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PERSONAL INJURY

TPD Claims

When Disability Changes Your Life, We Help Secure Your Future.

At Gouveia Legal, we’re committed to helping Australians secure the policy benefits they’re entitled to when dealing with insurance companies. We know that being out of work or facing financial stress can make it hard to cover legal costs, which is why we offer a No Win, No Fee promise. You won’t pay any legal fees unless we successfully resolve your case. This support is available to clients nationwide, no matter where in Australia you live.

What Is A TPD Claim?

TPD insurance provides a lump sum payment if you become totally and permanently disabled and unable to work. Most Australians have TPD coverage through their superannuation fund—often without realising it. You may also have standalone TPD policies through private insurance.

The definition of "total and permanent disability" varies between policies but
 typically falls into two categories:

Successful TPD claims can provide substantial financial relief, with benefits ranging from $100,000 to over $1million depending on your policy and circumstances.

Any Occupation

You must be unable to work in any occupation for which you're reasonably suited by education, training, or experience.

Own Occupation

You must be unable to work in your specific occupation—a more favorable definition that's easier to satisfy.

Who Can Make A TPD Claim?

You may be eligible for a TPD claim if:

  • You’ve been unable to work due to illness or injury for an extended
period (typically 3-6 months).
  • Your condition is unlikely to improve enough for you to return to work.
  • You meet your policy’s specific definition of total and permanent disability.
  • You were covered by the policy when you became disabled.

TPD claims can cover various conditions, including:

Even if you’re receiving workers compensation or other benefits, you may still be entitled to TPD payments.

  • Physical injuries (spinal injuries, amputations, severe burns).
  • Chronic illnesses (cancer, heart disease, autoimmune conditions).
  • Mental health conditions (severe depression, PTSD, bipolar disorder).
  • Neurological disorders (multiple sclerosis, Parkinson’s disease).
  • Vision or hearing loss

The TPD Claims Process:
What To Expect

This process typically takes 3-12 months, though complex cases may take longer.
The TPD claims process involves several stages: 

1. Policy Identification

Locating all your super funds and insurance policies that may contain TPD coverage.

2. Eligibility Assessment

Determining whether you meet the specific criteria outlined in your policies.

3. Medical Evidence

Gathering comprehensive medical reports that document your condition and prognosis.

4. Claim Preparation

Completing detailed claim forms and preparing supporting documentation.

5. Insurer Assessment

The insurer reviews your claim, which may involve additional medical examinations.

6. Determination

The insurer either approves your claim, requests more information, or issues a denial.

7. Resolution

If approved, you receive your benefit; if denied, we pursue dispute resolution options.

The TPD Claims Process:What To Expect

This process typically takes 3-12 months, though complex cases may take longer. The TPD claims process involves several stages: 

Policy Identification

Locating all your super funds and insurance policies that may contain TPD coverage.

Why TPD Claims Are Often Rejected (And How We Overcome This)

This process typically takes 3-12 months, though complex cases may take longer.

Incomplete or inconsistent medical evidence

Surveillance evidence contradicting disability claims

Pre-existing condition exclusions

Missed premium payments or lapsed policies

Strict interpretation of policy definitions

Failure to satisfy waiting periods

How We Help Maximise Your TPD Claim Success

Our comprehensive TPD claims service includes:

1.Superannuation Search

We identify all your super accounts and associated insurance policies, ensuring no potential benefits are overlooked.

2. Policy Analysis

We carefully review policy documents to understand specific definitions, exclusions, and requirements that apply to your case.

3. Strategic Medical Evidence

We work with your treating doctors to ensure medical reports address the specific criteria in your policy.

4. Claim Documentation

We prepare all necessary paperwork, ensuring every question is answered correctly and comprehensively.

5. Insurer Negotiations

We handle all communications with insurers, addressing their queries and challenging unfair decisions.

6. Dispute Resolution

If your claim is denied, we pursue internal reviews, complaints to the Australian Financial Complaints Authority (AFCA), and legal proceedings when necessary.

The Gouveia Legal Difference

As a family-owned firm led by Melissa and Andrew Gouveia, we combine personal
attention with expertise gained at Australia’s leading law firms. Our approach to TPD
claims is characterised by:

  • Direct access to our principals throughout your case.
  • A genuine understanding of the financial and emotional impacts of disability.
  • Meticulous preparation that anticipates and addresses potential obstacles.
  • Clear communication that keeps you informed at every stage.
  • A commitment to maximising your entitlements.

Don’t leave your financial security to chance. If
you’re unable to work due to illness or injury,
contact Gouveia Legal today for a free, no-obligation
assessment.

Andrew Gouveia

Andrew is a Sydney-based solicitor with a strong background in commercial litigation and transactional legal work. He has acted for a broad range of clients across insolvency, estate disputes, and property-related matters. His experience also extends to drafting and negotiating commercial agreements, advising on business and property transactions, and preparing tailored estate planning documents.

Known for delivering clear, commercially minded advice, Andrew established Gouveia Legal to provide clients with legal services that are practical, accessible, and results driven. Whether navigating a dispute or managing a transaction, he brings a strategic approach grounded in understanding each client’s goals and delivering value at every stage.

Clients come to Andrew for straightforward guidance and a solicitor who takes the time to understand their situation and can get results.

In his spare time, Andrew likes to train Jiu-Jitsu, take his dog Henry for long walks and enjoys watching anything by Guy Ritchie or Martin Scorsese.

Melissa Gouveia

Melissa is an experienced lawyer with extensive expertise in personal injury law and a keen interest in immigration.

Holding a Bachelor of Medical Science and a Graduate Law Degree, she combines a strong analytical foundation with a compassionate approach to legal advocacy.

With significant experience working as both a plaintiff lawyer at Australia’s top firms and a legal representative for Australia’s insurers, Melissa brings a well-rounded perspective to every case she handles.

Known for her exceptional negotiation skills, Melissa is dedicated to securing the best outcomes for her clients. Her empathetic nature allows her to connect with individuals, understanding their unique challenges and providing clear, supportive guidance through complex legal processes. Committed to achieving justice, Melissa ensures her clients receive fair and timely resolutions to their claims, whether through skilled negotiation or robust representation.

In her spare time, Melissa enjoys fashion, going out with friends and family.