Claimants’ views on total and permanent disability insurance claims

This study aims to investigate Australian claimants’ experience of the total and permanent disability (TPD) insurance claims process and documents their recommendations for improvement.

A qualitative methodology was used. In all, 12 claimants with finalized TPD claims were recruited via their superannuation fund. Data collected from in-depth interviews were thematically analyzed and reported using the COREQ checklist. Extracts from verbatim transcription were included to represent the claimant without bias.

Most interviewees described a flawed claims process in which important information was withheld or unclear, procedures were complicated and arduous, communication was poor and frequent need for “chasing up” was frustrating. The claims process undermined the well-being of many interviewees at a critical time in their adjustment to disability. Lump sum payment yielded unexpected consequences for ten interviewees. Some interviewees retained a desire to work despite serious disability.

The use of purposive sampling means that findings may not represent the experience of all claimants with finalized TPD claims. Saturation of knowledge was reached despite the relatively small number of in-depth interviews conducted. In the absence of previous research, this study identifies areas of concern in the TPD claimant experience and posits a set of important claimant issues for further investigation.

A person-centred approach is needed. Claimants would benefit from introduction of clear process information, a single point-of-contact throughout claim, advocacy/support and rehabilitation.

This inaugural study provides an understanding of challenges faced by TPD claimants. All interviewees provided suggestions for improvement in the TPD claims process.