What is Total and Permanent Disablement (TPD)?

TPD insurance cover is designed to help you financially if you suffer an illness or injury that leaves you totally and permanently disabled.

The benefit is paid as a lump sum and may be used at your discretion. The benefit is often used to clear debts, pay for medical expenses, or fund lifestyle changes such as moving to a new home that is more accessible for your condition.

If you have TPD cover, you can make a claim if, after an illness or injury, you're unlikely to ever work again in any occupation.

There is a waiting period from when you become ill or injured until the time that you are allowed to claim.

Before we can issue any TPD payment, our insurer will decide if your situation falls under one of the following TPD definitions, which are explained in further detail below.

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TPD definition 1 (unlikely to return to work)

An insured member satisfies all the following points: 

  1. is under 65 on the event date 
  2. is gainfully working on the day immediately prior to the event date
  3. has been employed for at least the minimum average hours, and
  4. in the insurer's opinion, based on medical or other evidence satisfactory to the insurer, solely because of the same injury or illness that is the subject of the event date, the insured member: 
  1. has not worked (whether or not for reward) during the entire waiting period 
  2. since the event date, has continuously been following the advice of a medical practitioner in relation to the injury or illness for which they are claiming, and 
  3. as at the date of disablement, is unlikely ever to work in any gainful employment for which he or she is: 
  • reasonably suited to by previous education, training or experience, or
  • may be reasonably suited to due to reasonable retraining. 

TPD definition 2 (permanent impairment)

An insured member satisfies all of the following:

  1. is gainfully working on the day immediately prior to the event date
  2. solely because of the same injury or illness that is the subject of the event date, the insured member suffers a permanent impairment of at least 25% of the whole person impairment as defined in the American Medical Association publication ‘Guides to the Evaluation of Permanent Impairment (5th Edition)’, or an equivalent guide approved by the insurer, and
  3. in the insurer’s opinion, based on medical or other evidence satisfactory to the insurer, solely because of the same injury or illness that is the subject of the event date, the insured member:
  1. since the event date, has continuously been following the advice of a medical practitioner in relation to the injury or illness for which they are claiming, and
  2. as at the date of disablement, is unlikely ever to work in any gainful employment for which he or she:
  • is reasonably suited to by previous education, training or experience, or
  • may become reasonably suited to due to reasonable retraining.

TPD definition 3 (loss of independent existence)

In the insurer's opinion, based on medical or other evidence satisfactory to the insurer, solely because of the same injury or illness that is the subject of the event date, the insured member satisfies all of the following: 

  1. since the event date, has continuously been following the advice of a medical practitioner in relation to the injury or illness for which they are claiming, and 
  2. as at the date of disablement, is: 
  1. totally and irreversibly incapable of performing at least two of the activities of daily living (a person will be considered totally incapable of performing an activity of daily living if they cannot perform the activity independently, without the assistance of another adult person or suitable aids), and 
  2. unlikely ever to work in any gainful employment for which he or she is reasonably suited to by previous education, training or experience.

TPD definition 4 (specific loss)

In the insurer’s opinion, based on medical or other evidence satisfactory to the insurer, solely because of the same injury or illness that is the subject of the event date, the insured member satisfies all of the following:

  1. suffers the total and permanent loss of the use of:
  1. two limbs (where ‘limb’ is defined as the whole hand or the whole foot), or
  2. the sight in both eyes, or
  3. one limb and the sight in one eye
  1. since the event date, has continuously been following the advice of a medical practitioner in relation to the injury or illness for which they are claiming, and
  2. as at the date of disablement, is unlikely ever to work in any gainful employment for which he or she is reasonably suited to by previous education, training or experience.

TPD definition 5 (cognitive loss)

In the insurer’s opinion, based on medical or other evidence satisfactory to the insurer, solely because of the same injury or illness that is the subject of the event date, the insured member satisfies all of the following:

  1. suffers cognitive loss
  2. since the event date, has continuously been following the advice of a medical practitioner in relation to the injury or illness for which they are claiming, and
  3. as at the date of disablement, is unlikely ever to work in any gainful employment for which he or she is reasonably suited to by previous education, training or experience.

Please note: In determining if you meet TPD definition 1, 2, 3, 4 or 5, the insurer may have regard to all relevant information available to it from the event date. This includes information relevant to your future capability, and, for TPD definition 1 and TPD definition 2, reasonable retraining. Any factors unrelated to your capability, solely because of injury or illness will not be considered. These include external factors such as availability of work and geographical location, as well as your personal circumstances such as your length of time out of the workforce or any other factors which may be relevant to the likelihood of you returning to work.

Please note that the final decision on all insurance claims is made by the trustee (LUCRF Super).

If you have any questions or would like further information about Death & TPD cover or our definitions, you can head to our Insurance Guide, call us on 1300 130 780 or email us at mypartner@lucrf.com.au.