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After a tragedy comes the inevitable paperwork. It was a car accident that took his life, leaving his wife scrambling for documents that would allow her to get the insurance money. It would have been a drawn-out process had Abdul, a MetLife claims adjudicator, not helped her every step of the way, including accompanying her to the court, hospital, police station, and arranging for the documentation. And in the middle of all this, she had to rush back to her home country to attend to another emergency. He sped up the process and ensured that she received the claim payout by the time she got to her home country.

For Abdul, this is just one example of how he and MetLife live up to the company’s slogan of navigating life together and ensure claims are paid fairly, quickly and efficiently, even during the most challenging times.

MetLife has been operating globally for more than 150 years, and in the Gulf for over 65 years. It offers products and services in more than 40 markets and serves 100 million customers — 700,000 of these are spread across the UAE, Bahrain, Kuwait, Oman and Qatar.

According to its Claims Report 2021, MetLife paid more than $837 million in group medical and individual claims to its Gulf customers from 2018 to 2020 — that works out to $764,000 a day — of which $178 million were payments made to customers now located in over 100 countries outside the Gulf. The top countries included India, the USA, Lebanon, Iraq and Singapore.

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Crucially, MetLife has achieved a 97.3 per cent score in successful claims payout, with just 2.7 per cent of claims not paid primarily due to non-disclosure or pre-existing exclusions. It has also seen a 20 per cent increase in individual payouts for Gulf customers — from $77 million in 2017-18 to $93 million in 2019-20. Close to $70 million of these were life claims, with 93 per cent coming in at under $250,000 — the highest life insurance claim paid in this period was $4 million — and the age of claimants ranging from 14 to 88 years, averaging out to 52 years.

Main causes for life claims

The report also reveals the top causes for life claims in the region. Heart problems top the table at 24 per cent followed by cancer clocking 11 per cent and injuries or accidents 7 per cent. Covid-19 marks an entry with 3.5 per cent, while stroke accounted for a little more than 1 per cent. A broad range of other conditions account for the remaining claims.

A gender split throws up interesting differences too. The top health risk for men is heart-related (heart attack 32 per cent, coronary artery disease 20 per cent), while for women it is cancer (breast cancer 30 per cent, other cancers 36 per cent). In the period 2018-2020, the youngest critical illness and cancer claimant was a one-year-old, while the youngest claimant for a heart condition was aged two. And though people made more insurance claims for accidents, the top reason for disability remained illnesses with cancer and stroke, contributing to almost 65 per cent of the disabilities.

Musculoskeletal diseases, respiratory disorders, endocrine or metabolic diseases, circulatory system diseases and digestive system diseases rounded off the top five diagnoses for medical claims.

Image Credit: Pranith Ratheesan

Equipped with local knowledge and a deep understanding of customers in this region, MetLife devises high-quality and unique medical benefits designed to prioritise every customer’s health. MetLife offers holistic coverage, even including dental and optical in some of the group plans — over the past three years, more than $35.5 million was paid for optical and dental support.

The pandemic effect

MetLife also understood the changing needs of its customers, especially in this pandemic era. Data shows that more than 60 per cent of temporary disability between January 2020 and May 2021 was due to Covid-19. During this period, MetLife continued to provide exemplary and efficient service — it settled 534 Covid-related claims in the Gulf, totalling close to $8 million, with the highest payout being $540,000.

In addition, the MetLife Foundation, which has made almost $1 billion in grants since its founding in 1976, committed $25 million in 2020 to help communities respond to and recover from Covid-19.

Also, to enhance remote care, MetLife offers an extensive telehealth service for Group medical members. Insured members can instantly access specialists and doctors who are ready to cater to their health needs, through an integrated video conference. Not surprisingly, MetLife’s telehealth claims rose over the past three years — doubling from more than $300,000 in 2018 to almost $600,000 in 2020.

Similarly, its innovative, easy-to-use online platform — myMetLife — makes the claims process faster and more convenient. The platform allows customers to submit, track a claim or even upload supporting documents through their mobile phone — feedback showed that more than 99 per cent of customers who made a medical claim through myMetLife preferred it to the traditional process. Moreover, personal assistance is available in English and Arabic to help customers during the claims process.

Despite all the ease in making claims and receiving benefits, MetLife’s 2021 study, Life Comes First found that 60 per cent of adults in the UAE are either inadequately insured or unsure whether their insurance would cover one of life’s eventualities, such as the loss of a loved one or a job. Forty-seven per cent are not financially prepared to face an unfortunate incident of any kind while a staggering 84 per cent cannot maintain their standard of living for more than two months.

All the more reason for customers to look closely at their financial preparedness to face unexpected events and zero in on the right insurance products from a range of innovative solutions available to protect themselves and their family.

For more information on MetLife Gulf claims and the 2021 claims report, click here.