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TPD Claim - it takes time, but its worth it

Anand Srinivasan provides us with some more detail on the recent article we recently wrote here.

It took me over 15 months to get this claim paid out from an initial decline, the key reason for success was every party played the role.

If someone thinks TPD will be paid out after 90 days wait they are sadly mistaken. 90 days is the wait period for being eligible to lodge a claim. Getting TPD out it is a different set of requirements and I feel very lucky to have experienced this journey so early in my career as an adviser.

My client went through the umpteen tests cross questioning and verification. It was not easy but same time it was not difficult because I knew there was light at end of tunnel. The one thing I learnt from this journey was the value an adviser brings to the table at claim time.

Insurer looks at adviser for right information and evidence. Client looks at adviser to give confidence that claim will be paid at some stage if they follow they comply. The reinsurer have to come to party so everything needs to stack up.

While as an adviser I was managing the insurance company expectation, my client Darrell managed the Doctors, Specialist, Occupation Physician, ACC assessor etc. No one person can claim credit  for getting a TPD payout everyone has to give their 100%.

A great outcome indeed which cements my faith that I will continue to be an adviser for a long time because it works.

I have another adviser who has been in touch saying that a client feels that the requirements to prove their TPD claim are too hard, and the insurer is deliberately trying to discourage them - and perhaps has no intention of paying the claim. I don't think that's true for most claims - but in fairness to other policy holders they have to be careful before they hand out claims payments. The case above was for more than $600,000.


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J-P Hale

Having helped Anand with some of this, TPD is a very high bar of disablement, and the sums vs the premiums are often out of whack with the comparable trauma cover. So the bar is deliberately high and hard.
By QPR’s own stats a TPD claim gets paid half as often as a death claim, that should be an indication that TPD claims can be painful.

The surprising piece is with own occupation class 3 & 4 products, knees and joints are how potentially TPD claims for the more manual end of these occupations, something the insurers may not have anticipated well.

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