RESPONSE TO THE ABC’S FOUR CORNERS EPISODE, ‘INSULT TO INJURY’
SYDNEY August 01, 2016
MetLife has great respect for the role police play in our community and recognises that they face challenging situations in the interest of keeping us all safe, situations that may leave them suffering from Post-Traumatic Stress Disorder (PTSD).
We would clarify that in total and permanent disability claims our role is not to diagnose physical or psychological conditions. Instead, it is to determine whether a claimant is unable to ever work again in any suitable occupation.
MetLife has a policy to use surveillance sparingly and only when there are inconsistencies in the information we have gathered as part of the assessment process. In 2015 surveillance was used in less than 1% of all claims under management.
In response to the dramatic increase of PTSD related claims, MetLife has conducted a thorough review of our claims management procedures, including surveillance. As a result, we now no longer use surveillance in the assessment of claims related to mental illness.
MetLife has a responsibility to all policy-holders and partners to apply rigorous assessment to ensure it pays genuine claims which meet the definition of Total and Permanent Disability.
Approximately 85% of current claims through the PBRI policy relate to mental illness and approximately 69% relate to PTSD. These kinds of claims are extremely complex and require comprehensive and detailed assessment, with advice from a number of independent medical specialists.
Surveillance is conducted by licensed investigators and is observational in nature – we do not condone intrusive or inappropriate surveillance techniques. We are clear with our providers that all surveillance activities must be conducted in line with a code of conduct which complies with the Australian Institute of Private Detectives’ National Code of Practice for Investigators and Mercantile Agents.
We would clarify that in Total and Permanent Disability claims under the PBRI policy our role is not to diagnose any condition. Instead, it is to solely determine whether the condition – be it a mental or physical illness or injury – is such that a claimant is unlikely to ever work again in any suitable occupation.
MetLife Insurance Limited (MetLife), an affiliate of MetLife, Inc., is a specialist provider of life insurance to affinity partners, superannuation trustees and employers in Australia. MetLife has expertise in designing and executing direct insurance programs for partners’ customers and insurance solutions to meet the needs of specific member groups. MetLife has been a specialist provider of life risk insurance products in Australia since 2005. MetLife, Inc. (NYSE: MET), through its subsidiaries and affiliates (“MetLife”), is a leading global provider of insurance, annuities and employee benefit programs. MetLife holds leading market positions in the United States, Japan, Latin America, Asia, Europe and the Middle East. For more information, visit www.metlife.com.