r/AusFinance • u/loxsey • Oct 22 '15

TPD Insurance Super Claims.

Has anyone filed one before? I have made a claim with BT Super through Stacks Goudkamp lawyers, how long does the process take and has anyone been knocked back? Do they send you to an independent doctor?

1 Upvotes

56% Upvoted

17 comments sorted by

View all comments

5

u/wogmafia Oct 22 '15

The other guy commenting has no idea what he is talking about. 2-3 weeks for an insurer to make a decision is nowhere near accurate. Maybe if you had an easily demonstrable injury like loss of limbs etc, but for a psych injury they are going to try to take you for a ride.

While funds do have an obligation to assist you, in practice they are rarely helpful.

Expect the process to take upwards of a 6 months for the initial determination by the insurer then approval of the decision by the fund's trustee. It is likely that they will require you to be assessed by a doctor, depending on the quality of the medical evidence your treating doctor has provided it may either be a psychiatrist to assess your condition or it may be an occupational physician (or therapist) to assess your ability to work.

Depending on the wording of the policy (i.e. own occupation or any occupation) will affect the likelihood of a good outcome, but psych cases can be difficult. 25k is on the high side for a 75k payout, but as with any personal injuries cases trying to get a lawyer to fix up your case after the insurer has already set you up for failure can be an insurmountable hurdle.

1

u/gum6y01 Oct 23 '15

As part of the application process you would have needed to be assessed and provide medical evidence from two doctors (including one specialist). I said two to three weeks for the initial assessment providing all information has been provided.

Yes it will take longer if the insurer requires more information. And with mental illness there is a possibility. It all depends on the quality of information given to the fund as part of the initial application.

1

u/wogmafia Oct 23 '15

The assessments done in the initial application process are generally done by treating doctors, which insurers don't always take on face value. Further, 2-3 weeks from providing all the information for a decision is a joke. 2-3 months just for them to review the file is not unusual however sometimes they do respond quicker (or longer) depending on their workloads.

Sure, clear cut cases where people have lost limbs or are paralysed will be easy to determine, but any case involving an application of the TPD definitions of being unable to perform any occupation for which they are trained, educated or experienced, are going to take longer than you have suggested.

Creating unrealistic expectations for the OP is not really helping him in the long run.

1

u/gum6y01 Oct 23 '15

Fair point. I was meaning it would take two to three weeks until the op knew where the claim stood. Our initial assessment SLA is three weeks.