TPD Claim Delays: When Is an Insurer Taking Too Long?
Waiting on a TPD claim is its own kind of stress. You cannot work, the money is running low, and the insurer that holds the answer has gone quiet. Weeks turn into months, and you are left wondering whether this is just how long these things take, or whether something has gone wrong. It is one of the most common and most demoralising experiences people have with a TPD claim.
Here is what many people do not realise. A slow claim is not simply bad luck that you have to endure. Insurers have obligations about how quickly they decide claims and how they keep you informed, and if a claim is being unreasonably delayed, there are real steps you can take, including treating the delay itself as something you can complain about.
This guide explains when a delay becomes unreasonable, the signs to watch for, your rights, and what you can do to move a stalled claim forward. Please treat it as general information rather than advice about your own claim, and you should seek legal advice about your particular situation before making decisions about it.
When is a TPD claim delay unreasonable?
Some waiting is normal. A TPD claim is an assessment of whether you meet a specific definition of disability, built from medical and employment evidence, and that genuinely takes time. So the question is not whether your claim is taking a while, but whether it is taking longer than it reasonably should.
There is a useful benchmark. Insurers that subscribe to the Life Insurance Code of Practice, which the major insurers do, are expected to decide a lump sum claim, including TPD, within six months. That period runs from the later of the date the insurer receives the first information for your claim, or the end of any waiting period. If your claim has passed that point without a decision, and without a genuine reason, that is a strong sign the delay has moved from normal into unreasonable. We explain the overall timeline in more detail in our guide on how long a TPD claim takes.
The table below helps distinguish normal processing from a delay worth acting on.
| Often part of normal processing | May signal an unreasonable delay |
|---|---|
| An initial request for your medical and employment records | Repeated requests for information you have already provided |
| One independent examination where the file is genuinely unclear | A series of examinations that add little |
| A reasonable period to assess a complex claim | Long stretches of silence with no explanation |
| Being kept updated on progress and next steps | Passing the six month mark with no decision and no valid reason |
Signs your claim is being unreasonably delayed
A few patterns tend to indicate a claim is drifting rather than progressing.
The insurer goes quiet, and you find yourself chasing updates that never come. Requests for information repeat, or the insurer asks for material you have already supplied, which can suggest the file is not being actively managed. You are sent for one assessment after another, or the insurer keeps seeking further medical opinions without clear reason. The insurer says it is waiting on a third party, such as a former employer or a treating doctor, but does nothing to move that along. Or the six month period passes and no decision arrives, with no proper explanation for the delay.
None of these guarantees the insurer is at fault, but together they are a signal that your claim needs a firmer hand.
Your rights when an insurer takes too long
You have more leverage than the silence might suggest.
Under the Code, an insurer that cannot decide within six months is not entitled to simply keep you waiting. It is required to write to you, explain that circumstances genuinely beyond its control apply, and tell you about your right to complain. If you are not receiving that communication, that itself is a departure from what is expected.
The most important right to understand is this. You do not have to wait for a decision before you can act. A failure to decide your claim within a reasonable time can itself be treated as something you are entitled to complain about, which means an insurer cannot shield itself from scrutiny simply by never giving you an answer.
What you can do to move a stalled claim
If your claim has stalled, there is a practical sequence that tends to get things moving.
- Ask the insurer, in writing, for a clear explanation of exactly what is outstanding and what is holding up the decision. Put it in writing so there is a record.
- Deal promptly with anything genuinely outstanding, particularly requests for medical evidence, because a delay on your side is the one delay the insurer can fairly rely on.
- If the six month Code timeframe has passed, say so in writing and ask for the reason for the delay.
- Lodge a formal complaint through the fund’s or insurer’s internal dispute resolution process. For superannuation complaints, they are generally required to respond within 45 days.
- If the complaint does not resolve the delay, take it to the Australian Financial Complaints Authority, which is free and independent and can consider a complaint about delay, not only a complaint about a refusal.
- Get legal advice, particularly where the delay is significant, the evidence is being contested, or you suspect the delay is a way of avoiding a decision.
That fifth step is the one most people do not know about. The Australian Financial Complaints Authority can look at unreasonable delay in its own right, which is a powerful lever when an insurer is simply not deciding.
How Stephen Young Lawyers can help
A great deal of what makes a TPD claim slow is avoidable, and much of what looks like unavoidable delay is not. The difficulty for someone in the middle of it is knowing whether a delay is reasonable, and what to do when it is not.
An experienced personal injury lawyer can assess whether your claim is genuinely being delayed, deal with the insurer directly, hold it to the timeframes it is expected to meet, and escalate promptly through the internal complaint process and the Australian Financial Complaints Authority where a claim is drifting. Where delay has caused you loss, we can also pursue the question of interest on your benefit.
If you want to read more, we have guides on how long a TPD claim takes, on whether you are eligible for a TPD claim through super, and on what to do when a TPD claim is denied. You can find an overview on our main TPD claims page. As an Accredited Specialist personal injury firm based in Sydney CBD, with a multilingual team and a No Win No Fee approach for eligible matters, we can review where your claim is stuck and what can be done to move it forward.
No lawyer can promise you a particular outcome or timeframe, and every claim turns on its own circumstances. What can be said is that unreasonable delay is not something you simply have to accept, and that there are real mechanisms to hold an insurer to account.
Speak with an experienced TPD lawyer today
If your TPD claim has stalled, or you are not sure whether the delay you are experiencing is reasonable, it costs nothing to have someone look at where your claim is stuck and what can be done about it.
Contact Stephen Young Lawyers today for a free, no obligation consultation. Call us or get in touch through our website to speak with an experienced personal injury lawyer about your claim and how to move it forward.