Kathryn MacDonell
Chief Executive Officer
Kathryn is Trilby Misso’s Chief Executive Officer.
Meet KathrynBy Kathryn MacDonell, Chief Executive Officer
Queensland Law Society Proctor profile
Last reviewed: August 2026
A TPD claim is an insurance claim that may be available when illness or injury causes permanent incapacity under the definition in a policy. Many eligible super fund members have TPD cover. Trilby Misso provides TPD legal services across Queensland on a no win no fee basis. Policy terms and time limits vary.
A Total and Permanent Disability claim, commonly called a TPD claim, is a claim under an insurance policy that pays a benefit when the insured person satisfies the policy’s definition of total and permanent disability or disablement.
TPD insurance is commonly attached to a superannuation account. The precise definition, insured amount, exclusions, waiting requirements and eligibility rules are determined by the relevant policy and super fund documents.
This makes a TPD insurance claim different from a workers compensation claim or many other personal injury claims.
A workers compensation claim generally concerns an injury connected with employment and operates under Queensland workers compensation legislation. A TPD claim is primarily concerned with whether the insured person satisfies the terms of the applicable insurance policy.
It is therefore possible for the same medical condition to be relevant to more than one type of claim. For example, a person whose condition arose from work may have a workers compensation claim and separate TPD insurance, depending on their circumstances and cover.
For more information about this area generally, see Total and Permanent Disability claims.
A successful TPD claim does not depend simply on the seriousness of a diagnosis. The central question is whether the policy definition is satisfied by the medical, occupational and other evidence.
The most reliable way to determine whether you have TPD insurance is to check your superannuation account, annual statement, insurance section of your online member portal and the Product Disclosure Statement or insurance guide applying to your account.
The Australian Government’s Moneysmart guidance on insurance through super explains that most super funds offer TPD insurance and that many eligible members receive cover automatically.
However, TPD insurance should not be assumed to exist simply because a person has super.
Automatic insurance is generally restricted for members under 25 and members whose account balance has not reached $6,000, unless an exception applies or the person opts in. Insurance may also be cancelled after a super account has been inactive for 16 months unless the member elects to retain it. Individual fund rules can impose additional requirements.
The Australian Prudential Regulation Authority publishes national fund-level superannuation statistics. APRA does not publish a reliable “top 10 Queensland super funds” ranking by Queensland member count, so describing one as such would be misleading.
The following table instead identifies major current Australian funds used by Queensland members and their general TPD insurance position. Individual cover must still be checked against the member’s account and policy.
| Super fund | Current status | Approximate national membership publicly reported | TPD insurance position |
|---|---|---|---|
| AustralianSuper | Current | More than 3.5 million | Basic TPD cover can commence automatically for eligible members |
| Australian Retirement Trust | Current | About 2.4 million | Standard TPD Assist cover can commence automatically for eligible members |
| Rest | Current | More than 2 million | TPD insurance is available, with default cover subject to eligibility and current insurance terms |
| Hostplus | Current | More than 1.9 million | Eligible members may receive default Death and TPD insurance |
| Aware Super | Current | About 1.3 million | TPD insurance is available, with arrangements depending on the member’s product |
| HESTA | Current | More than 1 million | TPD cover is available and eligible members may receive default insurance |
| Mercer Super | Current | About 1 million | TPD cover commonly forms part of employer plan insurance, subject to plan terms |
| Cbus Super | Current | More than 900,000 | Default TPD arrangements depend partly on membership division and occupation category |
| UniSuper | Current | More than 680,000 | TPD cover is available, with eligibility depending on the relevant membership product |
| CareSuper | Current | More than 600,000 | Eligible members may receive default TPD cover |
Fund names can change after mergers.
QSuper and Sunsuper merged in 2022 to form Australian Retirement Trust. QSuper accounts continue to be administered within Australian Retirement Trust.
MTAA Super is no longer a current fund name. MTAA Super merged with Tasplan in 2021 to form Spirit Super. Spirit Super then merged with CareSuper in November 2024 and operates under the CareSuper name.
Other major funds include AustralianSuper, REST, HESTA, Hostplus, Cbus and UniSuper.
Changing jobs can result in a person having more than one super account.
More than one account can mean more than one insurance policy, but it does not automatically mean that every TPD policy will pay a full benefit.
Each policy must be examined separately. Eligibility, the date cover commenced or ceased, TPD definitions, exclusions and provisions dealing with other insurance can differ.
Before consolidating or closing super accounts, insurance attached to each account should be checked. The Moneysmart guidance on consolidating super funds warns that closing a super account can result in associated insurance being lost.
The TPD definition is the test contained in the relevant insurance policy. It determines what must be established before an insurance benefit becomes payable.
Two commonly discussed definitions are own occupation and any occupation.
| Definition | General meaning |
| Own occupation | The insured person is unable to work again in the particular occupation they performed before becoming disabled |
| Any occupation | The insured person is unable to work again in an occupation for which they are reasonably suited by education, training or experience |
An any occupation definition generally sets a higher threshold than an own occupation definition because the assessment is not limited to whether the person can return to their previous job.
According to Moneysmart’s current TPD insurance guidance, own occupation cover is more commonly available outside super, while TPD insurance inside super commonly uses an any occupation style definition.
Some policies also contain other tests, such as activities of daily living or specific functional definitions. The precise wording of the policy applying when the person became disabled is therefore important.
The definition can require consideration of factors such as:
A serious diagnosis does not automatically establish TPD. Equally, the fact that a person may theoretically be capable of performing some activities does not by itself determine whether the relevant occupational definition is satisfied.
There is no fixed list of medical conditions that automatically qualify for a TPD claim.
The relevant question is generally whether the illness or injury results in the level of incapacity required by the particular insurance policy.
Conditions considered in TPD claims can include:
TPD insurance may also apply to psychological and psychiatric conditions where the policy definition and supporting evidence are satisfied.
Examples can include:
Where a psychological condition is connected with employment, separate information is available about psychological injury workers compensation in Queensland.
Claims can also involve conditions such as:
Some TPD claims involve conditions associated with a person’s work history, including:
The diagnosis alone is not the eligibility test. The policy wording and evidence about the effect of the condition on work capacity are central to the assessment.
The process varies between funds and insurers, but a TPD claim commonly involves the following steps.
Check current and previous super funds to identify any TPD insurance that may have existed when the incapacity arose.
Obtain the applicable insurance policy, insurance guide, Product Disclosure Statement and details of the insured amount and TPD definition.
The relevant policy may be an older version rather than the fund’s current policy.
Medical evidence commonly addresses the diagnosis, treatment history, prognosis, restrictions and work capacity.
Some policies require particular medical certificates or periods of absence before a claim can be assessed.
The fund or insurer generally provides the relevant TPD claim forms.
Documents can include:
The trustee and insurer may request further medical, employment or vocational information.
There is no universal 3 to 12 month statutory assessment period for every TPD claim. Insurers participating in the Life Insurance Code of Practice are subject to claims-handling standards, but the actual timeframe can depend on whether the insurer has received all required information, any policy waiting period and whether circumstances outside its control affect assessment.
If a TPD claim is declined, the reasons for the decision and the material relied upon should be reviewed.
An internal complaint or review may be available through the super fund.
The Australian Financial Complaints Authority can consider many complaints involving superannuation trustees and insurance within super.
AFCA has specific jurisdictional and time-limit rules for disability benefit complaints.
Court proceedings may also be available in some circumstances. The appropriate court and cause of action depend on the policy, trust arrangements, decision being challenged and applicable law.
A TPD insurance benefit is not calculated in the same way as compensation in a personal injury claim.
The starting point is generally the sum insured under the applicable policy.
This can be found in a super statement, online member account, insurance certificate or fund records.
The amount can vary because of:
If a person held more than one TPD policy, each policy must be considered separately. Moneysmart specifically cautions that having multiple super accounts does not necessarily mean a person can receive the full insured benefit from every policy.
A TPD payment should not be described as automatically tax-free for people under 60.
Tax treatment depends on factors including age, how the benefit is paid, the tax-free and taxable components of the super interest and whether the payment satisfies the tax definition of a disability superannuation benefit.
The Australian Taxation Office explains that disability super benefits can be paid as a lump sum or income stream and different tax rules can apply.
Where the statutory requirements for a disability superannuation benefit are satisfied, special rules can increase the tax-free component of a lump sum. This does not mean every TPD insurance payment is entirely tax-free.
The value and tax treatment of a TPD claim depend on the individual policy, superannuation arrangements and personal circumstances.
A rejected or declined TPD claim does not have the same explanation in every matter.
Reasons can include:
Insurance in super generally involves both the superannuation trustee and the insurer.
AFCA explains that the trustee is the policyholder under group insurance arrangements and has responsibilities when reviewing an insurer’s decision.
A person dissatisfied with a decision can generally first use the fund’s internal dispute resolution process.
If the dispute remains unresolved, an eligible complaint may then be made to the Australian Financial Complaints Authority.
AFCA is an independent external dispute resolution body and does not charge consumers a fee to lodge a complaint.
Court proceedings can be another avenue in some matters, subject to applicable limitation periods and legal issues.
TPD claims do not operate under the standard 3-year personal injury limitation period simply because the underlying condition is an injury.
There is also no single universal deadline applying to every TPD insurance claim.
Relevant time limits can arise from:
AFCA applies special time limits to superannuation disability benefit complaints.
In some circumstances, AFCA requires the original disability benefit claim to have been made to the superannuation provider within 2 years of permanently ceasing employment because of the condition giving rise to the claim. Separate 4-year or 6-year periods from a TPD decision can also apply depending on the circumstances.
Court proceedings based on a simple contract are generally subject to a 6-year limitation period from the date the cause of action arose under section 10 of Queensland’s Limitation of Actions Act 1974.
That does not mean every rejected TPD claim has exactly 6 years from the date on the rejection letter. Determining when a cause of action accrued can require consideration of the policy and circumstances.
For this reason, TPD time limits should be assessed by reference to the specific policy and dispute rather than relying on a single general deadline.
Legal costs depend on the terms of the written costs agreement between the client and the law firm.
Trilby Misso provides TPD legal services on a no win no fee basis, subject to the terms of the applicable written agreement.
Queensland’s Legal Profession Act 2007 regulates legal costs and conditional costs agreements. Any applicable costs arrangements should be set out in the written costs disclosure provided before legal work is undertaken.
General information about Queensland solicitors and legal costs is also available from the Queensland Law Society.
Further information is available on Trilby Misso’s no win no fee information page.
Working part-time does not produce the same answer under every TPD policy.
The effect of part-time or modified work depends on the particular policy definition and the nature of the work being performed.
For an any occupation definition, the issue may include whether the person is capable of gainful employment for which they are reasonably suited by education, training or experience.
For an own occupation policy, the question will generally focus more specifically on the person’s capacity to perform their own occupation.
Contrary to a common misconception, an own occupation definition is generally not the harder test. Any occupation cover ordinarily imposes the broader occupational test.
Returning to work, attempting rehabilitation, performing modified duties or moving from full-time to part-time employment does not automatically determine a TPD claim either way.
The insurer may consider:
The actual wording of the policy remains the starting point.
These four questions provide a basic starting point:
If the answer to these questions is yes, it may be appropriate to check the TPD insurance terms applying to the account.
These questions do not determine whether a TPD claim will be approved. Eligibility depends on the insurance policy, medical and occupational evidence and the circumstances of the individual claim.
There is no fixed Queensland statutory period applying to every TPD claim. Assessment time depends on the policy, insurer, waiting period, medical evidence, employment information and whether further evidence is requested. Life insurers participating in the Life Insurance Code of Practice are subject to claims-handling timeframes, including standards applying to lump sum claims.
Yes. TPD insurance is not limited to people aged 60 or older. Eligibility depends on whether the relevant policy was in force and whether its TPD definition is satisfied. Age can affect the amount and availability of cover because many policies reduce or cease TPD insurance at specified ages.
Making a TPD claim does not automatically remove the existing retirement savings in a super account. If an insurance benefit becomes payable, it is generally paid to the superannuation trustee and credited in accordance with the fund’s rules. Access to superannuation money is separately governed by superannuation law and applicable conditions of release.
Potentially, yes. TPD insurance is generally based on illness or injury and the applicable disability definition, rather than whether the condition occurred at work. A condition arising at home, through sport, through illness or in another setting may still be considered, subject to the policy terms and exclusions.
Not necessarily. Insurance can cease because of inactivity, age, insufficient account balance or other policy and fund rules. Under federal superannuation rules, insurance is generally cancelled where an account has received no contributions for 16 months unless the member has elected to retain the cover. The position should be checked against the historical account and policy records.
It can be possible to make claims under more than one policy, but payment under one policy does not establish eligibility under another. Each insurer applies its own policy definition and conditions. Moneysmart also cautions that a person may not be able to receive the full benefit from multiple policies, depending on their terms.
Tax treatment varies. A TPD insurance benefit paid through super is not automatically tax-free. The amount of tax can depend on the person’s age, the components of the super benefit and whether the payment qualifies as a disability superannuation benefit for tax purposes. The ATO publishes information about disability super benefits and taxation.
Potentially. Workers compensation and TPD insurance are separate systems. A WorkCover payment does not automatically prevent a person from making a TPD insurance claim. The TPD policy must still be satisfied independently. Information about Queensland workplace claims is available on the workplace injury claims page.
Kathryn MacDonell is Chief Executive Officer of Trilby Misso Lawyers. Kathryn began her legal career with Trilby Misso in 2001 and was admitted as a legal practitioner in Queensland in 2005.
She holds tertiary qualifications in Law and Business from Queensland University of Technology and the University of Queensland. She is admitted to the Roll of Legal Practitioners in the Supreme Court of Queensland and the High Court of Australia and has completed the Practice Management Course accredited by the Queensland Law Society.
Kathryn’s practice background is in Queensland compensation law.
External professional profiles: Kathryn MacDonell on LinkedIn and Queensland Law Society Proctor.
Last reviewed: August 2026
Disclaimer: This page contains general information only and does not constitute legal, financial or taxation advice. TPD eligibility, insurance benefits, taxation and time limits depend on the relevant policy, superannuation arrangements and individual circumstances. Actual compensation or insurance benefits depend on individual circumstances and are determined on a case-by-case basis under the relevant policy and legislation.
Kathryn is Trilby Misso’s Chief Executive Officer.
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