Living with a rare disease is challenging enough navigating a Total and Permanent Disability (TPD) claim shouldn’t add to the struggle. Yet many Australians with rare illnesses miss out on life-changing payouts because insurers misunderstand their condition or demand unrealistic proof.
This guide explains:
- Which rare diseases commonly qualify for TPD
- Why insurers push back on these claims
- How to strengthen your application
- Real case studies of successful rare disease TPD claims
Can You Claim TPD for a Rare Disease?
Yes! If your illness permanently prevents you from working, you may be eligible—even if it’s rare.
Common Rare Diseases That Qualify
Key Point: If your doctor confirms you can’t return to work, you likely qualify—regardless of how “rare” your diagnosis is.
3 Reasons Insurers Deny Rare Disease TPD Claims
- “Not Enough Evidence” Excuses
- Insurers may claim your medical records are “insufficient” because few specialists treat rare conditions.
- Solution: Get reports from neurologists, geneticists, or rare disease centres to prove severity.
- “You Might Improve” Delays
- Some insurers argue “experimental treatments” could help (even if unavailable in Australia).
- Solution: Show progressive decline with doctor statements like: “Patient’s condition is irreversible.”
- Policy Exclusions for “Pre-Existing” Conditions
- If symptoms appeared before your super/insurance policy started, insurers may try to reject you.
- Solution: Prove your diagnosis came after coverage began (e.g., MRI timelines).
Case Study: $620k TPD Payout for MND Patient
Background: A 52-year-old teacher with motor neurone disease was denied by her super fund, which claimed she could “work remotely.”
Our Action:
- Obtained 3 specialist reports confirming rapid physical decline.
- Submitted video evidence of her mobility struggles.
- Proved her job required speech & fine motor skills (impossible with MND).
Result: $620,000 lump sum approved within 3 months.
Next Steps: Getting Legal Help
TPD claims for rare diseases are uniquely complex, but you don’t have to fight alone.
WKB Lawyers Can:
- Review Your Policy – Check if your super/insurance covers rare illnesses.
- Build Medical Evidence – Connect you with rare disease specialists.
- Appeal Denials – 70% of rejected claims win with legal support.
Free Claim Assessment: Call 1800865225 or visit www.wkblawyers.com.au