Total and Permanent Disability Insurance - The what, why and how - Part two

What is the right TPD cover? - Own Occupation vs Any Occupation

The cover provided by a TPD insurance policy will typically fall under two categories: ‘Own Occupation’ or ‘Any Occupation’.

Own Occupation

These policies are ordinarily obtained independent of your superannuation, either through private life or trauma policies. An Own Occupation policy covers you if you are unlikely to return to the role you were working in at the time of your permanent disablement. 

Any Occupation 

These policies are the standard policy available within your superannuation. In order to meet the definition of Any Occupation, you generally need to prove that you are unlikely to ever be able to engage in any form of regular paid work again. 

If you are not working at the time of the disablement, some policies may still allow a claim under an Any Occupation policy. However, the criteria to qualify for the claim is usually quite onerous, and can include the need for you to demonstrate that you have an inability to perform certain activities of daily living, such as independent personal care, toileting, eating or drinking, or significant injuries such as the loss of a limb or sight.

If your TPD cover is found under a superannuation policy, the amount of cover you have may decrease over time, although it will usually crystallise as at the time you make the claim.

When taking out standalone TPD insurance, other important factors to consider are:

  • The cost of the cover -  This will be determined by your age, health, occupation, level of cover and the provider
  • The features and definitions of the policy - This should be discussed with the broker or lawyer to ensure that you are getting the right cover to ensure you have the right protection for your particular circumstances
  • What pre-existing or other conditions you will need to disclose - Insures can refuse cover for certain conditions and deny a claim if full and open disclosure is not provided at the commencement of the policy;
  • Any exclusions or restrictions on claims - As all policies come with exclusions, it is important to review them to determine what is covered under the policy and what is not.

For tailored advice you should speak with your insurance broker to find out what insurance product is best suited to you.

If you need to make a claim, we recommend seeking early legal advice.  For further information or discussion please contact a member of the Insurance team at HopgoodGanim Lawyers.

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