Gavin Hanrahan: Hello, my name’s Gavin Hanrahan and I’m a litigation lawyer and today I’m going to discuss making a claim on a total and permanent disability insurance policy. Lots of people have these policies these days, they’re often attached to your superannuation and because so many people have them, it’s perhaps not surprising that there’s also a lot of occasions when they are declined by the insurance companies. To put it simply, there are a lot of disputes about total and permanent disability insurance policies.

I’m going to come back to you discussing how to deal with the dispute shortly, but I just want to let you know the different types of policies. There’s basically two types of policies. There’s an own-occupation. If you have taken out an own-occupation policy, then you will be covered and that policy will kick in if you are unable to perform the usual duties of your usual occupation on a permanent basis due to an injury or illness that you have suffered.

The other type of policy is any-occupation policy and those types of policies kick in, if due to the injury or illness, you are unable to perform the duties of any occupation for which you are suited given your education training and experience. It’s really important when you’re putting in a claim, that you make sure that you have medical evidence to tick off all of the elements of the definition of total and permanent disablement that appears in your policy.

If you’re unsure about what the elements are, you should get legal advice about it and you should also get legal advice about the sort of evidence that should be obtained and submitted to the insurance company to put you in the best position to prove that you are suffering from total and permanent disability. If the insurance company declines your claim, then you’re in the best position to request it to review its decision, and most insurance companies have an internal review process.

Also, if the insurance company then refuses your claim still after the internal review process, you can ask the Australian Financial Authority to review it by simply lodging a complaint. Most policies of insurance are covered by the Australian Financial Authority’s jurisdiction. If all of that fails, then sometimes you just have to take these matters to court, and that’s where we come in to our own. We can put together your claim to be litigated and pursuing what is called a breach of contract claim against the insurance company.

I hope this is of some assistance to you. If you want to involve us at an earlier stage than litigation, feel free to contact us and we can assist you. Thank you.

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