How A Recent Court Case Can Impact Your Total Permanent Disability Benefit

Picture two people with the same illness, same diagnosis, same inability to work. One claimant receives the full Total Permanent Disability (TPD) benefit they expected and the second receives noticeably less or it is declined. The distinguishing factor is not medical but comes down to when the claimants saw their doctor. A recent federal court decision has placed a stronger emphasis on policy terms and the date of disablement.

Buckland case: The recent decision the Federal Court handed down Australian Retirement Trust Pty Ltd v Buckland [2025] FCA 1563 on 12 December 2025 demonstrates the importance of date of disablement.

TPD policies contain the term Date of Disablement which is generally

• the date the member ceased working gainfully in their education training and experience.

Certain polices however work in a “Certification Test” which is a secondary criterion as follows:

• The date a doctor certifies in writing that you are permanently unable to work again.

Within this case the claimant ceased work on 21 September 2021. They first had a doctor sign off being ‘unfit to return to work’ on 22 August 2022, however it was not until 2 February 2023 that a doctor certified that the claimant ‘will be unable to return to work in the future’.

The insurer originally identified the date of disablement as 2 February 2023, which was the first date that a doctor certified the claimant would not be able to return to work (policy terms). The claimant however did not agree with the is assessment and took the insurer to AFCA.

Initially AFCA ruled in the claimant’s favour and directed the insurer to pay the difference however the insurer appealed AFCA’s decision to the federal court.

Put simply:

• The insurer’s position was: the policy should be considered in the technical sense, if the policy calls for a point in time certification confirming the disablement – then the claim must be assessed accordingly.
• The claimant’s position was: A medical certificate which in substance confirms the claimant is disabled earlier should be able to be retrospectively affirmed by the same doctor at a point in time the claimants disablement is confirmed.

They argued s 54 of the insurance contracts act which would ordinarily prevents insurers from refusing a claim based on a technical breach of the policy by the policyholder, unless that breach directly caused the loss or financially prejudiced the insurer.

The court ruled in favour of the insurer.

What does this mean?

In essence, this decision means that if your policy contains this policy term – then the insurer may have the ability to rely on the technical features of the policy, which can alter your date of disablement to the first date a doctor certifies in writing that you are permanently unable to work again.

Why does this matter?

The deemed date of disablement may be the single most important factor when determining the amount of insurance payable.

Many default TPD insurance cover decrease in value, as members age (per year). It is not uncommon for a claimant to be disabled for multiple years before deciding to proceed with a TPD Claim. Meaning that it is important to seek advise as soon as you consider your condition may disable you from returning to work.

What to do if you’re claiming now.

If you have stopped work because of illness or injury, the date your doctor records that you are permanently unable to return to work can make a real difference to your TPD claim — including how much insurance is payable. If you are making a claim, already have a claim underway, or are unsure whether the insurer has used the correct date, get in contact with us for specialist advice before your entitlements may be affected.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.