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Our services
Process
Our legal methodology begins with a forensic review of your insurance policy, employment contract, and superannuation fund rules to establish the legal basis of your claim. We analyse medical evidence against policy definitions of 'total and permanent disability' (TPD) or 'income protection,' often engaging independent medical specialists. A critical step involves meticulously preparing and lodging the claim, then strategically negotiating with insurers, who initially deny approximately 30% of long-term disability claims. If required, we escalate to formal dispute resolution through the Australian Financial Complaints Authority (AFCA) or litigation. For claims that have been refused, our detailed process for a denied disability claim is essential to challenge the insurer's decision.
Local Considerations — Australia
Long-term disability claims practice varies across Australian jurisdictions due to differing court procedures and the specific focus of regional industries. In major financial hubs like Sydney and Melbourne, claims often involve complex income protection policies for professionals, while in resource-rich areas, claims may relate to mining or industrial injuries. The interpretation of policy terms can also be influenced by prevailing judicial attitudes in state-based courts. Our national team adapts its strategy to these regional legal landscapes, ensuring robust representation whether a claim is administered in Brisbane, Perth, or Adelaide, leveraging deep familiarity with each jurisdiction's procedural nuances.
At a Glance
| Parameter | Reference Value |
|---|---|
| Typical Claim Assessment Period | 3-12 months |
| Common Policy Definitions | TPD, Own Occupation, Any Occupation |
| Key Documentation | Policy, Medical Reports, Employment History |
| Primary Legal Frameworks | Insurance Contracts Act 1984, Superannuation Law |
Standards & Compliance
- Insurance Contracts Act 1984 (Cth)
- Superannuation Industry (Supervision) Act 1993 (Cth)
- Australian Financial Complaints Authority Rules
- Corporations Act 2001 (Cth)
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Frequently Asked Questions
What is the most common reason for a long-term disability claim denial?
The most frequent reason is a dispute over whether the claimant meets the specific policy definition of disability, such as 'Total and Permanent Disability.' Insurers often argue the medical evidence does not satisfy the 'own occupation' or 'any occupation' test outlined in the contract.
How long does the long-term disability claims process typically take?
From initial lodgement to resolution, the process typically takes 3 to 12 months. This timeline can extend if the claim is denied and proceeds to AFCA dispute resolution or court litigation, where cases can take 18-24 months or longer to finalise.
Can I claim if my disability is due to a mental health condition?
Yes, provided your policy covers it. Many income protection and TPD policies cover psychological injuries, but insurers often scrutinise these claims heavily. Strong, consistent medical evidence from treating psychiatrists and psychologists is crucial to substantiate the impact on your capacity to work.
How much does long-term disability claims assistance cost in Australia?
Our fees are typically structured on a 'no win, no fee' basis for eligible claims, meaning you only pay if we successfully recover your benefits. Alternatively, we can work on a fixed fee or hourly rate. The specific cost depends entirely on the complexity of your policy, the volume of evidence, and whether litigation is required. We provide a clear cost agreement after an initial assessment of your case.