader cover than more recent arrangements. This makes it important to identify all super funds you held and determine what insurance was available at the relevant time.

Our specialist superannuation lawyers are here to help

If you're living with a serious illness or injury and are unsure what insurance cover you hold, understanding your superannuation history and reviewing the policies held through your funds can be an important first step in identifying what entitlements may be available to you.

Contact us as soon as you think you have a claim. 

Our lawyers understand the details and the pitfalls of a range of TPD policies and can help you find the information you need to get the benefits you deserve.