making a total and permanent disablement claim

A serious illness or injury that stops you from ever working again is life changing. Total and Permanent Disablement (TPD) Cover is there to help when you need it the most.

 

what is total and permanent disablement (TPD) cover?


Total Permanent Disablement (TPD) Cover is insurance cover designed to provide you with a lump-sum payment if you suffer a serious injury or illness that leaves you permanently unable to work again.

Here's what TPD Cover may provide if you become permanently disabled and are unlikely to be able to return to work:

  • Medical and care costs like rehabilitation, ongoing treatment, and professional home care
  • Home modifications to adapt your living environment to your new needs
  • Peace of mind knowing that you and your family are financially protected


Check if you have TPD Cover

At HESTA, TPD Cover can’t be purchased on its own, it’s always combined with Death Cover. You can have a combination of either of these:

  • combined Death and TPD Cover or
  • Death Cover, TPD Cover and Income Protection (IP) Cover.

You can apply for and hold more TPD Cover than Death Cover.

Check your insurance cover in your online account >

 

what is a TPD benefit?


A TPD benefit is a lump sum payment paid by the insurer. It’s paid if you become totally and permanently disabled. This means you are unlikely to ever work again.

There are strict conditions to accessing TPD Cover. You must meet certain criteria before a claim can be paid. Your case manager will explain what applies to you.

 

who can make a TPD claim?


You may be able to claim if:

  • you hold TPD cover through your HESTA account
  • you have a serious illness or injury that stops you from ever working again
  • your doctor confirms you are unlikely to return to work
  • you meet the TPD definition in the policy.

 


 

 

how the claims process works

 

diagram of process to claim death benefit including notifying HESTA, lodging your claim, assessing your claim, letting you know our decision and payment 

Before you start your claim, check you have the right documents. Gathering these upfront helps us assess your claim faster.

  • a completed claim form
  • proof of your identity
  • detailed medical reports from your doctors
  • your employer's contact details
  • proof of your work history and duties
  • any other supporting documents (such as hospital records or specialist reports)

We need these documents to assess your claim, prevent fraud and ensure we’re complying with applicable laws.

 

Let us know as soon as you can. The fastest way is through your online account.       

We'll need some basic details:

  • your member number
  • your full name and date of birth
  • a short summary of your illness or injury
  • the date you stopped working
  • your contact details.

 

Notify us via your online account

 

Once you tell us, you’ll be assigned an AIA case manager. They will explain what you need to do. You can also lodge your TPD claim online.

 

 

AIA will review your claim. As part of the assessment, they may:

  • ask your doctors for more medical details
  • ask your employer to confirm your work history and duties
  • set up a medical exam
  • ask for other proof that supports your claim.

TPD claims can take longer than other claims. We need strong medical proof to show you are unlikely to ever work again in the occupation for which you are reasonably suited by education, training or experience, or that you meet one of the other TPD definitions that apply to your circumstances. Your AIA case manager will keep you updated.


Tips to avoid delays:

  • fill in all parts of the claim form fully
  • ask your doctors to give detailed reports about your condition, treatment, and outlook
  • ask your employer to complete their part quickly
  • send certified or signed documents
  • reply to any requests for more information as soon as you can
  • include all medical records, test results, and specialist reports.

 

AIA send their decision to you in writing, and they'll explain the next steps.


If your claim is approved

If your claim is approved, we'll tell you:

  • how much you'll be paid
  • how payment will be made
  • any tax that may apply.


If your claim is not approved

If your claim isn't approved, we'll explain why. We'll also tell you how to appeal or make a complaint.

 

Once you’ve met the definition of totally and permanently disabled and your claim is successful and approved by AIA:

  • the funds will be paid by AIA to your HESTA account, or
  • the money may stay in super and be used to start a retirement income stream, if you meet the Permanent Incapacity definition.


We aim to pay claims as soon as we can. We'll let you know if we need more time.

 

 

 

  

Our commitment

We must act in the best financial interests of our members and their beneficiaries. All claims are assessed on a fair and reasonable basis. Your AIA case manager will help you through each step in the claims process.


 

 

tax on TPD payments


The tax on a TPD benefit depends on your age and the type of payment. The rules can be complex.

 

SituationWhat happens
You're over 60Usually, no tax
You're under 60Some tax may apply, depending on the type of payment
Payment kept in superTax paid will depend on when and how you access it


Need more detail?

  • Visit the ATO website to learn more about tax on TPD benefits.
  • Talk to a financial adviser or tax expert to learn how tax may affect your TPD claim.

Important: we can't give you tax or legal advice about your claim.

 

 

 

 

what if my claim isn't approved?

 

If your claim isn't approved, you can:

  1. ask your case manager to explain the reasons
  2. send more medical proof and ask for a review
  3. make a formal complaint through HESTA
  4. contact the Australian Financial Complaints Authority (AFCA).

 

what if I'm unhappy with the process?

 

Lodge a complaint with us 

If you have a complaint about your claim or the claims process, please contact us to make a complaint.
 

Make a complaint

 

If you're not happy with our response, you can escalate your complaint to the Australian Financial Complaints Authority (AFCA). Visit our Complaints page for more information. 

See our Vulnerable Members Policy to learn about our commitments and expectations for dealing with members who are experiencing difficulty and need extra care.


 


 

 

more resources

Nominate a beneficiary

Your super isn’t automatically included in your estate, so nominating a beneficiary means there are clear instructions on who you want to receive your super.

More on why nominating a beneficiary is important 

Check your insurance cover

You can check your insurance cover by logging in to your online account, and clicking on the Insurance tab.

Log in to your online account 

We're here for you

Our team can help with questions about the process, an existing claim, or starting a new claim. You can get in touch by calling 1800 813 327 or contacting us.