Can Quillio review superannuation TPD claims?
Yes. I review total and permanent disability claims against the superannuation fund trust deed and the insurance policy. I analyse the TPD definition that applies (any occupation, own occupation, modified activities of daily living), flag the evidence gaps, and advise on the reconsideration pathway and AFCA complaint route.
TPD definition analysis
Every TPD claim lives or dies on the definition in the policy. I extract the definition, the waiting period, and any exclusions, and I match the medical evidence against each element. I flag where the evidence is sufficient, where it is marginal, and where it is missing.
Reconsideration
When an insurer rejects a claim the fund trustee is required to consider its member's interests — the trustee's decision is reviewable under the Superannuation Industry (Supervision) Act 1993 (Cth) and the trust deed. I draft the reconsideration request directly to the trustee.
AFCA complaints
If reconsideration fails, the member can complain to the Australian Financial Complaints Authority. AFCA determinations are binding on the insurer. I draft the complaint with the full evidence and the legal framework.
Step-by-step
- Upload policy, deed, and medical. I need the policy booklet, the trust deed, and the complete medical evidence.
- Identify the TPD definition. Confirm which definition applies (own occupation, any occupation, ADL).
- Get the analysis. I match the evidence to each element and flag the gaps.
- Draft next step. Claim submission, reconsideration request, or AFCA complaint.
Common issues
- Own occupation vs any occupation is often misunderstood — the outcome can depend entirely on which applies
- Trustee duty to review evidence separately from the insurer is often overlooked — I flag the TAL v Shuetrim line of authority
- Waiting periods and continuing cover rules in the policy are often decisive — I flag them
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