Total and Permanent Disability (TPD) Insurance

For most owners and professionals, earning capacity is one of the most valuable assets they hold and it is rarely insured with the same discipline as property or liability. Total and permanent disability cover is designed to answer the financial side of a permanent loss of that capacity. It pays a lump sum where the insured person meets the policy’s definition of total and permanent disability, which can help clear debt, fund care and rehabilitation and replace earning capacity that will not return.

The definition is the centre of this cover and it deserves care. Policies are commonly written on an “own occupation” or an “any occupation” basis and the two are materially different in when a claim is payable. We explain those definitions generically and cautiously, because which definition applies and how it is worded, shapes how the cover responds. We do not assert which definition applies to you or promise how a claim will be assessed.

DKG is an advisory-led general insurance broker with specialist Life and People Risk capability. We advise before we place. We help you understand how TPD cover sits within a personal-risk programme that may also include life, income protection and trauma cover and we set honest expectations about underwriting and definitions before cover is placed. Cover is shaped by disclosure, health, occupation and insurer appetite and is always subject to policy wording.

What are the benefits?

• A lump sum designed to be available where illness or injury permanently prevents you from working, as defined by the policy.
• Funds that can help clear debt that personal income would otherwise have serviced.
• Funds that can support the cost of care, rehabilitation and adapting to a permanent change in circumstances.
• A way to replace earning capacity that is not expected to return, designed around your obligations.
• Cover that can sit alongside life, income protection and trauma cover, so the personal-risk programme answers more than one event.
• An adviser who explains the occupation definitions clearly and acts as your advocate if a claim is made.

What can it cover?

TPD cover is often held alongside or attached to life cover. In general terms and subject to underwriting, terms, conditions, exclusions and policy wording, cover can be designed to provide:

• A lump sum where the insured person meets the policy’s definition of total and permanent disability.
• A benefit assessed against an “own occupation” or “any occupation” definition, depending on how the policy is written. These definitions differ in when a claim is payable and we explain the difference before cover is placed.
• Funds that can help clear debt, fund care and rehabilitation and replace lost earning capacity.
• Cover structured to work alongside life, income protection and trauma cover within a personal-risk programme.

Which definition and structure suit you depend on your occupation, your obligations and what underwriting will support. We work through that with you before any cover is placed.

What usually isn’t covered?

Cover responds to the policy’s definition of total and permanent disability and the events the policy is written to answer. In general terms and subject to policy wording, the following are usually not covered:

• Conditions that do not meet the policy’s TPD definition.
• Undisclosed pre-existing conditions.
• Self-inflicted injury.
• Exclusions noted and agreed at underwriting.

What a policy covers and excludes is determined by the insurer and the policy wording. The occupation definition and the disclosure made at application both shape how a policy responds and we explain that before cover is placed.

How DKG supports you

We start with your reliance on personal earning capacity and your obligations, then help you understand how TPD cover is defined and where it fits within a wider personal-risk programme. We take particular care with the “own occupation” and “any occupation” definitions, because they materially affect when a claim is payable. We do not provide personal financial, legal or tax advice on these life-risk lines and we refer those questions to the appropriate adviser.

When a claim is made, total and permanent disability claims are often evidence-heavy and turn on the policy definition. We act as your advocate from notification through to resolution. We help prepare and present the claim, work through the definition and the medical and other evidence and manage insurer engagement. The insurer and the policy wording determine the outcome and we make no representation as to claim results.

DKG’s Life and People Risk practice is led by Marnie Maloney, Head of Life and People Risk. She brings more than 20 years of experience in life insurance and financial advice, with deep expertise across personal risk advice, business succession planning and corporate protection. To review your total and permanent disability cover and how it is defined, contact Marnie via email or phone on 1800 252 926.

Other cover may be considered and additional exclusions may apply.

Related services include:

• Personal Life Insurance
• Income Protection Insurance
• Trauma Insurance
• Buy-Sell and Key Person Insurance

Important note− The information provided is general advice only and has been prepared without taking into account your objectives, financial situation or needs. When making decisions about total and permanent disability insurance, please consider the Product Disclosure Statement.