MetLife

At MetLife, protecting your information is a top priority.

You may have seen recent news coverage of customers of financial services companies falling victim to social engineering scams. Scammers impersonate a trusted company to convince their targets into revealing or handing over sensitive information such as insurance, banking or login credentials. This scamming can happen via text, email or websites set up to look like the trusted company.

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FOR PROVIDERS

  • Dental Professionals Account

FOR RETIREMENT PLAN PARTICIPANTS

  • mlr.metlife.com
  • online.metlife.com

FOR EMPLOYERS

  • Group Benefits Administration
  • Plan Service Center (PSC)

FOR BROKERS & CONSULTANTS

  • Structured Settlements Broker Resources (SBR)

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Forms Library

MetLife |  Metropolitan Tower

Want to Change an Address?

If you have a new address or phone number, use this form to let us know so we can keep you informed about the status of your policies. Get started online by clicking the link below:

Access Online Change of Address Form

Select any of our product categories below

Visit www.metlife.com/annuityforms to find frequently used forms to service your Annuity.

Download and complete the appropriate form below. Then mail or fax it to us at the address or number provided. Mail form to:  MetLife  PO Box 10356  Des Moines, IA 50306 - 0356 Fax: 1-877-549-5834

Change of Beneficiary Use this form to correct, change or designate your beneficiaries.  PDF version (52k)

Make Corrections to Group Participant Information This form is for use by an Administrator to change Group Participant information (e.g., name changes, deletions, corrects, etc.).  PDF version (52k)

403(b) Withdrawal Request Form - Non-ERISA This form is for a participant or alternate payee to request a distribution from a 403(b) Non-ERISA annuity other than for a hardship or as a systematic withdrawal. PDF version (52k)

Coronavirus-Related Withdrawal Form Use this form if you were impacted by SARS-CoV-2 or COVID-19 and are eligible to take a distribution as defined by the CARES Act.  PDF version (53k)

403(b) Beneficiary Change Use this form for a change of Beneficiary and Spousal Consent for ERISA or Non-ERISA 403(b).  PDF version (52k)

For additional forms please visit https://eforms.metlife.com

Dental Claim Form DOWNLOAD FORM If you download a form we recommend that you bring a claim form with you when you visit your dentist for an appointment.

How to file a claim online How to file a claim by phone How to file using a claim form Disability paper claim form guide Tips for Employers for paper claims

Medical Authorization/Disclosure of Information Use the form to inform your physician(s) that MetLife will be administering your disability claim and give authorization to release your medical information to MetLife.  PDF Version (41k) Mail Medical Authorization/Disclosure of Information to:   Metropolitan Life Insurance Company  Attn: MetLife Disability Claims  PO Box 14590  Lexington, KY 40511-4590  Fax: 1-800-230-9531

Attending Physician Statement This form is used to gather medical information necessary for the ongoing management of disability claims. Have your physician complete this form when your case manager requests new/updated medical information. PDF version (237k) Mail Attending Physician Statement to:   Metropolitan Life Insurance Company  Attn: MetLife Disability Claims  PO Box 14590  Lexington, KY 40511-4590  Fax: 1-800-230-9531

Electronic Funds Transfer (EFT) Authorization Form Complete, sign and mail/fax this form to MetLife to authorize electronic funds transfers of your disability insurance payments directly to your bank. Please verify that your employer's plan offers electronic funds transfer for disability income benefit payments before submitting this form to MetLife. PDF version (41k)

Mail Electronic Funds Transfer (EFT) Authorization Form to:   Metropolitan Life Insurance Company  Attn: MetLife Disability Claims  PO Box 14590  Lexington, KY 40511-4590  Fax: 1-800-230-9531

FMLA Certification These forms are used to gather medical information necessary for the ongoing management of Family and Medical Leave Act (FMLA) Claims for yourself, a family member or a service-member family member. Have the physician complete this form after you file your claim.  Certification for Employee's Serious Health Condition Certification for Family Member's Serious Health Condition Certification for Qualifying Exigency for Military Family Leave Certification for Covered Service-member for Military Family Leave Mail FMLA Certification to:  Metropolitan Life Insurance Company  Attn: MetLife Disability Claims  PO Box 14590  Lexington, KY 40511-4590  Fax: 1-800-230-9531

PFML These forms are used to gather information necessary for the ongoing management of Paid Family and/or Medical Leave Act (PFML) Claims for yourself, a family member or for some military family needs. Depending on the leave reason, you may need to have the physician complete this form after you file your claim. PFML Claim Form PFML Certification - All Leaves

HI specific TDI – Temporary Disability Claim Form

NY specific DBL – Disability Claim Form PFL – Paid Family Leave Claim Form and Certifications

NJ specific TDI – Temporary Disability Claim Form

Current life insurance policyholders  can visit  metlife.com/lifeinsurance  to:

  • Access forms
  • Manage your life insurance policy
  • Get answers to frequently asked questions

Beneficiaries of a life insurance policy  can visit  metlife.com/lifeinsuranceclaims  to:

  • Learn about the claims process and what you’ll need to submit your claim
  • Search for a life insurance policy
  • Start a claim

Visit www.metlife.com/ltc/documents to find frequently used forms to service your Long-Term Care policy.

TCA – Beneficiary Designation Form

To add or change beneficiaries on your Total Control Account.

COMPLETE ONLINE or DOWNLOAD FORM

Change Accountholder’s Name or Address of Record

To change or correct TCA Accountholder name and address.

TCA Death of Accountholder Standard Claim Form

To make a claim for benefits upon the death of a TCA Accountholder, or to replace a claim for previously sent to you by MetLife upon the death of a TCA Accountholder.

(Use the Standard Claim Form if the Accountholder did not reside in MN or NY at the time of death, or if the beneficiary does not reside in AK, FL, LA, MN, or NY. Please call 1-800-638-7283 for questions.)

TCA Death of Accountholder Elective Claim Form

To make a claim for benefits upon the death of a TCA Accountholder, or to replace a claim form previously sent to you by MetLife upon the death of a TCA Accountholder.

(Use the Elective Claim Form when the Accountholder resided in MN or NY at the time of death, or if the beneficiary resides in AK, FL, LA, MN, or NY. Please call 1-800-638-7283 for questions.)

MetLife Claim Form   In English  PDF Version (161k)   En Español  PDF Version (163k)

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Please note that MetLife, Inc is not affiliated with Adobe® or Adobe Acrobat® Reader and makes no representations regarding the suitability of Adobe Acrobat Reader for your computer and assumes no liability with respect to your accessing the site or installing any Adobe software from it, including Adobe Acrobat Reader.

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