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A life changing TPD and income protection claim paid out in full

 


A life changing TPD and income protection claim paid out in full

CASE STUDY – “JEREMY”

Jeremy was referred to Berrill & Watson by one of our Financial Counsellor friends. The Financial Counsellor was working with Jeremy to help him establish a budget to make his Disability Support Pension go a bit further and to try to reduce his debt. In doing this work, the Financial Counsellor recognised that Jeremy might have a Total and Permanent Disability (“TPD”) claim.

Our initial investigation into what TPD insurance Jeremy had

We got in touch with Jeremy and conducted some investigations to see what super he had when he last worked and if that super had insurance cover at the relevant time. This process was not as easy as it sounds, as Jeremy hadn’t worked for about 11 years and knew the details of only two of the approximately 6 super funds that he had been a member of over his working life.

To complicate the search for super funds further, the spelling of Jeremy’s last name is a unique spelling of a very common name which had been mis-recorded by the Government and his super funds several times such that he had a different last name on many of his accounts. Also, he did not have any current photo identification, so we had a hard time proving that he was who he said he was!

The steps to finding what super insurance cover was still available

After working closely with Jeremy, we were able to initially achieve:

  • getting him some photo identification;
  • sorting out the issues relating to the spelling of his last name;
  • speaking with the Australian Tax Office to identify all super funds that he had been a member of throughout his working life; and
  • proving that we were entitled to make investigations on his behalf.

With these issues sorted, we identified that Jeremy had TPD cover when he last worked in 2005, on one of his 6 super funds. This was the case even though he hadn’t worked for several years and the account had been closed due to a zero balance some year previous. It’s important that you do not assume you have no cover simply because you worked some time ago or you believe your accounts are now closed.

Not only did we follow up on a TPD claim, we also investigated income protection options

We were told by the fund that he did not have any income protection cover at this time. However, because we know this particular super fund well, we were puzzled as to why there was no income protection insurance cover.

We made some further investigations with the fund’s insurer directly and these investigations revealed that Jeremy did have income protection cover (as well as TPD insurance cover) when he last worked.

As a result, we claimed the TPD insurance and the income protection insurance benefit too!

Why we love what we do

This claim was not easy because, in summary, when Jeremy ceased work after he slipped at work and hit his head, his doctors had not been able to find any evidence of brain injury.

Nonetheless, Jeremy had been unable to work since the injury and complained of a number of cognitive issues which have been diagnosed as “mental health issues”.

Because of the difficulties with diagnosis, a couple of failed attempts Jeremy had made to return to work and the fact that he had changed doctors a lot (due to various interstate moves related to homelessness), we had a hard time getting doctors to confirm that Jeremy had been unable to work since his fall.

Nonetheless, after engaging with Jeremy and a few of his doctors over a period of months, we were able to get claim forms completed that confirmed that Jeremy ceased work due to injury in 2005, had been unable to work since and was not likely to work in the future.

The fund/insurer made some further investigations with the ATO, Jeremy’s former employer and his doctors and, sometime later, they accepted the claim.

Jeremy was paid a back dated income protection benefit of 75% of his pre-disability income (paid for 2 years) and a TPD benefit of about $50,000.

He is using the money to have “his teeth fixed” and pay back some of his loyal friends and family who have supported him over the years since he has been unwell and unable to work. We also hope that Jeremy uses some of his disability entitlements to find more secure housing and to help him out in the future.

The success of these claims for Jeremy are life changing. It’s unlikely he would ever have seen any of these moneys without a highly experienced, tenacious and compassionate team of professionals on his side and that’s what makes us love what we do.


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