A total and permanent disability claim moves through a set sequence, from gathering policy details to a fund decision, and knowing the order helps you prepare.
A total and permanent disability claim follows a set sequence: identify your cover, notify the fund, submit evidence, wait for assessment, then receive a decision. Understanding this order in advance helps you gather the right material early and avoid delays that are often within your control.
Many people assume a TPD claim is a single form and a quick answer. In practice it is a process with several distinct stages, each with its own requirements. If you are unsure whether you even have a claim, our short guide to what a TPD claim is explains the basic test before you start.
Step one, work out which policies apply
Total and permanent disability cover usually sits inside your superannuation but can also be found in a standalone insurance policy you hold directly. The first task is identifying every fund you have belonged to, because each period of employment can bring a new default policy. If you have changed jobs more than once, you may hold more than one policy, and our note on claiming with multiple super funds explains why this step matters so much. Skipping it is the most common way claimants leave money on the table.
Step two, notify the fund and request the claim pack
Once you know which funds may hold cover, you contact each one and ask for its claim forms and the relevant insurance policy in place, so you can understand the definition of total and permanent disability that applies. Definitions vary between funds and even between policies within the same fund, so it is worth reading the wording closely rather than assuming it matches a definition you have seen elsewhere. This is also the point to ask the fund about a certain time frame for lodging, since strict timeframes set by the regulator and by the policy itself can affect how long you have.
Step three, gather medical and employment evidence
This is usually the longest step. A fund will require treating doctor reports, specialist opinions, clinical records, and sometimes an independent medical examination that it arranges itself. You will also need employment records showing your role, your duties, and the date you stopped working or reduced your hours because of the condition. Claims involving a psychological or psychiatric condition often need more detailed evidence linking symptoms to functional capacity, so allow extra time to collect this material properly rather than submitting a thin file.
Step four, the insurer assesses the claim
Once your file is complete, the fund will lodge the claim with its insurer, which reviews it against the relevant policy definitions. This is not usually a quick step. The insurer may request further information, arrange its own examination, or ask treating doctors additional questions. It is common for this stage to take a certain time frame, and following up periodically, rather than waiting silently, tends to keep a claim moving. It is very important to maintain regular contact with the insurer during this period so the claim does not sit untouched.
Step five, the decision
Once the insurer has made a recommendation to the fund, the fund will either accept the claim, in which case a payout is calculated according to the policy sum insured, reject it, or ask for more information before deciding. Our article on how much a TPD payout is worth explains why the amount depends entirely on the specific policy and is never a fixed figure. If a claim is rejected, you generally have a right to seek an internal review or take the matter to the Australian Financial Complaints Authority, and strict timeframes again apply to that step.
Where delays commonly happen
| Stage | Common cause of delay |
|---|---|
| Identifying policies | Old super funds forgotten or consolidated without checking for cover first |
| Requesting the claim pack | Uncertainty about which fund holds the applicable policy |
| Gathering evidence | Incomplete medical reports or gaps in employment history |
| Assessment | Insurer requests for further information not answered promptly |
| Decision and review | Missing a strict timeframe to request an internal review |
What to do next
If you are still working or have recently stopped due to injury or illness, the most useful first step is to identify every superannuation account you have held and check each one for TPD cover before you approach any fund. This groundwork often changes how a claim is structured and can affect the outcome. Our no win, no fee arrangement means there is no cost to getting this checked properly. Start with the entitlement check, or contact us and we will walk you through the process for your circumstances.