TPD Claims: How They Work, Timeframes & Lawyer Fees

A TPD claim is made by lodging a claim form with the super fund or insurer that holds the cover, together with medical and employment evidence, and under the Life Insurance Code of Practice the insurer generally decides the claim within 6 months of being notified of it. The claim succeeds if the evidence meets the policy's definition of total and permanent disability, which is usually that the person is unlikely ever to work again in their own job or in any job suited to their education, training or experience.

To start, find every super account and check which ones hold TPD cover: log in to each account, read the annual statement or call the fund. Then ask the fund or insurer for its claim forms, and read the product disclosure statement for the TPD definition and any exclusions. If the claim is delayed or declined, TPD & Superannuation Claim Lawyers in Australia handle claims through super and retail policies.

What is TPD insurance?

TPD insurance is cover that pays a lump sum if an illness or injury leaves a person permanently unable to work. Most super funds, other than self-managed super funds, offer TPD cover to members, and most automatically give life and TPD cover to members aged 25 or over.

Default cover in super does not start automatically for a new member under 25, or where the account balance is under $6,000, unless the member asks for it or works in a dangerous job and the fund provides automatic cover. By law, super funds cancel insurance on accounts that have received no contributions for at least 16 months, and the fund must contact the member before cover ends.

TPD through super vs a retail policy

TPD cover held through super and a retail TPD policy bought directly both pay a lump sum, but they differ in definitions, cost, tax and complaint time limits.

"Any occupation" vs "own occupation": what is the difference?

The TPD definition decides how hard the claim is to prove. MoneySmart describes 3 common types:

Many "any occupation" disputes turn on which jobs are genuinely suited to the person's education, training and work history, and on whether the medical evidence shows the incapacity is permanent.

How do you make a TPD claim?

You make a TPD claim in 6 steps:

1. Contact the fund or insurer that holds the cover. If the cover came through an employer, speak to the employer; if through a broker or adviser, speak to them first.
2. Ask how the claims process works and which forms are needed, with your member or policy number ready.
3. Gather medical evidence, including reports and test results from your treating doctors.
4. Gather employment evidence, including your work duties, hours, payslips and tax returns, or financial statements if self-employed.
5. Sign the authorities that let the insurer contact your doctors, and attend any independent medical examination the insurer arranges.
6. Keep copies of everything you lodge and every letter you receive.

If the illness or injury continues to affect your ability to earn an income, the insurer may also ask for regular assessments and progress claim forms.

How long does a TPD claim take?

A TPD claim generally takes up to 6 months from the date the insurer is notified, or 6 months after any waiting period ends, under the timeframes in the Life Insurance Code of Practice. Income protection claims are decided faster, generally within 2 months. Claims can take longer when the insurer needs further medical reports or an independent examination. The Code is now the responsibility of the Council of Australian Life Insurers, and the Life Code Compliance Committee, administered by AFCA, monitors compliance. MoneySmart's life insurance claims comparison tool shows each insurer's average time to finalise claims.

Why are TPD claims declined?

Common reasons a TPD claim is declined include:

1. The definition is not met, for example where the insurer considers the person could do other suitable work.
2. The cover had ended, such as after 16 months without contributions or after a fund change.
3. An exclusion applies, such as a pre-existing condition exclusion.
4. Information was left out of an application for retail or increased cover; the insurer may then change or cancel the cover or refuse the claim.

What can you do if your TPD claim is declined?

First, make a complaint in writing to the super fund or insurer. If the complaint is not resolved, the Australian Financial Complaints Authority (AFCA) offers free, independent dispute resolution. AFCA has no monetary limit for superannuation complaints.

What are the AFCA time limits for TPD complaints?

AFCA's time limits for super TPD complaints are set by rule B.4.1.1 of the AFCA Rules, and AFCA will not extend them:

The decision date is the date of the original decision, even if the fund later confirmed or varied it after an internal complaint. For TPD policies held outside super, AFCA generally requires the complaint within 6 years of when the person became aware of the loss, or within 2 years of the firm's complaint response if that is earlier.

Is a TPD payout taxed?

A TPD benefit paid from super may be taxed at up to 22% if the person is under age 60, so the amount received can be less than the sum insured. The exact tax depends on the person's age and the components of the benefit. A registered tax agent or financial adviser can confirm the figures for a particular benefit.

How much do lawyers charge for TPD claims?

Most lawyers who act on TPD claims offer no win, no fee terms, where the professional fees are payable only if the claim succeeds. Indicative totals range from around $3,000 to $10,000 for a straightforward claim with one fund and around $10,000 to $30,000 or more for disputed or multi-fund claims, as at September 2026. These figures vary with the firm, the evidence needed and whether the claim reaches AFCA or a court.

In NSW, Victoria and Western Australia, the Legal Profession Uniform Law:

1. requires the law practice to disclose how costs are calculated and an estimate of total legal costs when instructions are first given (section 174);
2. allows conditional costs agreements, which must be in writing, signed by the client and include a cooling-off period of at least 5 clear business days (section 181);
3. caps any uplift fee in a litigious matter at 25% of the legal costs excluding disbursements (section 182);
4. prohibits fees calculated as a percentage of the amount recovered (section 183).

Ask for the expected net payout after legal costs and tax before signing.

Finding a TPD lawyer

A TPD lawyer is most useful when cover sits in several funds, the claim is delayed past the Code timeframes or the claim has been declined. Compare TPD & Superannuation Claim Lawyers in Australia by disability claims experience, fee model and public review records, and check firms offering conditional terms in No Win No Fee Lawyers in Australia. Many injury firms also run TPD claims, so you can compare Personal Injury Lawyers in Sydney, Personal Injury Lawyers in Melbourne or Personal Injury Lawyers in Brisbane and ask whether they handle super claims. If the disability followed a workplace injury, see Workers Compensation Claims in Australia for the separate statutory claim.