Our Claims Philosophy
A caring and compassionate claims process from a trusted global insurance provider, we deliver on our promise and look after customers when it matters most.
Claims at MetLife
Our priority is to be 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 efficiently, honestly and fairly
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 COMMITMENT
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.
Our commitment to your claim:
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.
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 or as otherwise agreed.
- Claim decision — up to 15 business days of getting all the information we need and completing all reasonable enquires.
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.
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.
We understand that being healthy is important to our customers’ overall wellbeing. That’s why we provide access to medical expert advice, health support and specialised services through MetLife 360Health to support your health and wellbeing.
With MetLife 360Health you can access a suite of award winning health services from medical, mental health and nutrition advice, to fitness and recovery support. You can use these services whenever you need them, whether you are making a claim or not, and they complement your existing treatments to help support your health and wellbeing goals.
We take our customers’ privacy very seriously and have robust processes in place to protect it at all times.
Read our Privacy Policy.
MetLife recognises that a customer’s vulnerability may be due to a single factor or a combination of factors.
If you need extra support to access our Claims service due to vulnerability, we will work with you to find a suitable, sensitive and compassionate option and do this as quickly and safely as possible. Our team are trained to identify, recognise and support customers experiencing vulnerability. This includes specific support for culturally and linguistically diverse individuals, Aboriginal and Torres Strait Islander peoples and individuals who may have difficulty understanding certain health issues. This also includes people who have issues with accessibility, such as people with a sight impairment.
Please contact us on 1300 555 625 or auservices@metlife.com to access a range of additional support services. More detail can be found here.
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.
You can find the feedback & complaints process on our Feedback & Complaints page.
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.