Claims Philosophy

Delivering on our promise and looking after customers when it matters most

Our business is about being there for our customers when they need us most. So we aim to pay every legitimate claim we receive, as fast as we can and with compassion and care.

We pride ourselves on delivering exceptional customer experiences and guiding customers through some of the most difficult moments in their lives. It’s what makes us different in the market and what drives us to keep improving the claims service we provide.

We strive to be the most caring and easiest to deal with life insurer in Australia — and claim time is our moment of truth. So we’ve created a process that puts the customer at its very heart – with claims handled expertly, sensitively and ethically.

Our approach

Our claims teams have the authority, training and experience to manage claims efficiently – so our customers can start receiving their benefits as soon as possible. But they also aim to deal with every customer with empathy and care – supporting them through a difficult time.

If you need to make a claim, you’ll be assigned a dedicated claims assessor, who is supported by a team of experts, including doctors. They’ll manage your claim throughout the entire process – so you’ll always deal with someone who knows your story and can update you on your claim.

When you make a claim, we get in touch with you and identify all the information we need up-front to make a decision. We’ll only ask for, and rely on, information and assessments that are relevant to your claim and will explain why we’re requesting these in plain and simple language. We will assess your claim for all available benefits under the Policy.  

We will deal with all issues raised by the information and will always seek clarification of inconsistencies or gaps. We’ll also protect the interests of all our customers by not paying claims which are not covered under the policy, so we can keep insurance cover as affordable and accessible as possible.

Our commitments

To help us provide the best claim experience, we’ve put high standards in place for our claims teams and work hard to meet them every time.

 

Here’s how we commit to dealing with your claim:
Fairness

We are committed to delivering on our contractual promise in our policy. We aim to be fair and to use common sense – and explain our decision to you in language that’s easy to understand.

Timeliness

We deal with every claim as fast as possible, so you’re not kept waiting for a decision.

We work towards the following standard timelines and continue to deliver a market leading service:

  • Up to 10 business days for initial assessment and to     explain the claims process (after receiving your claim).
  • Progress updates — at least every 20 business days.
  • Claim decision — up to 10 business days of getting all the        information we need.

This can sometimes take longer depending on when you, your doctor or another party send through requested information. Our service delivery can be impacted by the timeliness of their response.

Communication

We treat every customer as an individual. That means being sensitive to the fact that you are experiencing a difficult time.

It’s about providing the easiest and most caring claims experience we can, whether that means helping with information or with filling in a form – or dealing sympathetically with a concern or complaint.

Lifestyle Support

We believe that being healthy and able to earn a living through work are important to our customers’ overall wellbeing. So we provide Return to Health services to help you recover to wellness and good health.

Privacy

We take our customers’ privacy very seriously and have robust processes in place to protect it at all times.

Read our Privacy Policy.

Feedback & Complaints

We try to get it right every time — and we have Quality Assurance and Customer Relations teams in place, to continually monitor your feedback and improve the service we provide.

If you have a complaint, we’ll deal with it immediately. And if we can’t sort it out straight away, you can access internal and external dispute resolution committees to make sure it’s reviewed and resolved in a fair and impartial way.

What’s more, if you don’t agree with a claim decision, we’ll conduct a fair and transparent internal review or we will assist you in obtaining an independent review by external bodies.

Life Insurance Code of Practice

In addition to these promises, we also follow the industry standards set out in the Life Insurance Code of Practice (code), which sets out specific service standards, turnaround times and complaint handling processes. The standards set out in the Code are the minimum requirements for life insurers, and we seek to exceed them as far as possible.

This website contains general information only, which does not take into account your personal financial situation, objectives or needs. Before deciding whether to acquire, or continuing to hold, any of our products, please seek appropriate independent financial advice to assess whether it is suitable for you. You should also consider the relevant Product Disclosure Statement, available upon request by calling 1300 555 625, before making any decision. Life insurance products are issued by MetLife Insurance Limited ABN 75 004 274 882, AFSL 238096.

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