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What is Total and Permanent Disablement (TPD)?
As an insured member, you may be considered totally and permanently disabled if you meet the requirements for any of the five definitions below:
1. Unlikely to return to work
If you have suffered an injury or illness and as a result of that illness or injury you have:
- Been totally unable to be employed or engaged in your occupation, business, profession or employment for a period of six consecutive months, and
- Been determined by the Trustee at the end of that six-month period (or such later time as the Trustee and insurer determine) to be permanently incapacitated to such an extent as to render you unlikely to ever be employed or engaged in any gainful occupation, business, profession or employment for which the Insured Member is reasonably suited by education, training or experience.
2. Permanent impairment
If you have suffered an illness or injury and, as a result of that illness or injury, you have:
- Suffered a permanent impairment of at least 25% of whole person function as defined in the American Medical Association publication, Guides to the Evaluation of Permanent Impairment, 4th edition; or an equivalent guide to impairment approved by the insurer, and
- Been disabled to such an extent, as a result of this impairment, that they are unlikely ever again to be able to be employed or engage in any gainful occupation, business, profession or employment for which they are reasonably suited by their education, training or experience.
3. Specific loss*
If as a result of illness or injury, you have suffered the total and permanent loss of the use of:
- Two limbs (where ‘limb’ is defined as the whole hand or the whole foot), or
- The sight in both eyes, or
- One limb and the sight in one eye.
4. Loss of independent existence*
If as a result of illness or injury, you suffer the loss of independent existence. This means we have determined you to be totally and irreversibly unable to perform at least two of the following five ‘activities of daily living’ without the assistance of another adult person:
- Bathing and/or showering
- Dressing and undressing
- Eating and drinking
- Using a toilet to maintain personal hygiene, or
- Getting in and out of bed, a chair or wheelchair, or moving from place to place by walking, wheelchair or with assistance of a walking aid.
5. Cognitive loss*
If as a result of illness or injury, you have suffered cognitive loss, defined as the total and permanent deterioration or loss of intellectual capacity and:
- Require continuous care and supervision by another adult for at least six consecutive months, and
- At the end of that six month period, you are likely to require permanent ongoing continuous care and supervision by another adult.
* Members aged between 65 and 69 have restricted TPD cover for specific loss, loss of independent existence and cognitive loss only.
Please note: the final decision on all insurance claims is made by the Trustee. If you have any questions or would like further information about any aspect of the insurance available, please call us on 1300 130 780 or email email@example.com.