If you've ever wondered whether the cost of working with a financial adviser is truly worth it, the latest data from Australia's peak insurance regulator provides a compelling answer — especially when it comes to Total and Permanent Disability (TPD) insurance claims.
According to the Australian Prudential Regulation Authority's (APRA) Life Insurance Claims and Disputes Statistics publication, covering the 12-month period from 1 January 2025 to 31 December 2025, the gap in outcomes between advised and non-advised policyholders is striking — and in some cases, the difference runs into hundreds of thousands of dollars.
What the APRA Data Tells Us About TPD Claims
In 2025, Australian life insurers received a total of 3,483 TPD claims. Of these, the overwhelming majority — 3,350 claims — came from individuals with a financial adviser, compared to just 133 from non-advised individuals.
But it's not just the volume that stands out. It's what happened next.
Payout Rates
Of advised TPD claimants, 70 per cent had their claim paid out. For non-advised individuals, that figure dropped to just 53 per cent — meaning nearly half of people without an adviser who made a TPD claim received nothing. This also does not take into consideration that fact that financial advisers are more likely to advise their clients to lodge a claim should they think there is a possibility that a TPD claim can be made.
For someone going through a serious illness or injury that has permanently affected their ability to work, the difference between a successful claim and a rejected one can be life-changing.
Admittance Rates and Average Payout Amounts
The overall admittance rate for advised TPD claims came in at a strong 82.3 per cent, compared to just 68.8 per cent for non-advised claims.
The dollar figures are equally stark:
| Advised | Non-Advised | |
|---|---|---|
| Average TPD claim payout | $785,000 | $312,000 |
| Claims admittance rate | 82.3% | 68.8% |
| Claims paid out | 70% | 53% |
The highest average TPD payout among advised clients was recorded by TAL, coming in at $919,000.
This shows that not only do clients who have an adviser have a higher percentage of claims acceptence, they also have higher amounts of cover.
The $473,000 gap in average payout between advised and non-advised clients reflects a combination of factors — higher sum insured amounts, better-structured policies, and more successful navigation of the claims process itself.
What About Death Claims?
Death cover remains the most commonly claimed life insurance policy, with 4,462 death claims recorded in the same period. Admittance rates are high across the board — 97 per cent for advised clients and 92.2 per cent for non-advised — and the difference in outcomes between the two groups is less pronounced than with TPD.
This is consistent with the nature of death claims, which are generally more straightforward to assess. TPD claims, by contrast, involve complex medical definitions, functional assessments, and detailed documentation — areas where having an experienced adviser in your corner makes a significant difference.
Speed of Resolution: Advised Clients Win Again
Beyond payout rates and amounts, the APRA data also reveals meaningful differences in how quickly claims are finalised.
Death Claims — Time to Resolution
| Advised | Non-Advised | |
|---|---|---|
| Finalised within 2 months | 74.2% | 61.3% |
| Finalised within 6 months | 96.8% | 90.5% |
| Average duration | 1.6 months | 2.3 months |
TPD Claims — Time to Resolution
| Advised | Non-Advised | |
|---|---|---|
| Finalised within 3 months | 28.4% | 19.7% |
| Finalised within 6 months | 61.7% | 54.1% |
| Average duration | 5.9 months | 7.4 months |
For TPD claimants, the average advised claim is resolved 1.5 months faster than a non-advised claim. When someone is seriously ill or injured and unable to work, waiting an extra six weeks for a financial lifeline is not a small inconvenience — it can mean significant financial hardship.
Dispute Rates: Fewer Disputes for Advised Clients
When a claim is denied or disputed, the process becomes longer, more stressful, and more expensive. The APRA data shows that advised clients are significantly less likely to end up in dispute.
| Advised | Non-Advised | |
|---|---|---|
| TPD dispute rate | 6.5% | 11.2% |
| Death claim dispute rate | 2.1% | 3.8% |
Non-advised TPD claimants are almost twice as likely to end up in a dispute as their advised counterparts. This reflects the reality that poorly structured policies, incorrect ownership arrangements, or inadequate documentation at application stage can create problems years later — problems that a qualified adviser works to prevent from the outset.
Why Does Having an Adviser Make Such a Difference?
The data raises an obvious question: why do advised clients consistently achieve better outcomes?
There are several reasons:
1. Correct policy structure from day one An adviser ensures your TPD policy is owned and structured correctly — whether inside or outside superannuation,which directly affects both your eligibility to claim and the tax treatment of any payout. An adviser can also explain the differences between any and own occupaiton and which definition is suited to each clients circumstances.
2. Accurate sum insured Many people who take out direct policies underestimate how much cover they actually need. An adviser calculates a sum insured based on your income, debts, lifestyle, and long-term financial needs — which explains the significantly higher average payout amounts among advised clients.
3. Clear and accurate applications Non-disclosure at application stage is one of the most common reasons TPD claims are denied. An adviser guides you through the application process to ensure your health history is declared accurately, reducing the risk of a claim being rejected later.
4. Claims support When it comes time to make a claim, an adviser advocates on your behalf. They understand the definitions, know what documentation insurers require, and can navigate the process far more effectively than an individual going it alone — which directly contributes to faster resolution times and lower dispute rates.
The Bottom Line
The APRA data doesn't leave much room for debate. Across every meaningful measure — payout rates, claim amounts, speed of resolution, and dispute rates — advised clients consistently achieve better outcomes than those without an adviser.
A 70 per cent payout rate versus 53 per cent. An average TPD payout of $785,000 versus $312,000. Claims resolved in 5.9 months versus 7.4 months. Dispute rates of 6.5 per cent versus 11.2 per cent.
These differences aren't small by any means. They represent the real-world value of having a qualified professional structure, manage, and advocate for your insurance from day one.
If you have TPD insurance arranged directly — or no TPD insurance at all — it's worth having a conversation with a the team at Protectinsure.
We provide full personal advice suited to your needs. For an obligation free chat, click on the contact us button and get in touch today.
Source: Australian Prudential Regulation Authority (APRA), Life Insurance Claims and Disputes Statistics, 12-month period ending 31 December 2025.
This article is general in nature and does not constitute personal financial advice. Please consult a licensed financial adviser before making any decisions about life insurance or TPD cover.
Steve Davies Pty Ltd trading as Protectinsure (AFSL 493386) | (ABN: 94 611 606 056)