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A delay and a rejection are different things — a claim taking time doesn't mean it's being declined.
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Plain-English Information
Plain-English information, reviewed by the Thrive Claims team. This guide explains how TPD claims are assessed, what insurers actually look at, and the circumstances that may be relevant to your own situation.
A TPD claim can take time to assess, but a delay doesn't necessarily mean your claim will be unsuccessful. The important question is why the claim has been delayed and what stage it's actually at. Reach out to Thrive Claims if you are experiencing delays with your TPD claim and see how we can help.
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Call1300 059 888Why Is My TPD Claim Taking So Long?
There's no single timeframe that applies to every TPD claim. A claim may take longer where:
01 Medical information is still being obtained or assessed
02 Further information has been requested
03 Employment information needs to be considered
04 The insurer requires clarification about work capacity
05 There are multiple medical conditions
06 Questions exist about the applicable insurance policy
07 More than one super fund or policy is involved
08 The claim involves complex medical or employment history
A delay does not automatically mean the claim is being rejected.
What Can Cause a TPD Claim Delay?
Medical evidence can take time to obtain and assess, particularly where multiple treating practitioners, specialists, hospitals or treatment providers are involved. The relevant question isn't simply whether a person has a diagnosis — the insurer may need to consider the nature of the condition, its severity, treatment, prognosis, functional restrictions and impact on work. See TPD Medical Evidence →
Employment Information Can Also Be Relevant
Depending on the policy and circumstances, information about your occupation, duties, work history, hours, restrictions and changes to your employment may form part of the assessment.
Policy and Insurance Information Also Needs Assessing
This can involve questions about whether cover existed, which policy applies, the relevant TPD definition, policy conditions, exclusions or limitations, and when cover was actually in force.
Delays With Multiple Conditions
Where a person has more than one condition, the assessment may involve understanding how those conditions affect overall functional and work capacity — genuinely more to consider, and naturally more time to consider it properly. See TPD Claims With Multiple Conditions →
Delays With Multiple Super Funds
If there may be more than one TPD policy, old super account or historical fund involved, this can add another layer of complexity to the assessment timeline. See Multiple TPD Policies & Super Funds →
What If the Insurer Has Asked for More Information?
A request for additional information doesn't necessarily mean something is wrong with your claim — it may simply mean the insurer considers further information relevant to assessing the policy requirements. The important question is what's been requested, and why it matters to the decision being assessed. See TPD Claim Documents →
Can Medical Evidence Delay a TPD Claim?
Yes. Medical evidence may involve information from GPs, specialists, psychologists, psychiatrists, hospitals and other treating practitioners — the time involved can depend on the availability of records and practitioners, as well as the complexity of the medical circumstances. A medical evidence delay is not the same thing as a medical rejection.
Can a Claim Be Delayed Because I'm Still Working?
It can lead to additional questions about work capacity, depending on the circumstances — working doesn't automatically prevent a TPD claim.
- Hours worked
- Duties performed
- Changes to responsibilities
- Workplace adjustments
- Absences
- Sustainability of employment
What If My Claim Has Been Delayed for Months?
If a claim has been outstanding for a significant period, it can be useful to understand what stage it's reached, whether information has been requested, whether information is outstanding, whether a particular issue exists, and what the claims process provides. There's no universal number of days after which every TPD claim should automatically be approved or rejected.
What If My Claim Has Stopped Progressing?
If you believe your claim is no longer moving, the relevant issue is understanding why. Circumstances can vary considerably between claims — there's no single explanation that applies to every delay. Your claim correspondence, policy documents and previously provided information can help establish what stage the claim has actually reached.
Does a Delayed Claim Mean It Will Be Rejected?
No. A delay and a rejection are different things. A claim may be delayed because further information is required, or because the insurer is still assessing the relevant issues. If a claim is ultimately rejected, that decision should be considered separately from the fact that it took time to assess. See TPD Claim Rejected →
How Long Does a TPD Claim Take?
There's no universal TPD claim timeframe. The length of a claim can depend on the policy, insurer, medical evidence, employment circumstances, complexity of the claim, additional information requested, and whether multiple policies are involved. See TPD Claim Timeframes →
Related claim areas: our services, TPD claims, superannuation claims, income protection claims, multiple super funds claims, mental health claims, physical injury and illness claims, TPD claims for DSP recipients, TPD claims for NDIS participants, TPD claims for motor accident claimants, and TPD insurance through super.
A delay can leave you unsure whether the insurer is still collecting information or whether something has stalled. Understanding the stage of your TPD claim is more useful than assuming that time alone predicts the result. A claim held through your fund may involve superannuation claims processes, and claims with more than one super fund may progress at different speeds. If loss of income is the immediate concern, it may also be worth checking whether Income Protection claims are relevant under separate cover. Outstanding evidence could concern physical injury or illness or mental health injury or illness, including treatment and the prospects of returning to work. People receiving Disability Support Pension or participating in the NDIS may still need an insurer to assess their circumstances under its own requirements. After a motor accident affecting work capacity, the medical history may also require clarification. Our Thrive Claims services can help you explore the relevant pathways without treating a delayed assessment as either a refusal or a promise of approval.
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TPD Claims Resources
20 pages of plain English resource library covering evidence, timeframes, payouts and appeals.
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TPD claims can arise from many different illnesses and injuries. Explore by category below.
Common questions
Frequently Asked Questions
Straight answers about TPD claim delayed, written in plain English.
Why can a TPD claim be delayed?
TPD claims can involve medical evidence, policy information, employment history and other information that may take time to obtain and assess. Delays can also arise where further information or clarification is requested during the assessment. See TPD Claim Timeframes →
How long does a TPD claim take?
There is no single timeframe that applies to every TPD claim. The time required varies depending on the policy, complexity of the circumstances, evidence and parties involved.
What if my insurer has not made a decision?
If a claim appears to have stalled, it may be important to understand what stage the claim has reached and whether further information has been requested. For disputes involving a financial firm, ASIC explains that firms must properly consider complaints through their internal dispute-resolution process.
Can missing medical evidence delay a TPD claim?
Yes, it can. Medical evidence may be an important part of assessing a TPD claim, and further information is sometimes required depending on the circumstances. See TPD Medical Evidence →
What if my super fund says the insurer is responsible for the delay?
Insurance through super can involve both the trustee and insurer. AFCA explains that the trustee remains the key decision maker for insured superannuation benefits, even where the insurer has made the underlying decision. See TPD Claim Appeal →
Can I complain about a delayed TPD claim?
Yes, depending on the circumstances, you may be able to raise a complaint with the relevant financial firm and, if unresolved, take an eligible matter to AFCA. ASIC identifies internal dispute resolution as the first step for life insurance disputes.
Does a long delay mean my claim will probably be rejected?
No, a lengthy delay on its own doesn't indicate the likely outcome either way. Some genuinely straightforward claims take longer simply due to processing backlogs, while some complex claims move faster than expected once all the right evidence is in place.
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