In the business of paying claims

— 1 minute read
Claim time is probably the most important time in the relationship between insurer and customer, says MetLife Australia.
As we often say in the insurance industry, we are in the business of paying claims. Claim time is probably the most important time in the relationship between insurer and customer. 

I was interested to read Andrew Howard's contribution in Investor Weekly at the beginning of July about the importance of good policy. I agree that the policy sets out the promise, which is extremely important. So now I would like to explore the delivery of that promise, which happens at claim time.

As we know in the industry, it is a myth that insurers don't pay claims. In fact, insurance companies in Australia pay out almost $10 million in claims every day.

Delivering on the promise to our customers is crucial, but we also believe the experience of the promise is equally important. When customers rely on their life insurance company at claim time, it is in many instances an already traumatic time.

Everything we do is about ensuring the best customer experience and we have recently taken a fresh approach to our claims process by hiring specialised expertise in-house.

Earlier this year, MetLife hired two qualified psychologists and a qualified nurse.

We believe this is an innovative approach to managing claims and there are many benefits, including internal management of our claims process and the experience we can deliver to our customers. 

In the past we have outsourced medical advice to assist with our initial decision and ongoing management of claims. Often these disabilities are complex and require specialised knowledge. By bringing the skills in-house, we have not only increased our medical understanding within the team, but improved our service standards.

Many of our funds now receive detailed information on our decision making as the new team has provided the in-house skills to provide clarification around claims decisions. This has enhanced our customers' experience through transparency and created trust in our process.

It also saves time because our specialised team is working full time in-house, so time isn't lost consulting for advice externally. One of the most significant benefits we have seen in the past few months is the reduction in time to make a decision. For instance, having in-house medical expertise means we can pick up the phone immediately to clarify information in medical reports. 

Another initiative we have taken by employing in-house medical expertise is the ability to profile new claims. This allows us to apply early intervention strategies, such as rehabilitation programs. These programs are designed to assist people getting back to their normal life prior to the disability or accident.

There is also a significantly positive impact on the development of our people. Developing and enhancing the skills and knowledge of our claims team is an important element in how we can better provide an enhanced customer experience. Our new team members work in the claims department, using their expertise to assist in the assessment of claims as required. They also provide assistance to our underwriters.

Granted, it has been a sharp learning curve for our new recruits; certainly a change of environment working outside the hospital and learning the aspects of the life insurance industry. What is clear is how medical assessments and reports play a vital role in assisting with our decision/outcomes on claims.

Improving the claims experience of customers requires a comprehensive approach. It means having the right people, with the right capabilities and skills, as well as a continued commitment to technology to ensure a great customer experience at claim time. Delivering on the promise is important; delivering the promise with a great customer experience is best.



In the business of paying claims
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