TPD claims drive insurance disputes

Australia's life insurers continue to accept most claims, but total and permanent disability (TPD) and disability income insurance claims remain the main sources of disputes and delays, according to the latest data from APRA and ASIC.

The Australian Prudential Regulation Authority's Life Insurance Claims and Disputes Statistics, covering the 12 months to 30 June 2026, found acceptance rates varied considerably by cover type and distribution channel.

Death claims recorded acceptance rates of 97% for individual advised policies and 98% for group superannuation cover. By comparison, TPD claims were accepted at rates of 81% for advised policies and 88% for group super.

Disability income insurance acceptance rates were higher, at 94% for advised policies and 96% for group super.

Disability income insurance recorded 326 disputes per 100,000 lives for advised policies and 493 for non-advised cover, compared with 98 for group super. TPD also attracted elevated dispute rates across individual policies.

Claims processing times presented another challenge. While 75% of death claims were finalised within two weeks, only 23% of TPD claims were completed within that period. The estimated average time to finalise a TPD claim was 3.9 months.

The data showed most disputes were resolved, with between 81% and 94% resolved across cover types. Of those resolved, 83% to 99% were completed within 45 days.

The findings also pointed to the role of policy terms in declined claims. Failure to meet contractual definitions of eligibility requirements accounted for 80% of declined advised TPD claims and 91% of declined group super TPD claims.

APRA's publication provides industry and insurer-level data across individual advised and non-advised policies, group superannuation and group ordinary business.