What to do if your TPD claim is rejected.
Having your total and permanent disability (TPD) claim rejected can feel overwhelming, especially when you’re already dealing with the stress of illness or injury. But a rejection isn’t the end of the road. Many declined claims are later overturned, and with the right legal support, you could still receive the benefits you’re entitled to.
At Law Partners, we’re Australia’s largest specialist personal injury firm, and we’ve helped hundreds of Australians successfully appeal rejected TPD claims. If your claim has been declined and we think that’s an incorrect decision, we’re here to help you fight back and win.
Why TPD claims are rejected.
TPD claims are often rejected for reasons that don’t reflect the full picture. Insurers rely on strict definitions and limited evidence, and they don’t always get it right. Here are some of the most common reasons we see:
- Non-disclosure or misrepresentation issues
- Not meeting treatment or waiting period requirements
- Not meeting the policy’s definition of total and permanent disability
- Insufficient or inconsistent medical evidence
- Insurer says you can still work in some form
- Not meeting work history or age requirements
- Contradictory reports (e.g. insurer’s medical examiner, surveillance footage)
What a rejection letter really means.
Receiving a rejection letter can be disheartening, but it’s also a valuable document. It outlines the insurer’s reasoning and gives you clues about how to challenge their decision.
Before you respond, take time to review the letter carefully. Here are five key things to look for:
- The exact policy definition they’ve applied
- Medical evidence they’ve relied on
- Timeframe for responding or appealing
- Whether internal review or AFCA is mentioned (see below)
- Contact details for the insurer’s dispute team
Many rejections are based on narrow interpretations or missing evidence. That’s why it’s critical to seek expert advice before taking your next step.
Your options after a TPD claim is declined.
If your claim has been rejected, you still have several pathways to challenge the decision. Each option has its own process and time limits, so it’s important to act quickly. Let’s take a look at these options now.
This is the first step in the appeals process and is handled by a different decision-maker within the insurer. It’s free and often successful when new or stronger evidence is submitted.
At Law Partners, we go further than a standard internal review that an insurer may conduct. We also lodge a formal complaint under Section 101 of the SIS Act, which requires trustees to respond within 45 days (a requirement under the ASIC Regulatory Guide 271). If the claim is rejected again, we can seek Counsel’s advice on your prospects of going to court, on a no win, no fee basis.
The Australian Financial Complaints Authority (AFCA) is an independent body that handles disputes involving superannuation and insurance. It’s a free service and its decisions are binding for super disputes. Key considerations with AFCA include:
- A two-year time limit from the date of rejection
- It focuses on fairness, with mediation before formal decisions
- This approach often leads to resolution without needing court action
Court is a last resort, but it can be a powerful one. Many cases settle before trial, and having legal representation is essential. Here’s what you need to know:
- There’s a six-year timeframe to lodge
- Lawyers manage evidence, deadlines, and negotiations
- This approach can sometimes result in substantial settlements
Don’t miss critical deadlines: Contact Law Partners to protect your right to appeal.
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Why mental health TPD claims are often rejected.
Mental health-related TPD claims are more likely to be rejected than claims for physical injuries. According to the Australian Prudential Regulation Authority (APRA), psychiatric conditions consistently rank among the most declined claim types, with rejection rates typically ranging from 17% to 29% depending on the insurer and policy*
Insurers often argue that:
- Symptoms are variable or not permanent
- Treatment hasn’t been consistent
- You still have “capacity to work” in some form
At Law Partners, we specialise in psychiatric TPD claims. We work with independent psychiatrists, gather detailed evidence, and challenge insurer bias. We’ve helped many Australians with depression, PTSD, anxiety and other conditions secure the benefits they were initially denied.
*Source: APRA Life Insurance Claims and Disputes Statistics, June 2024. Available at apra.gov.au
How we help overturn rejected TPD claims.
Appealing a rejected claim takes more than just resubmitting paperwork. It requires a strategic, evidence-based approach. Here’s how we help, as your Law Partners TPD legal team will:
- Review your policy wording and definitions
- Arrange independent medical assessments (at no upfront cost)
- Build evidence packages insurers can’t ignore
- Challenge shortcuts like rushed reviews or biased experts
- Manage strict appeal deadlines
- Provide compassionate support to you throughout, not just legal paperwork
Real stories: from rejected to approved.
Ali was a university student when he was rear-ended on the motorway. His physical injuries were minor, but his mental health deteriorated rapidly. Diagnosed with PTSD, Ali couldn’t continue his studies or part-time jobs. His condition worsened over time, and he became socially isolated, anxious, and unable to drive.
Initially, Ali’s TPD claim was rejected. But our team at Law Partners recognised the legitimacy of his case and took over the process. We gathered psychiatric reports, personal statements, and built a compelling submission. The insurer reversed their decision, and Ali received a TPD payout of just over $629,000.
“I’ll never forget their kindness and the way they went into bat for me,” Ali says. “I now have the financial assistance to navigate what lies ahead.”
FAQs about rejected TPD claims.
Here are answers to some of the most common questions we receive about rejected TPD claims.
Can I appeal if I missed the deadline?
Yes, in some cases. If there were circumstances beyond your control, we may be able to argue for an extension.
Do mental health claims really have a lower success rate?
Yes, but with the right evidence and legal support, they can absolutely succeed.
Can I make multiple TPD claims?
Yes, if you have more than one super fund with TPD cover, you can claim against each policy.
How long does the appeal process take?
Anywhere from a few months to over a year, depending on the complexity and the appeal pathway.
What if my insurer puts me under surveillance?
It’s legal, but we can challenge surveillance if it’s misleading or taken out of context.
Why choose Law Partners?
Choosing the right legal team can make all the difference. Here’s why so many Australians trust Law Partners with their TPD claims:
- We’re proud to be Australia’s largest specialist personal injury firm
- Our team brings decades of experience in superannuation and TPD disputes
- We lead with compassion and always put our clients first
- You won’t pay unless we win – and there are no hidden costs, ever
- We’ve helped countless clients turn rejected claims into successful payouts
Get help today.
If your TPD claim has been rejected, don’t give up. With the right help, your outcome could be very different. Contact Law Partners today for free advice and let us help you fight for the benefits you deserve.
Get FREE claim advice today.
Call now to talk to one of our friendly lawyers and arrange a phone or video consultation. We’ll listen to you, review your situation, and tell you how much you can claim.
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