In 2023 I began familiarising myself with Total and Permanent Disability (TPD) insurance. In Australia, most Superannuation companies will have TPD insurance built into their cover. It is there to help cover costs of living if one becomes permanently unable to work due to injury or illness. The ‘total’ part is a little more loose by definition, as it usually means that you will no longer be able to be gainfully employed in any of your previous roles.
Mid 2023 I contacted Firm A, a mid-level organisation boasting experience and personalised claim management, and discussed my case with them. The biggest obstacle I could see was that with my gene mutation diagnosis in 2017, my claim would be ineligible from the get go. However, there was no initial medical questionnaire on application to the fund, plus there are “Limited Cover” and “At Work” criteria clauses that, to some extent, were there in place of a pre-existing clause when I joined. When I knew I was heading for medical retirement (mid 2024) I contacted another company, Firm B. I was again, very impressed by the personal approach and industry experience.
The day I was going to sign and return the cost agreement with Firm B, Firm A finally got back to me after I contacted them for the second time after stopping work. Due to the delay in their response, and a few oversights in their information (for example assuming that my claim, if successful, would be paid out in stages – I have a specified medical condition that under the Product Disclosure Statement (PDS) would make me eligible for lump sum payout), plus successful initial meeting with Firm B, I was going to politely end the call. However before long we got to the fees.
Firm A had a very competitive structure, but I was really torn. The lawyer at Firm B was a better fit personality wise, being much warmer (I even got smilies in my emails!), had a tonne of experience, dealing straight with the Principal Lawyer who had spent so much time considering her approach before I had even signed an agreement – and I really appreciated this.
Firm B’s fee structure was just a little bit ambiguous and open ended though, plus firm A included and allowed for a lot more in their initial cost stage in terms of to-and-froing with the assessor. My claim could become complex so this was especially important for me.
I ran both agreements plus emails through ChatGPT, and we both were leaning toward Firm A. The Google reviews of both firms are 5 star (not even 4.9), with Firm A having 105 and Firm B having 9. Obviously Firm A is bigger and more established, and although my lawyer is comparatively very young, the reviews that name him speak volumes, he has been successful in many tricky situations and all cases are overseen by the team and principal lawyers.
Today, my claim lodged with Firm A is still under review with the insurance underwriter (AIA), and this can take 6-9 months for a payout. While we have not yet had confirmation, the initial stage of claims assessor decision was for the supervising team the to approve. We have had a request for further information that will most likely require a further letter from my GP and employer, confirming that I was working full duties at the “checkpoint” in time eligible for payout. So its a small hurdle, but one that I had expected after disucssions with Firm B. From what I can establish, Firm A has chosen to go in with a “less is more” approach, giving only the basic information required at application, and letting the underwriter ask for what they need.
I have just sent a follow up email to the Litigation Assistant requesting an update on how to procede.