TPD (Total Permanent Disability) insurance is meant to provide security if you cannot work for at least two years due to a severe accident or illness. However, the insurer can reject your TPD claim on some grounds.
So if you are wondering what to do if you TPD claim is rejected, there are a few solutions. Knowing the common reasons (and how to fix them) makes it easier for you to follow up with your insurer and financial planner. The most common reasons why your TPD claim might be refused include:
- Wrong Diagnosis
Before submitting your claim to the insurer, you will need to have a medical diagnosis that confirms that TPD is your only option. Before doing so, make sure you work with an insurance specialist to provide accurate information about your condition. It can be avoided if you obtain the necessary facts from the hospital to get treatment. If you do not, the chances are that your TPD claim will be rejected.
- Unsatisfactory Evidence
Before submitting your claim, you need to know what information or documents the insurer asks for and when they ask for it. This way, there won’t be any problem providing them with the necessary evidence. Otherwise, you might find yourself rejected even before your TPD claim is processed.
- Changing Your Mind
Insurance companies consider TPD insurance an investment because it has a limited window for submitting claims—and if they don’t process it within that time frame, then no payout will be made. It is also why they will reject your claim if you change your mind or cancel it for any reason before you are approved.
- Not Disclosing Any Pre-Existing Conditions
Before signing up for TPD insurance, it is essential to be honest about any pre-existing condition that might affect your claim later on—if not, this might be used against you later. When your TPD claim is rejected, checking through the insurance terms should be your top priority.
- Claim Submitted Too Late
There is a time limit to submitting your claim, usually six months after the TPD event—and if it’s more than that, then expect your insurer to reject it (although some will still process it but with an additional fee). To avoid this, make sure to follow up with your insurance specialist and provide the necessary documentation as soon as possible.
If you think that your TPD claim has been rejected for one of the reasons mentioned above, it is best to double-check with your specialist and find out what else you can do to get back on track. They might have missed something, or the insurer needs documents from someone else involved in the process. If so, then ask them to provide it as soon as possible.
The insurer might also ask you to get another medical examination before processing your claim. If that’s the case, then take that into account and schedule something with the hospital—make sure this new diagnosis is accurate before submitting it again to the insurance company.
If you feel that you’ve been unfairly rejected, then make sure to file an appeal and explain your side. For a faster resolution, it is best to hire a TPD lawyer that can help put together your case and show it in a way that will give you the best chances of getting approved. Here’s how they can help:
- Applying on your behalf and, if approved, start the payout immediately even before you’ve stopped working;
- It enables you to get compensated for your treatment, medication, and rehabilitation;
- It helps reduce paperwork to focus on more important things—like your recovery.
It’s crucial to note that there is a time limit in filing for legal action after the rejection of the claim has been received. If you miss the deadline, the insurer will not be held liable—so make sure to consult with a lawyer immediately.