If you are unable to work As a result of an injury or medical condition

You may be able to access benefits attached to your superannuation or insurance policy.

The injury or medical condition does not need to be work related.

The benefits may include:

You can pursue these claims even if you are in receipt of workers compensation or Centrelink benefits.

To find out more about what you may be entitled to, contact Prime Injury Lawyers
03 7043 0100. Our dedicated team is here to give you advice about your rights and entitlements.

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Free Claim Check Process3 Simple Steps

1.
Submit the Claim Check Form

Fill out our easy and straightforward claim check form by providing your personal details. Briefly describe your legal needs and the situation you’re facing. This information will help us better understand your case.

2.
Receive a Phone Call or Email

Our legal team will carefully review the details you provided in the form. Expect a prompt communication from us, either through a phone call or email, seeking any additional information required for a thorough assessment.

3.
Schedule a Formal Discussion

Upon confirming the viability of your case for a legal claim, we will coordinate with you to arrange a formal meeting. This meeting, scheduled at your convenience, will allow us to discuss your case in detail and outline the necessary steps for proceeding with the legal action.

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What Our Clients Say About Us

“From the very beginning, Tim and Maddison took care of my case and went above and beyond to help me in every way possible. When I met Tim, I immediately felt at ease and as if I had known him for years. Maddy was a great support for Tim and they are a great team to have representing you. Prime injury lawyers was always warm, welcoming and made be feel like I was family, and I am truly thankful for that. “

Elaine Whateley

 

“I was very fortunate to have been referred to Tim resulting in a successful claim. Tim is extremely experienced, knowledgeable and created a positive atmosphere in all our meetings. This gave me great confidence along the journey and as mentioned resulted in a successful claim. I have no hesitation to recommend Prime Injury Lawyers and in particular Tim Jackson if anyone has a need for a good and capable legal representation.”

Praba Karan

 

“John from prime has been excellent and very understanding of my circumstances. When I first had an appointment with John and told him I was in a wheelchair and unwell he didn’t hesitate to make a trip to my home for our first consultation. He was very professional and Very understanding of my needs and was happy to make the process easy for me to understand. I would recommend anyone that needs legal advice to contact Prime Lawyers.”

Jude Rainsford

 

Frequently Asked questions

  • What type of insurance cover does my superannuation include?

    What cover you have will depend on you superannuation policy or policies. Typically, the following cover may be included:

    • Total and Permanent Disability
    • Income protection
    • Death & terminal illness

    Contact us to find out whether you have a claim. Our team of experts will assist you in getting the benefits you deserve.

  • When can I make a total and permanent disability claim?

    Although there are no real time limits for making a total and permanent disablement claim, Prime Injury Lawyers recommends that you make a claim as soon as you can. There are however strict time limits if you need to challenge the superannuation fund or the insurer’s decision about your claim.

    Contact us to get legal advice and know where you stand – even before you lodge your claim. Start your free online Superannuation Claim Check here.

  • Can I make more than one claim if I have multiple superannuation policies?

    It is not unusual for someone to hold multiple superannuation or insurance policies at the same time. If you do, you can make multiple total and permanent disablement claims if these policies were validly held at the time you stopped working because of your disability.

    To know where you stand, contact us – we will investigate your claim free of charge and provide you will clear and comprehensive advice.

  • Do I have to be unable to work completely to make a total and permanent disability claim?

    Generally, you can make a total and permanent disability claim if you have suffered an injury or illness that permanently prevents you from being able to work in your normal job or any other job for which you are suited. You do not have to demonstrate that you cannot work.

  • What type of illnesses are usually covered in order to make a total and permanent disability claim?

    For total and permanent disability claims, the injury or illness does not need to be related to your work. There are many non-work related injuries or illness that you can claim for a total and permanent disability claim:

    • Strokes
    • Heart attacks
    • Mental health injuries or illnesses
    • Cancer
    • Multiple sclerosis
    • Parkinsons Disease
    • MND
    • Sporting injuries
    • Transport accident injuries

    To know where you stand and to maximise your potential benefits, contact us for free legal advice.

  • If my claim is rejected, what can I do?

    If your claim is rejected, you can challenge the superannuation fund or insurer’s decision. The process for challenging a superannuation fund or insurer’s decision can be quite technical and difficult. There are also often strict time limits involved for challenging such decisions. You do not have to fight this fight alone – Prime Injury Lawyers is here to help. If your claim is rejected contact us for advice and assistance.

  • What is income protection insurance?

    Income protection (or salary continuance benefits) are weekly payments paid to the injured or an unwell person. The benefits are usually paid each month that you are not able to work. Typically, these payments continue until you are able to work.

  • Can I claim income protection if I can still work but not as much?

    Yes. Most income protection policies will allow you to claim an income protection or salary continuance benefit even if you are still working some hours. How a superannuation fund or insurer defines partial incapacity will depend upon the terms of the relevant policy and how partial incapacity is defined.

    If you are unable to work your full hours after your injury or illness and you want to know whether you are entitled to make an income protection or salary continuance claim, contact us.

  • What if I am receiving WorkCover or TAC weekly payments or Centrelink benefits – are income protection payments offset against these?

    Yes. Most policies have offset clauses which means that income protection benefits are offset against payments such as WorkCover or TAC weekly payments and Centrelink benefits. Some policies will allow your to claim the portion that WorkCover or TAC are not paying.

  • What are the costs associated with making a total and permanent disability claim?

    Unlike most other firms, for total and permanent disability claims we offer a No Win No Fee fixed fee arrangement. This gives you peace of mind knowing exactly what your fees will be.

    You will not be required to pay any fees upfront –only at the end of your claim and only if you are successful.

Our specialist superannuation claims lawyers who specialise in total and permanent disability (TPD) are experienced in winning fair compensation on a ‘no win, no fee’ basis. Our TPD lawyers are here to help guide you through the process for making a claim with your insurance as well as disputes for declined TPD claims. We’ll do everything we can to get you the result you deserve.

Who can make a TPD claim?

You may be eligible to make a TPD claim for compensation if you’ve suffered an injury or illness that permanently prevents you from working in your normal job or any other work for which you are suited by education, training or experience. The injury or illness doesn’t have to be work related. There are many injuries that can be reasons for your TPD claim:

  • heart attack
  • cancer
  • injuries sustained at home
  • sports injuries
  • car accident injuries
  • chronic illnesses

Our TPD lawyers have also helped our clients with successful claims for psychological illnesses such as:

  • anxiety
  • depression
  • PTSD
  • bipolar disorder
  • schizophrenia and other psychotic disorders

You may be eligible to make a TPD insurance claim if:

  1. You have TPD insurance cover (either through your super fund or another channel). Most super funds automatically include TPD insurance.
  2. You can show you’re unable to do your normal job or any other work related to your education, training or experience.

Always be wary of tricky exclusion and eligibility clauses in the total and permanent disability insurance policy’s small print that can be used to deny your claim. Our team of specialist superannuation lawyers will help you understand the policy fine print and work with you to ensure you get every dollar and benefit that you’re entitled to. Terminal Illness If you have been diagnosed with a terminal illness, you may be able to claim against the death benefit insurance policy.

What are the time limits for making a TPD claim?

It’s best to submit a total and permanent disability claim as soon as you can, but you may be able to claim a long time after your injury or illness has occurred. However, when it comes to challenging the super fund’s or insurer’s decision regarding your TPD claim, there are strict time limits. It’s therefore important to get legal advice from an experienced TPD lawyer as soon as possible, even before you submit your claim, so you know where you stand.

TPD compensation and benefits

TPD benefit amounts vary depending on the policy terms negotiated by your super fund or employer. Benefits are usually paid as a lump sum and can be worth tens or even hundreds of thousands of dollars. The total permanent disability insurance payout amounts can decrease or lapse as you age so it’s important to check the level of cover at the time you stopped working (even if that cover has since ended).

Multiple TPD insurance claims

You can often have multiple TPD claims if you have multiple insurances in place when you stop working due to disability.  However, some policies won’t pay if you’ve already received or been entitled to claim another TPD benefit. Our lawters are experts at overcoming these provisions but it’s important to get advice before making any total and permanent disability insurance claims. In addition to the TPD lump sum benefit through your superannuation, you may also be able to make additional claims through income protection, or other forms of insurance.

You may even have access to additional benefits through:

  • your employer
  • an enterprise agreement
  • your employment contract
  • your loans such as a mortgage, car loan or credit card
  • your insurance purchased through a financial institution or advisor.

Read more about the different insurance benefits you could access when you are unable to work due to illness or injury.

TPD claim processing time
Your super fund has to make a decision on your TPD claim within 6-12 months of receiving all the required claim documentation, depending on the complexity of your claim. Our TPD lawyers are experts at getting insurance claims paid early.

What is trauma insurance?

Many superannuation funds and insurance companies offer you the option of taking out an insurance policy for specific medical conditions, or for certain types of surgery as specified in the policy. This is called trauma insurance and it entitles you to a lump sum benefit if you suffer from one of the listed conditions.

Trauma insurance differs from income protection policies which typically cover any medical condition that temporarily prevents you from working.

The three most common claims for Trauma Insurance are for:

  • Cancer
  • Heart attacks
  • Strokes

There are often exclusions and other requirements in trauma insurance policies, such as waiting periods and exclusions for pre-existing medical conditions, so we suggest you read your policy carefully.

What is income protection insurance?

Income protection insurance provides you with an income stream when you can no longer work due
to illness or injury.

  • Income protection is a regular payment (usually monthly), paid while you can’t work
  • Income protection is sometimes also called salary continuance (SC), total disability (TD), or total and temporary disability (TTD)
  • There is a waiting period, usually between two weeks and three months
  • It is paid for a set period of time, usually 2 years, 5 years, or to age 65
  • The payment is usually around 75% of your income
  • Income protection is usually reduced by other income, including workers compensation and Centrelink payments
  • Some income protection insurance policies pay top up if you can only return to work part- time, or in a lower paid job

Many Australian workers now have income protection insurance. Some people buy it directly from an insurer, or through their bank, while others get it through their super. Many people do not even know they are covered.

How does income protection insurance work?

Generally, income protection insurance covers you for about 75% of your pre-injury salary. The frequency of payments, age limit restrictions and the length of time you are entitled to claim for benefits vary between policies. In addition, payments may cease if your employment is terminated or if you have been paid a TPD claim benefit.

Policy terms also tend to vary relating to how severe your condition needs to be for you to qualify for benefits. Some policies will pay you an income protection benefit only where you are unable to perform your usual job, while others pay where you cannot perform any occupation for which you are suited based on your education, training or experience.

Some policies may have an offset clause. This means that the benefit payout you receive from the insurer may be reduced if you have received other income while you have been unable to work, such as WorkCover payments or Centrelink benefits.

How do I make a claim?

We’re experts in this area of law and we suggest you obtain independent legal advice so you are aware of all your potential disability benefits, and to maximise your claim to entitlements. You should act quickly when lodging a claim, as time limits may apply.

  • The first thing is to find out how much income protection cover you have. We can find out
    for you, on an obligation-free basis.
  • We can then run the claim for you, including dealing with insurer, doctors, tax office,
    Centrelink, and your workers compensation insurer.
  • We act No Win – No Fee* in income protection claims.

What if the insurer doesn’t pay?

We often see clients who tell us that their insurer has refused to pay their income protection claim. Sometimes the insurer finds a doctor who says the person can work. In other cases, the insurer tries the cancel policy, saying that there was non-disclosure, or insurance fraud. Sometimes the insurer says the condition is a pre-existing condition.

Our experience is that very often we can overcome these problems and get our clients paid, either by lodging a dispute with the insurer directly, or by taking the case to Court.

What types of income protection insurance policies are available?

The two types of income protection insurance policies are:

  • Agreed value insurance – your benefit payment is predetermined and reflects your income when your policy commenced.
  • Indemnity value policies – your benefit payments may vary depending on your income at the time of making a claim.

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