09 July 2020
Effective from 1 July 2019, MLC Life Insurance (MLCL) in conjunction with NULIS Nominees (Australia) Limited (the policy holder) made improvements to the Total and Permanent Disability (TPD) insurance cover provided to MLC MasterKey Business Super members.
This includes removing the Activities of Daily Living (ADL) component of the TPD definition for TPD claim events that occurred on or after 1 July 2019, with employed members now assessed against an ETE (Experience, Training, Education) definition. Going forward, we expect the proportion of TPD claims assessed under the ADL definition to reduce.
The use of the ADL definition in assessing TPD claims represents a very small proportion of all group insurance claims in the life insurance industry. Of the 18,758 TPD claims made in 2019, only 5 per cent were assessed using an ADL definition. Of that 5 per cent, 57 per cent of these claims were paid.
MLC Life Insurance is transitioning away from using the Activities of Daily Living definition in assessing TPD claims.
We want super fund members and policy holders to have confidence in their insurance cover, and we continue to work on making improvements to the insurance experience for them.
In 2019, MLC Life Insurance paid out more than $1.3bn in claims.
On Ms Jenkins’ claim:
We assess all claims empathetically, professionally and in line with industry standards as set out under the Life Insurance Code of Practice.
While we cannot comment on the specifics of Ms Jenkins’ case, we note we have not yet made a decision to decline the claim. Ms Jenkins and her legal representatives have the option to provide additional information before a final decision is made.
In addition, the coronavirus pandemic has no bearing on Ms Jenkins’ claim nor any relationship to the FSC’s Total and Permanent Disability COVID-19 Claims Initiative. Her date of claim was pre 11 March 2020.
 FSC / KPMG Claims Data Report 2019