One of the most common concerns people have about TPD claims is whether a condition they had before getting insurance cover will disqualify them. The answer is: it depends — and it's more nuanced than a simple yes or no.
How pre-existing condition exclusions work
Super funds' default insurance typically includes standard exclusions rather than individually assessed exclusions (which are common in retail life insurance). For most default super TPD policies, exclusions apply to claims arising directly from conditions that were known and treated in a specified look-back period (often 5 years) before the insurance started.
When it gets complicated
- If you had a back condition before joining a super fund and later suffered a more severe injury, the exclusion may or may not apply depending on whether the two are considered the same condition
- If your TPD is due to a condition unrelated to the pre-existing one, the exclusion doesn't apply
- A condition that worsened significantly may support a claim even with some prior history
Don't assume exclusion = rejection
Many people assume they're excluded and never claim — only to find on investigation that either their condition isn't excluded or the exclusion doesn't apply in the way they thought. Have your specific policy reviewed. Start with a free eligibility check.