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Glossary @ TPD Claims Lawyers
Your guide to understanding TPD and insurance claim terms.
Navigating Total and Permanent Disability (TPD) claims, income protection, and insurance disputes can feel overwhelming if you’re unfamiliar with the terminology.
Total and Permanent Disability (TPD) and insurance claims can be complex, often causing confusion at a time when clarity is crucial. Our goal is to simplify the process, providing straightforward guidance and strong support to help you secure the benefits you’re entitled to.
If you need further information regarding TPD, income protection, or other insurance claims, please call us on 1300 300 457.
A
Agreed Value Policy
A type of income protection or insurance policy where the benefit amount payable is agreed upon at the start of the policy, rather than being based on your income at the time of claim. This can be advantageous if your income decreases before you make a claim.
Arrears Payment
When insurance or income protection benefits are paid for a period after it has passed, rather than in advance. For example, a monthly benefit covering January may be paid in early February.
Assessment Period
The time taken by an insurer or superannuation fund to assess your claim once all required documentation and evidence have been provided.
B
Beneficiary
A person or entity entitled to receive benefits from a superannuation fund, insurance policy, or estate. In TPD or death benefit claims, beneficiaries are typically named in the policy or determined according to fund rules.
Binding Death Benefit Nomination (BDBN)
A legal document provided to a superannuation fund directing the trustee on exactly who should receive the death benefit upon the member’s passing. It must be valid and up to date to be enforceable.
Benefit Payment Period
The duration for which an insurer or superannuation fund will make benefit payments under an income protection or TPD policy. This can be fixed-term or until a specific age, depending on the policy terms.
Business Expense Insurance
A type of cover designed for self-employed individuals that reimburses fixed business expenses if the insured is unable to work due to illness or injury.
C
Claimant
The person who lodges a claim for benefits under a TPD, income protection, trauma, or life insurance policy. This is usually the insured member themselves, but in some cases (such as death benefits) it may be their beneficiary or legal representative.
Claim Form
The document required by insurers or superannuation funds to formally begin a claim. It typically requests personal details, medical information, employment history, and the nature of the illness or injury.
Claim Waiting Period
The minimum amount of time that must pass from the onset of illness or injury before benefits become payable under a policy. Waiting periods can range from a few weeks to several months, depending on the cover selected.
Commencement Date
The date on which an insurance policy or cover within a superannuation fund begins. This date is important because only events (such as illness or injury) occurring after the commencement date are usually covered.
Conditional Cover
Insurance cover that begins immediately upon application or membership but is subject to certain conditions. For example, some super funds provide conditional TPD or death cover until full underwriting is completed.
Contributions (Superannuation)
The money paid into a superannuation fund on behalf of a member. Contributions can come from an employer (super guarantee), the member (personal contributions), or the government (co-contributions). Insurance premiums for TPD or income protection cover are often deducted from these contributions.
Continuous Disability Clause
A clause in many income protection policies that requires a disability to be continuous for a certain period before benefits become payable. If the disability is not continuous, the claim may not qualify.
D
Death Benefit
A lump sum paid by a superannuation fund or life insurance policy to the deceased member’s nominated beneficiaries or dependants. The payment amount may include both the member’s account balance and any insured component attached to the fund.
Deferred Period
Also known as a waiting period, this is the length of time you must be off work due to illness or injury before benefit payments (such as income protection) commence. Typical deferred periods range from 14 days to 6 months.
Disability Definition
The specific wording in an insurance policy that explains what qualifies as a total and permanent disability (TPD) or temporary disability. Common definitions include “own occupation” (unable to work in your specific job) and “any occupation” (unable to work in any job suited to your education, training, or experience).
Disclosure
The legal obligation to provide accurate and complete information to an insurer when applying for cover. Non-disclosure or misrepresentation can affect whether a claim is accepted or declined.
Duty of Disclosure
A requirement under the Insurance Contracts Act that applicants must tell the insurer anything they know that is relevant to the insurer’s decision to accept the risk. Failure to comply may allow the insurer to reduce or refuse a claim.
Dispute Resolution
The process of resolving disagreements between a claimant and an insurer or superannuation fund. This may involve an internal review, a complaint to the Australian Financial Complaints Authority (AFCA), or, in some cases, court proceedings.
E
Early Release of Superannuation
A process that allows you to access part of your superannuation balance before reaching preservation age in limited circumstances, such as severe financial hardship, compassionate grounds, or permanent incapacity (TPD).
Eligible Person
A person who is entitled under legislation or superannuation fund rules to claim a benefit. For example, in death benefit claims, an eligible person may be a dependent, spouse, child, or someone in an interdependent relationship with the deceased.
Excess
An amount that may be deducted from an insurance payout before benefits are paid. While common in general insurance (e.g., car insurance), some income protection policies also contain excess-style provisions.
Exclusions
Specific circumstances or conditions listed in an insurance policy that are not covered. For example, a policy may exclude claims relating to self-inflicted injuries, certain pre-existing conditions, or hazardous activities.
Expiry Age
The maximum age at which certain insurance benefits can be paid. For example, income protection benefits often expire at age 65, while TPD cover through superannuation may expire at age 70 depending on the policy terms.
Extended Cover
An arrangement where an insurer continues to provide cover after employment ends, provided premiums are paid (often deducted from super). This is sometimes referred to as “continuation cover” and can prevent loss of insurance when changing jobs or leaving a fund.
F
Financial Hardship
A situation where a person cannot meet reasonable and immediate living expenses. In superannuation, members facing financial hardship may be able to apply for early release of some of their super.
Functional Capacity Assessment (FCA)
An evaluation, usually carried out by an occupational therapist or specialist, to measure a person’s ability to perform work-related tasks. Insurers and superannuation funds often request an FCA to help decide a TPD or income protection claim.
Fund Trustee
The legal entity responsible for managing a superannuation fund in the best interests of its members. Trustees make decisions on claims, including whether to release TPD or death benefits, in line with the fund rules and legislation.
Future Service Benefit
An additional insurance benefit sometimes included in superannuation-based TPD cover. It represents contributions the member would likely have made to their super if they had continued working until retirement age.
Fixed Term Benefit
A type of income protection or insurance benefit that is payable only for a set period (for example, 2 years or 5 years), regardless of whether the claimant remains unable to work beyond that time.
Fraudulent Non-Disclosure
When an applicant deliberately withholds or misrepresents information when applying for insurance. If proven, the insurer may cancel the policy and refuse to pay claims.
G
Gainful Employment
Work for which a person is remunerated, usually through wages, salary, or business income. Many TPD policies use this definition when assessing whether a claimant is able to return to any form of suitable work.
General Waiting Period
A standard period of time that must pass before certain superannuation or insurance benefits become payable. For example, income protection policies often include a general waiting period of 30, 60, or 90 days before payments commence.
Group Insurance
A type of insurance policy arranged by an employer or superannuation fund that covers a large number of people under a single contract. Most TPD and default death cover provided through superannuation is group insurance.
Grace Period
An additional period of time given after the due date for premium payment, during which cover remains active. If payment is not made within the grace period, the policy may lapse and claims may be declined.
Gross Income
A person’s total income before deductions such as tax or superannuation contributions. Income protection benefits are often calculated as a percentage of gross income.
Guaranteed Renewable Policy
An insurance policy that requires the insurer to continue cover as long as premiums are paid, regardless of changes to the insured person’s health or occupation. Most retail income protection and TPD policies are guaranteed renewable.
H
Hazardous Occupation
A job that involves higher-than-normal risk due to the nature of the work, such as mining, construction, or aviation. Insurers may charge higher premiums, impose exclusions, or limit cover for people in hazardous occupations.
Hazardous Pursuits / Activities
Recreational or lifestyle activities considered high risk by insurers — such as skydiving, scuba diving, motor racing, or mountaineering. Many policies exclude claims arising from these activities unless additional cover has been purchased.
Hybrid Policy
An insurance product that combines features of more than one type of policy. For example, a hybrid TPD policy may provide both “own occupation” and “any occupation” definitions of disability, giving broader cover.
Holding Trustee
In some superannuation arrangements, a holding trustee (also called a bare trustee) may temporarily hold assets or insurance proceeds on behalf of the member or beneficiaries until a final distribution is made.
Hospitalisation Clause
A provision in some income protection policies where benefits are payable immediately (or after a shorter waiting period) if the insured is confined to hospital for a specified number of days due to illness or injury.
Household Services Benefit
A feature in certain TPD or income protection policies that provides payments to cover the cost of domestic assistance, such as cleaning or childcare, if the insured is unable to perform those tasks due to disability.
I
Income Protection
An insurance policy that pays a regular benefit (usually monthly) if you are unable to work due to illness or injury. Benefits are typically a percentage of your pre-disability income and are paid for a set benefit period or until you can return to work.
Indexation
An automatic annual increase applied to insurance benefits to keep them in line with inflation or rising costs of living. For example, a TPD benefit of $200,000 may increase each year by the Consumer Price Index (CPI).
Insurer
The insurance company responsible for providing cover under a policy and assessing claims. In the context of superannuation, the insurer works alongside the fund trustee to decide whether benefits should be paid.
Interim Cover
Temporary insurance cover that begins when an application for permanent cover is lodged but has not yet been fully assessed. Interim cover often has limitations and may only apply to certain events such as accidental injury or death.
Invalidity Benefit
A payment from a superannuation fund if a member permanently ceases work due to physical or mental ill-health. Invalidity benefits are usually linked to TPD definitions under superannuation law.
Involuntary Unemployment Clause
A clause in some income protection or loan protection policies that provides limited cover if you lose your job through redundancy or employer insolvency, subject to strict eligibility criteria.
Insurable Interest
A legal requirement that the policyholder has a genuine interest in the life or wellbeing of the person insured. For example, you can usually insure your own life, but not a stranger’s.
J
Job Classification
The category assigned to your occupation by an insurer when determining risk levels, premiums, and policy terms. For example, “professional/clerical” jobs may attract lower premiums than “manual labour” or “hazardous” occupations.
Joint Policy
An insurance policy that covers two people under one contract, often spouses or business partners. Benefits may be payable if either insured person suffers TPD, death, or another insured event.
Jurisdiction
The legal authority under which a dispute or claim is decided. For TPD, income protection, or superannuation matters in Australia, disputes may be handled under federal legislation, state laws, or through external dispute resolution bodies like AFCA (Australian Financial Complaints Authority).
Judicial Review
A process where a court reviews the decision-making process of a trustee or insurer (rather than the merits of the claim itself) to ensure it was lawful and fair.
K
Key Person Insurance
A type of insurance (usually held by a business) that provides a benefit if a key employee, owner, or director becomes totally and permanently disabled, suffers trauma, or dies. The payout helps the business cover lost revenue, recruit replacements, or repay debts.
Knowledge Test
A legal assessment sometimes used in disputes to determine whether a trustee, insurer, or decision-maker had sufficient information and acted reasonably when making a decision about a claim. It ensures decisions are based on proper consideration of the evidence.
Known Condition
A medical condition that an applicant already has (or has had symptoms of) before applying for insurance cover. Many policies treat known conditions as pre-existing and may exclude them unless disclosed and specifically accepted by the insurer.
L
Lapse of Cover
When an insurance policy ends because premiums have not been paid within the required time. Once cover has lapsed, the insurer is no longer liable to pay benefits, and the policyholder may need to reapply (often with new underwriting).
Life Insurance
A type of insurance that pays a lump sum to nominated beneficiaries or dependants if the insured person dies or, in some policies, is diagnosed with a terminal illness. Life insurance is commonly bundled with TPD cover inside superannuation.
Limited Cover
A restriction placed on some superannuation-based insurance policies, often when automatic cover is provided without full health checks. Under limited cover, claims are only payable for accidents or certain events for a set period, usually 12–24 months, until full cover activates.
Loading (Premium Loading)
An additional cost added to insurance premiums because the insured person presents a higher risk. For example, premium loadings may apply due to pre-existing health conditions, smoking status, or hazardous occupations.
Lump Sum Benefit
A one-off payment made under an insurance policy, such as TPD, trauma, or life insurance. Unlike income protection (which pays ongoing monthly benefits), lump sum benefits are designed to provide immediate financial support.
Lump Sum Tax
Tax payable on certain superannuation benefits received as a lump sum, including TPD payouts. The amount of tax depends on factors such as the member’s age, components of the benefit, and whether the payment is taken before preservation age.
M
Maximum Benefit Period
The longest period that an income protection policy will pay benefits. Common maximum benefit periods are 2 years, 5 years, or up to age 65, depending on the policy terms.
Member Benefit
The balance held in a member’s superannuation account, which may include employer contributions, personal contributions, investment earnings, and any attached insurance cover such as TPD or death benefits.
Medical Certificate
A formal statement from a treating doctor or specialist confirming a person’s medical condition, work capacity, or prognosis. Insurers and superannuation funds often require medical certificates as part of a TPD or income protection claim.
Medical Definitions
The descriptions in a policy that set out the medical criteria required to qualify for a benefit. For example, some trauma policies define specific illnesses (such as cancer or stroke) that must meet certain diagnostic thresholds to trigger a claim.
Medical Evidence
All medical information used to assess a claim, including reports from doctors, hospital records, test results, and specialist assessments. The strength of medical evidence is often critical in determining whether a claim is accepted.
Member Statement
A document provided by a superannuation fund that outlines a member’s contributions, account balance, fees, investment returns, and details of any insurance cover linked to the fund.
Monthly Benefit
The regular payment made under an income protection policy, usually calculated as a percentage of the insured’s pre-disability income. Payments are often made monthly in arrears.
N
Non-Disclosure
When an applicant for insurance fails to tell the insurer something relevant about their health, lifestyle, or occupation. Non-disclosure (whether accidental or intentional) may allow the insurer to reduce, delay, or deny a claim.
Non-Occupational Cover
Insurance that only covers events not related to work. For example, some default superannuation policies may provide “non-occupational TPD” cover that only pays if the disability occurs outside the workplace.
Notice Period
The amount of notice an employee or insured person must give before ending employment or cancelling a policy. Some insurance benefits (like income protection) may also include a required notice period before claims are processed.
Nomination of Beneficiary
A formal instruction by a superannuation fund member naming who should receive their death benefit if they pass away. Nominations can be binding (must be followed if valid) or non-binding (the trustee has discretion but will consider the nomination).
Non-Renewable Policy
An insurance policy that has a fixed term and does not automatically renew at the end of that term. The insured would need to apply for new cover once it expires.
Normal Retirement Age
The age at which a superannuation member is expected to retire, usually between 60 and 67 depending on legislation and fund rules. Many TPD policies inside super specify that benefits cease once the member reaches normal retirement age.
O
Offset Clause
A provision in many income protection policies that reduces the benefit payable if the claimant is receiving other income or benefits. For example, workers’ compensation or Centrelink payments may be offset against income protection benefits.
Own Occupation (TPD Definition)
A definition of total and permanent disability where a claim is assessed based on the insured’s ability to return to their specific occupation at the time of disablement. This is often broader cover than “Any Occupation” TPD, but it is generally more expensive and not always available through superannuation.
Occupational Classification
The category an insurer assigns to an applicant’s job when determining risk, premiums, and policy terms. Different occupations may be considered low, medium, or high risk depending on the likelihood of injury or illness.
Occupation Rating
A rating system used by insurers to reflect the level of risk associated with a person’s job. It directly influences the cost of premiums and whether certain exclusions apply.
Out-of-Pocket Expenses
Costs that a claimant must personally pay and that are not covered by insurance or superannuation benefits. These may include medical costs, rehabilitation, or ongoing care expenses.
Overinsurance
When the total amount of insurance cover held by a person (e.g., multiple income protection or TPD policies) exceeds their financial needs or allowable limits. Insurers may reduce benefits to avoid overinsurance.
P
Partial Disability
A condition where a person is not totally disabled but is still unable to work to their full capacity. Many income protection policies provide partial disability benefits to cover reduced earnings while the person is working in a limited capacity.
Permanent Incapacity
A condition defined in superannuation law where a member is unlikely, because of ill-health, to ever work again in a job for which they are reasonably qualified by education, training, or experience. This is often the legal basis for accessing TPD benefits through superannuation.
Policy Owner
The person or entity who owns an insurance policy and has the legal right to make changes, pay premiums, and receive benefits (unless assigned to another party, such as a super fund).
Policy Schedule
The document provided by an insurer that outlines the key details of a policy, such as the type of cover, benefit amount, waiting period, and expiry date. It forms part of the overall contract of insurance.
Premium
The amount of money paid (usually monthly or annually) to maintain an insurance policy. Premiums may be fixed or stepped, depending on whether they stay constant or increase with age.
Premium Loading
An extra cost added to a standard premium because the insured person presents a higher level of risk — for example, due to health history, occupation, or lifestyle factors.
Preservation Age
The age at which you can generally access your superannuation, currently between 55 and 60 depending on your date of birth. TPD benefits paid through super may be subject to preservation rules.
Product Disclosure Statement (PDS)
A legal document provided by an insurer that explains the terms, conditions, exclusions, and features of an insurance product. It is designed to help consumers make informed decisions before purchasing cover.
Q
Qualifying Period
The minimum time you must wait before being eligible to claim under a policy. For example, some trauma or income protection benefits only become available after the cover has been in place for a set period, such as 90 days.
Quality of Life Benefit
An additional payment in some insurance policies that recognises a severe impact on day-to-day living, such as the loss of independence or the need for permanent care. This is separate from standard TPD or income protection benefits.
Quotation (Insurance Quote)
An estimate provided by an insurer outlining the cost of premiums, levels of cover available, and any loadings or exclusions. A quotation is not a binding contract but helps members understand the cost and terms before taking out cover.
Quorum
In the context of superannuation and insurance claims, a quorum refers to the minimum number of trustee directors required to be present at a meeting to make a valid decision, such as the approval of a benefit payment.
R
Reinstatement
The process of restoring an insurance policy that has lapsed (usually due to unpaid premiums). Reinstatement may require the policyholder to provide updated health information or meet new conditions set by the insurer.
Residual Disability
A condition where the insured is able to return to work in some capacity but cannot perform their full duties or hours. Many income protection policies provide a residual disability benefit that pays a proportionate amount to cover lost income.
Retirement Age
The age at which a superannuation member can usually access their full retirement benefits. For most Australians, this is between 60 and 67 depending on birth year. TPD benefits through super typically cease once a member reaches retirement age.
Review Period
The timeframe in which an insurer or superannuation trustee reassesses an ongoing claim to ensure eligibility continues. For example, some income protection claims are reviewed every 12 months.
Rider (Policy Rider)
An optional extra or amendment added to an insurance policy to provide additional benefits or alter coverage. For example, a rider might extend an income protection policy to cover specific expenses.
Roll-Over (Superannuation Roll-Over)
The transfer of superannuation funds from one account or fund to another. Care should be taken when rolling over super, as it can sometimes cancel insurance cover such as TPD or income protection attached to the original fund.
Return to Work Program
A rehabilitation program designed to help an injured or ill worker gradually re-enter the workforce. Participation may be encouraged or required by insurers during an income protection claim.
S
Salary Continuance Insurance
Another term for income protection insurance. It provides ongoing monthly payments (usually a percentage of pre-disability income) if you are unable to work due to illness or injury.
Stepped Premiums
A type of insurance premium structure where the cost increases each year as you get older. While cheaper in the early years, stepped premiums can become significantly more expensive over time compared to level premiums.
Standard Risk
An insurance classification given to applicants who present an average level of risk based on health, age, and occupation. Standard risk applicants pay normal premiums without loadings or exclusions.
Superannuation Trustee
The entity or board of directors responsible for managing a superannuation fund in the best interests of its members. Trustees decide on claims and benefit payments in line with legislation and the fund’s governing rules.
Superannuation Death Benefit
A payment made from a superannuation fund to a member’s beneficiaries or estate upon their death. It may include both the account balance and any insurance cover attached to the fund.
Statutory Declaration
A written statement declared to be true in the presence of an authorised witness. Insurers or trustees may require a statutory declaration as part of the claims process to confirm facts such as employment status or living arrangements.
Success Fee / Uplift Fee
An additional fee that some law firms charge on top of their standard costs if a claim is successful. At TPD Claims Lawyers, we do not charge uplift or success fees under our No Win No Fee terms.
Supplementary Benefit
An extra payment provided under some insurance policies in addition to the standard benefit. This might include rehabilitation expenses, accommodation benefits, or child care support.
T
Terminal Illness Benefit
A lump sum paid when a person is diagnosed with a terminal illness and has a life expectancy (usually certified by two medical practitioners) of less than 12–24 months. This benefit is often available through life insurance or superannuation.
Total and Permanent Disability (TPD)
A type of insurance cover that pays a lump sum if you are unlikely to ever return to work due to illness or injury. TPD can be defined as “own occupation” (unable to work in your specific job) or “any occupation” (unable to work in any job suited to your education, training, or experience).
TPD Benefit
The lump sum payment made under a TPD policy when a claim is accepted. It is designed to provide financial support to cover living expenses, debts, and medical or care costs.
TPD Exclusion
A clause in an insurance policy that limits TPD cover in certain circumstances. Common exclusions include claims arising from self-inflicted injuries, criminal activity, or pre-existing conditions not disclosed at the time of application.
Trustee Duty
The legal responsibility of superannuation fund trustees to act in the best interests of members. In TPD and death benefit claims, trustees must assess applications fairly, reasonably, and in line with the fund’s rules and superannuation law.
Trauma Insurance (Critical Illness Cover)
A type of insurance that pays a lump sum if you are diagnosed with one of the specified serious medical conditions listed in the policy, such as cancer, stroke, or heart attack. Trauma cover is separate from TPD and income protection.
Temporary Disability Benefit
A benefit provided under some income protection or TPD policies that pays a limited amount if you are temporarily unable to work due to illness or injury, but are expected to recover.
Trust Deed
The legal document that sets out the rules under which a superannuation fund operates. The trust deed governs how contributions are managed, how benefits are paid, and how claims are assessed.
U
Underwriting
The process an insurer uses to assess the risk of providing cover. It may involve questions about health, occupation, lifestyle, and family history. Depending on the outcome, the insurer may accept cover on standard terms, apply loadings or exclusions, or decline the application.
Unitised Cover
A type of insurance offered through superannuation where the amount of cover is based on “units.” The value of each unit is set by the fund and usually decreases as you get older, meaning the level of cover reduces over time unless you increase the number of units.
Unclaimed Super
Superannuation benefits that have not been claimed by the member and are transferred to the Australian Taxation Office (ATO). This can occur when accounts are inactive, have low balances, or when the fund loses contact with the member.
Uninsurable Condition
A medical or personal condition that makes it too risky for an insurer to provide cover. If a condition is deemed uninsurable, the insurer may decline to offer a policy or exclude the condition from cover.
Uplift Fee / Success Fee
An additional fee that some law firms charge on top of their standard legal costs if a claim is successful. At TPD Claims Lawyers, we do not charge uplift or success fees under our No Win No Fee terms.
Urgent Claim
A claim that is prioritised for faster assessment because of financial hardship, terminal illness, or other exceptional circumstances. Insurers and super funds may fast-track urgent claims to ensure support is provided quickly.
V
Valid Claim
A claim that meets all of the policy’s requirements and is supported by the necessary evidence. A valid claim must satisfy the policy definitions, waiting periods, and any disclosure obligations.
Variation of Policy
A change made to an existing insurance policy, such as increasing the benefit amount, extending the expiry age, or altering premium payment terms. Variations may require underwriting or acceptance by the insurer.
Vesting (Superannuation)
The process by which superannuation contributions and earnings become the member’s legal entitlement. In Australia, employer contributions made under the Superannuation Guarantee are immediately vested in the employee.
Voluntary Contributions
Extra payments made by an individual into their superannuation fund in addition to compulsory employer contributions. Voluntary contributions can help increase retirement savings and may also help maintain insurance cover within superannuation.
Voluntary Disclosure
Providing information to an insurer or trustee beyond what is strictly required. Voluntary disclosure (for example, of a past medical condition) may help avoid disputes about non-disclosure if a claim is lodged later.
W
Waiting Period
The minimum amount of time that must pass after becoming ill or injured before insurance benefits (such as income protection) start being paid. Waiting periods are chosen when taking out cover and can range from 14 days to several months.
Work Capacity Assessment
An evaluation (often requested by an insurer or trustee) to determine whether a person can perform their current job or any other work for which they are suited by education, training, or experience. These assessments are critical in TPD and income protection claims.
Without Prejudice Offer
An offer made by an insurer or fund during a dispute that is not an admission of liability. Such offers are designed to encourage settlement and generally cannot be used against the party if the matter proceeds to court or AFCA.
Withdrawal Benefit
A payment of a member’s superannuation account balance when they meet a condition of release, such as retirement, reaching preservation age, or permanent incapacity (TPD).
Whole Person Impairment (WPI)
A medical assessment used in some compensation systems to measure the overall degree of permanent impairment to the body. While not always used in TPD claims, WPI ratings can be relevant in workers’ compensation or statutory insurance schemes.
Work Test (Superannuation)
A requirement under superannuation law for individuals aged 67–74 to demonstrate they are gainfully employed for at least 40 hours over a 30-day period in a financial year before they can claim certain tax concessions on personal contributions.
X
Ex Gratia Payment (Cross-reference “X”)
Sometimes informally referred to as an “X-gratia payment.” This is a payment made by an insurer, trustee, or employer as a goodwill gesture, even though they are not legally required to pay under the policy or law. These payments are rare and usually discretionary.
Excluded Condition (see also Exclusion)
Occasionally written as “X Condition” in policy schedules. This refers to a medical condition specifically excluded from cover by the insurer, often due to pre-existing history or risk factors.
XML Data (Insurance Processing)
A technical term, but relevant in superannuation and insurance administration. XML (Extensible Markup Language) is often used by funds, insurers, and regulators to exchange claim data securely and consistently.
Y
Yearly Renewable Term (YRT) Insurance
A type of insurance where the premium is recalculated and renewed each year based on the insured’s age and risk factors. Many group life and TPD policies inside superannuation are structured as YRT cover, which means premiums typically increase as you get older.
Yield (Investment Return)
In superannuation, yield refers to the earnings generated by investments (such as interest, dividends, or capital gains) on the fund’s assets. While not directly part of TPD claims, investment yield impacts the overall super balance from which insurance premiums are often deducted.
Youth Discount (Insurance Premiums)
Some insurers and superannuation funds apply reduced premiums (a “youth discount”) for younger members, reflecting the lower risk of claim at early ages. Premiums usually increase as members age.
Z
Zero Balance / Zero Premium Account
A superannuation account that no longer holds funds because the balance has been fully withdrawn or transferred. If premiums cannot be deducted due to a zero balance, any attached insurance cover (including TPD) may lapse.
Zurich Insurance
One of the major insurers operating in Australia that provides life, TPD, trauma, and income protection products. Zurich also partners with some superannuation funds to provide group insurance cover for members.
Zonal Pricing
A premium calculation method where insurance costs vary depending on geographical region or risk area. While more common in general insurance, it can sometimes apply to income protection policies where regional risk factors are considered.
Why Choose TPD Claims Lawyers
Supportive. Focused. Proven.
We help you access TPD, income protection, and death benefit payouts — with expert guidance and real results.
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Core Values
Guided by experience, driven by results
We are dedicated to helping Australians access their full insurance entitlements with clarity, compassion, and persistence. Our values shape how we approach every claim and how we support every client.
Our Mission
TPD Claims Lawyers is a specialist legal team dedicated to helping Australians access their full insurance entitlements when injury or illness prevents them from working. As part of the Carter Capner Law group, we proudly carry on a tradition of legal excellence that spans over 75 years.
Our mission is to apply our deep knowledge of TPD, income protection, and death benefit claims to deliver legal outcomes that truly support our clients’ financial recovery and peace of mind. We aim to simplify complex processes and provide guidance every step of the way.
We are committed to acting with compassion, integrity, and precision — anticipating obstacles and addressing them with strategy and care to achieve the best result possible for every client.
Our Approach
Exceptional legal service is about more than just lodging forms — it’s about supporting you through one of life’s most difficult moments with clarity, compassion, and experience.
We understand that every person’s situation is unique. Whether you’re navigating a Total and Permanent Disability (TPD) claim, pursuing income protection benefits, or seeking a death benefit after losing a loved one, we take the time to learn about your circumstances in full. We don’t just process claims — we listen, investigate, advise, and act in your best interests at every stage.
Our firm is built around a simple but powerful idea: people first. We take a compassionate, client-focused approach that makes legal processes less overwhelming. We cut through complexity and communicate in plain language — not legal jargon — so you feel informed and empowered from start to finish.
To ensure your matter progresses efficiently, we use up-to-date case management systems that allow our team to provide real-time updates. You’ll never be left wondering where your claim stands — and we’re always available to answer questions when you need us.
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