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Total and Permanent Disability (TPD)

Can TPD insurance cover mental health conditions?

Category: Coverage

TPD insurance coverage for mental health conditions is complex and has evolved significantly in recent years. Modern TPD policies generally do cover mental health conditions including severe depression, anxiety disorders, PTSD, bipolar disorder, schizophrenia, and other psychiatric conditions, provided they meet the total and permanent disability criteria. However, older policies (particularly those issued before 2015) often contained mental health exclusions or severe limitations, excluding psychological or psychiatric conditions entirely or limiting claims to 2 years of benefits. To successfully claim TPD for mental health conditions, you need comprehensive evidence from psychiatrists and psychologists showing the severity and permanence of your condition, documentation of all treatments attempted including medication, therapy, and hospitalization, functional capacity assessments demonstrating how the condition prevents you from working, and evidence the condition is unlikely to improve with further treatment. Mental health claims face higher scrutiny and rejection rates because permanence is harder to prove - mental health conditions can sometimes improve with treatment, making 'permanent' disability challenging to establish. Insurers often argue claimants haven't tried all available treatments. Since 2015, industry reforms have improved mental health coverage, but it remains one of the more difficult claim types. If you have mental health conditions, carefully review your policy's Product Disclosure Statement for specific exclusions or limitations.

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