Australian Retirement Trust and its insurer have overturned an AFCA ruling that tried to backdate a TPD benefit, after the Federal Court rejected an attempt to use section 54 to shift the payment date.
The case, Australian Retirement Trust Pty Ltd ATF Australian Retirement Trust v Buckland [2025] FCA 1563, was an appeal from a determination made by the Australian Financial Complaints Authority on 26 March 2025. The Notice of Appeal was filed on 23 April 2025. Justice Derrington delivered judgment on 12 December 2025, allowing the appeal and setting AFCA’s determination aside, with no order as to costs.
At the centre was a familiar tension for insurers and super fund trustees running group cover: when a member’s condition is assessed over time, what fixes the start date for a lump sum Total and Permanent Disablement benefit?
Kate Frances Buckland, a member of the Australian Retirement Trust superannuation fund, ceased work due to illness on 17 September 2021. On 1 October 2021, she lodged an “Income Protection Benefit Claim”. Her regular general practitioner, Dr S Burgess, completed an “Income Protection Benefit Claim (Part C) – Doctor’s Statement” on 8 October 2021, certifying Buckland was “unfit” to work from “17/09/2021 to 01/11/2021 inclusive” and was “expected to return to work” by February 2022. Dr Burgess issued a further certificate on 2 November 2021 stating Buckland would be “unfit” to work from “01/11/2021 to 10/12/2021 inclusive”.
On 17 January 2022, the income protection claim was approved on the basis that Buckland was suffering from a Temporary Disablement, and she began receiving a monthly benefit effective from 18 October 2021.
The TPD turning point came later. On 22 August 2022, psychiatrist Dr B Jacobs completed a “Total and Permanent Disability (TPD) Benefit Claim (Part C) – Doctor’s Statement”. In that statement, Dr Jacobs indicated his belief Buckland’s symptoms presented “a barrier to [her] return to work”. Buckland lodged a claim for a “TPD Benefit” under the policy on 14 September 2022. After making inquiries, QInsure determined the claim in her favour on 4 November 2022 and calculated the benefit from 22 August 2022. The reasons record why: “The first medical report supporting Kate Buckland as is permanently unable to work again” was the doctor’s statement dated 22 August 2022, and “Prior to this report, the medical was supporting a likely return to employment.”
Following payment of the final monthly benefit under the income protection claim on 2 December 2022, QInsure paid the TPD benefit of $312,960 to Buckland one week later. The reasons state she was paid $312,960 on 9 December 2022.
Then came a retrospective shift. On 2 February 2023, Dr Burgess issued another certificate saying Buckland ceased paid employment “September 21st 2021” due to illness, that in April 2022 the goal had been a return to work, but that “in hindsight” and with access to other reports, “it is clear that she has in fact been incapacitated since she ceased working on September 21st 2021.” Buckland’s solicitors wrote on 10 February 2023, attaching that certificate and requesting recalculation of the insurance benefit. Buckland then applied to AFCA on 6 April 2023 seeking review of the amount she received.
AFCA accepted that, under the policy definition, the relevant “Date of Disablement” for TPD was the date a medical practitioner certifies the member is permanently unable to work again, and concluded Buckland did not meet that definition until 22 August 2022. But it still applied section 54 of the Insurance Contracts Act 1984 (Cth), and ordered the insurer to pay as if the Date of Disablement were 21 September 2021. It awarded $36,480, calculated as the difference between the Sum Insured at 21 September 2021 ($349,440) and at 22 August 2022 ($312,960).
The Federal Court disagreed. It held section 54 could not be used to sidestep the policy’s certification-based trigger, and found there was no evidence any medical practitioner could (or would) have issued the required certification earlier than 22 August 2022. The result was simple: AFCA’s determination was set aside.
Takeaway: When a TPD policy ties the start date to a doctor’s written certification, a later “in hindsight” opinion cannot shift the Date of Disablement, and section 54 will not rewrite that trigger.
