Total and Permanent Disability: How to Claim Insurance?

An unexpected disability brings many new challenges on its own, not to mention the financial uncertainties that come with it. Luckily, Total and Permanent Disability (TPD) insurance plans can help preserve your financial well-being regardless of your life circumstances.

Here are some useful information regarding Total and Permanent Disability, the appropriate insurance coverage and how to file a claim if you ever need to.

What is Total and Permanent Disability?

The Persons with Disabilities Act 2008 (PWD) defines disablement as individuals who possess long-term physical, mental, intellectual, or sensory impairments that prevent their full and effective participation in society as an equal due to environmental and attitudinal boundaries.

In the working environment, permanent disability applies to those who can no longer earn a living due to physical or mental injuries brought on by an accident or illness.

How is total and permanent disability determined?

The general guideline for TPD measures how well the affected individual can perform everyday activities, such as breathing, walking, talking, eating, learning, or working.

To claim insurance payout for TPD, one must possess a disability that:

1. results in a medical condition deemed fixed and stable with no chance of improvement over time;

2. has persisted continuously for at least six (6) months;

• stagnates even upon reaching maximum medical improvement;

1. prevents you from returning to work as well as other forms of relevant occupation.

Permanent disability examples

Permanent disabilities can be categorised into two types, depending on the severity of the condition.

Permanent partial disability

A disablement that prevents you from working to your full capacity for the rest of your life, for example:

• Sensory loss (e.g. vision damage, loss of speech)

• Loss of a digit

• Loss of a limb

• Back and neck injuries

• Carpal tunnel syndrome
  
  

Permanent total disability

A disablement that prevents you from working at all for the rest of your life, for example:

• Loss of limbs

• Paralysis

• Chronic pain

• Post-traumatic stress disorder (PTSD)

 

Regardless of the severity of the impairment, these are some common medical conditions which may prevent a person from working:

• Anxiety

• Depression

• Amputation

• Motor neuron damage

• Degenerative diseases
  
  

What is total and permanent disability insurance?

A life-long illness or injury may cut short your career and ability to provide for your loved ones and yourself. In situations like these, an insurance plan that covers such a risk can serve as a safety net.

TPD insurance requires the insurer to pay you a benefit if you're severely ill or injured to the point you can no longer return to work in exchange for a premium.

What does total and permanent disability insurance cover?

TPD coverage provides you with a lump sum payment if you're permanently disabled and unable to return to work. Based on the insurer's policy, this could apply to your occupation or any occupation in your profession.

You can use the TPD payout to cover your out-of-pocket medical bills, debts, loans, everyday living expenses, travel expenses for treatment or rehabilitation, and costs to support your loved ones.

How to claim total and permanent disability insurance in Malaysia?

Wondering how you can file for your TPD benefits? Here is a general guideline on how you can apply for a TPD claim in Malaysia.

1.Check your eligibility for a TPD claim and make sure that 6 months have passed since your disability date.

2. Request a medical certificate from your doctor to confirm your status as totally and permanently disabled.

3. Prepare all necessary documents needed to file a claim. These may include:

• TPD Claim Form

• Attending Physician's Statement for a TPD claim

• All relevant medical reports

• SOCSO report and letter

• EPF withdrawal letter

• Termination letter from employer

• NRIC/passport/birth certificate

• Bank statement

• Evidence of cause of disability, if any (e.g. police report, newspaper cutting)

Note: You may need to submit a certified copy for certain documents. The checklist provided by different insurers may vary from one another.

4. Submit your claim for assessment with the required documents attached. This step can typically be done personally or through your insurance agent.

Be sure to thoroughly check your application before handing it in. Missing information and documents may delay the approval process.

Do you need total and permanent disability insurance?

In the event of an unexpected life-long injury or illness, will you be able to maintain a suitable lifestyle without a steady income? If this is something you think about, TPD might be the answer.

When deciding whether or not you need TPD insurance, a good place to start is by listing all your long-term expenses covered by your salary. These might include:

• Day-to-day living expenses, e.g. household expenditures, food, utilities, transport, and subscription fees;

• Debts, e.g. mortgage, credit card payments, and loans;

• Medical and rehabilitation costs;

• Retirement savings and future expenses for dependants.

 

An often overlooked aspect is the increased cost of living with a disability. So it could be helpful to keep that in mind as you go through the above checklist.

The next step is to subtract your assets from your financial commitments. These might include your:

• Savings or investments;

• Health insurance that can cover your hospital and medical costs;

• Income protection insurance.

 

In addition to financial aspects, you might also want to consider the risk of injury your line of work brings. It might be wise to take up TPD insurance if your job increases your chances of sustaining a physical/mental injury or illness.

With this in mind, you should now have an estimation of whether you should take up a TPD plan and how much you need.

How to buy total and permanent disability insurance in Malaysia?

You can purchase TPD insurance through a financial advisor, an agent, or directly from an insurance company. Simply speak to a customer service representative on the phone or visit a nearby branch outlet if you need clarification on the submission process.

Subsequently, submission of completed forms and supporting documents can be done via an agent or directly to any branch office of your preferred insurance provider.

Conclusion

Total and Permanent Disability insurance is a great safety net to relieve your financial burden and protect your financial goals in the case of an accidental permanent disablement. Or if you’re an employer, insurance companies such as Prudential offer PRUGroup Life, a customised insurance plan specially designed to protect and retain your employees.

Whether you need help understanding more about the terms or if you meet the criteria for a TPD claim, we are always happy to help. Feel free to contact our Customer Service line at 03-2116 0228 or visit your nerest Prudential branch.