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Early Onset Dementia (Alzheimer's) & TPD Insurance - Wise Financial Services
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Early Onset Dementia (Alzheimer’s) & TPD Insurance

Early Onset Dementia (Alzheimer’s) & TPD Insurance

Our team recently settled a Total and Permanent Disablement (TPD) and Income Protection claim with a large Industry fund.

According to APRA (Oct 2020) the current non-advised retail policy claim timeframe is over 5 months. Our team settled this claim in just over a month. See our post on APRA claim statistics here.

Background:

The claimant was in her early 60s and diagnosed with early onset Dementia. She was advised by a specialist to cease working in her longstanding role at a major hospital. Upon receipt of the specialist report the claimant sought our help to navigate the paperwork-heavy industry fund claim process.

There are numerous causes of dementia but the onset is often characterised by:

  1. Memory loss that disrupts daily life
  2. Repetitive behaviour
  3. Difficulty performing familiar tasks
  4. Social isolation

Common headwinds when making a claim with an industry or retail fund:

Industry funds will strictly apply the definition of TPD in their Product Disclosure Statement (PDS) according to the diagnosis contained in Doctors reports. It is important that reports include an accurate expectation of future working capacity from the specialist attending doctor.

The specialist doctor will be contacted by the insurer to complete a form to confirm the diagnosis. To prevent delays it is commonplace to arrange a consultation with the specialist doctor to complete and collect the form.

Additional required information is often requested by the insurer in an ad-hoc manner which can lead to delays. Our working knowledge of the claim process and information required upfront by the insurer enabled us to settle the claim quickly.


Our recent journey to claim settlement:

  • Initial application for claim made with the industry super fund for TPD and Income Protection.
  • An enduring power of attorney provided decision making support for family members when requested by the industry fund.
  • Income protection was claimed simultaneously to TPD.
  • At the discretion of the insurer, Income Protection may be paid out in future as a lump sum when the claimant approaches the benefit period expiry.

Outcome:

  • We obtained a claim settlement from the insurer on behalf of the claimant for a lump sum Total and Permanent Disablement benefit and monthly Income Protection benefit.
  • We negotiated back payment of the Income Protection benefit so that the waiting period commenced in line with the Doctors recommended date to cease working.
  • The settlement amount provided capital to support her financial needs in addition to government supported disability benefits.

To learn more about our unique approach please contact us via form or phone 07 3394 8465

Important links

https://www.dementia.org.au/about-dementia/health-professionals/dementia-the-essentials/early-warning-signs

https://www.wisefinancial.com.au/?p=30618

https://www.apra.gov.au/life-insurance-claims-and-disputes-statistics


“Unless specifically indicated, the information contained here is general in nature and does not take into account your personal situation. You should consider whether the information is appropriate to your needs, and where appropriate, seek personal advice from a financial advisor.”



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