The retail claims process

Nov 2019

Metlife Senior Claims QA Consultant Peter Kelly offers some practical tips for advisers on making the claims process as smooth as possible – for everyone.

1. How should advisers explain the claims process to clients?

First, make sure you understand what's happened to the client and what their immediate needs and concerns might be. Explain to the client that this information will help get the claim moving and allow Metlife to tailor the right approach, including addressing all potential entitlements.

2. What is MetLife’s customer service approach?

Reassure the client that all contact will be initiated by MetLife. At each point of contact, we’ll arrange a time for the next phone call that aligns with the client’s recovery process. We will keep you and your client up to date on the status of the claim and answer any concerns. By scheduling the next contact in advance, we ensure you are not left wondering ‘what’s next’. As soon as the claim gets to us, we review it. Then we get on the phone with the customer to start exploring their entitlements and explaining the process. We will explain the reason for each piece of information we request and what it will be used for. This way the process is clear to the client.

3. What does MetLife do to help reduce the stress of making a claim?

Empathy is the core of our claims process. We make sure the customer feels comfortable and understands the process. We also ensure they know what to expect, what's required of them, and when their benefits are coming. If a customer experiences difficulty accessing or providing information requested for the claim that might cause the claim to be delayed, we will explore options and alternatives appropriate to the circumstances..

4. People contact you at what’s possibly the worst time of their life. How can advisers support clients in distress?

It is quite often the worst time and not just because the client is sick or injured but also because of financial stress. Our approach is more than conducting a claims assessment: we strive to understand the client’s lifestyle so we can tailor the approach to their needs, including immediate and ongoing support. It’s our responsibility to help alleviate the financial element by getting the claims process moving as soon as possible so they can focus on getting better. We also provide access to our Nourish service[WU1], which offers an extensive range of rehabilitation services to help people return to health.

5. How can advisers help reassure people that MetLife pays valid claims?

If an adviser recommends Metlife Protect to a client, it’s worth mentioning that Metlife has a solid history of paying claims – and at a higher rate than other insurers. Our claims data for January to December 2018 shows Metlife paid 98% of death claims, 96% of IP claims, and 88% of TPD claims.

6. What’s the main thing people want from their adviser?

The number one quality is trust. Trust that they’re getting the right advice, and that their adviser will be available when they need them. A good adviser is not just there to sell you the product. They’re there to support you when that product needs to be used. To find out more about what clients want from their relationship with their adviser, read our Understanding The Adviser-Client Relationship Report 2019.

7. Are there any common problems at claims time?

A common problem customers report is the income protection claim excess or waiting period. Many customers don't understand this means they're not going to get paid for the duration of the excess period they’ve chosen, which could create financial concerns. Advisers can help by making this really clear at policy inception stage. Ask people how long they want their excess period to be and make sure they know they won’t have funds for that period.

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