MetLife Forms
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:
Select any of our product categories below
Electronic Payment Authorization Forms
Tired of mailing your insurance payment every month? Simplify and go green! We offer two monthly electronic payment options that are safe, secure, and convenient. Plus, they’re better for the environment.
ExpressIT®
We will automatically deduct the amount due from your checking/savings account each month. You may even receive a discount with this plan!
Recurring Credit/Debit Card
We will charge your credit/debit card each month for the amount due. We accept Visa, MasterCard, Discover, and American Express. A $2 fee applies in most states. PAK II policies are not eligible for this payment plan.
Monthly Recurring Credit Card Authorization Form
Enroll Now
Download and complete the appropriate form above. Don’t forget to sign it. Then fax it to us at the number listed on the form. It’s that simple! Please allow 15 business days to process this change.
Change of Beneficiary
To correct, change or designate your beneficiaries.
Mail Above form to:
MetLife
PO Box 10342
Des Moines, IA 50306 - 0342
Fax: 1-908-552-3402
Change or Name a New Owner or Joint Owner
To correct, change or name a new owner or joint owner. You cannot change an owner if your account is an IRA account.
Mail Above form to:
MetLife
PO Box 10342
Des Moines, IA 50306 - 0342
Fax: 1-908-552-3402
Change Owner's Name on Record
To correct, change or name a new owner or joint owner. You cannot change an owner if your account is an IRA account.
Mail Above form to:
MetLife
PO Box 10342
Des Moines, IA 50306 - 0342
Fax: 1-908-552-3402
Request a Nursing Care Provision Withdrawal
Use if your account is eligible for this benefit.
Mail Above form to:
MetLife
PO Box 10342
Des Moines, IA 50306 - 0342
Fax: 1-908-552-3402
Change of Beneficiary
To correct, change or designate your beneficiaries.
Mail Above form to:
MetLife
PO Box 10356
Des Moines, IA 50306 - 0356
Fax: 1-908-552-3403
Make Corrections to Group Participant Information
For use by an Adminstrator to change Group Participant information (i.e., name changes, deletions, corrects, etc.)
Mail Above form to:
MetLife
PO Box 10356
Des Moines, IA 50306 - 0356
Fax: 1-908-552-3403
Dental Claim Form
We recommend that you bring a claim form with you when you visit your dentist for an appointment.
Mail Above form to:
MetLife Dental Claims
PO Box 981282
El Paso, TX 79998-1282
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.
Mail Above form 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.
Mail Above form to:
Metropolitan Life Insurance Company
Attn: MetLife Disability Claims
PO Box 14590
Lexington, KY 40511-4590
Fax: 1-800-230-9531
Health Care Provider Certification-FMLA
This form is used to gather medical information neccessary for the ongoing management of Family and Medical Leave Act (FMLA) Claims. Have your physician complete this form after you file your claim.
Mail Above form 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.
Mail Above form to:
Metropolitan Life Insurance Company
Attn: MetLife Disability Claims
PO Box 14590
Lexington, KY 40511-4590
Fax: 1-800-230-9531
Electronic Payment (EP) Account Agreement
Pay your premiums and make other transactions with our convenient Electronic Payment (EP) Account Agreement. Use this form to authorize electronic fund transfers from your checking, savings or share draft account to pay premiums due on your personal life insurance policies. The form contains detailed instructions on how to use this convenient service.
Mail Above form to:
MetLife
PO Box 354
Warwick, RI 02887-0354
Fax: 1-908-552-2442
Change of Beneficiary Form
Change the beneficiary of your policy with this easy to use form.
PDF version (340 KB)
Request a Loan Form
This form is used to request a loan on your life insurance policy.
PDF version (250 KB)
Partial Withdrawal Form
This form is used to request a partial withdrawal from a universal life policy.
PDF version (246 KB)
Dividend Withdrawal Form
This form is used to request a withdrawal of dividend or riders from a traditional life insurance policy.
PDF version (247 KB)
Policy Surrender Form
This form is used to request a full cash surrender on your life insurance policy.
PDF version (237 KB)
If you would like to perform these service transactions online, please register or log in to Manage Your Accounts.
TCA – Beneficiary Designation Form
To correct or change beneficiaries on your Total Control Account.
(Note: Please do not use the standard life or annuity designation forms for TCA beneficiary designations.)
Mail Above form to:
MetLife and Affiliates
Total Control Account
PO Box 6511
Utica, NY 13504-6511
Fax: 315-792-5813
Change Accountholder’s Name or Address of Record
To change or correct TCA accountholder name and address.
Mail Above form to:
MetLife and Affiliates
Total Control Account
PO Box 6511
Utica, NY 13504-6511
Fax: 315-792-5813
TCA Death of Accountholder 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.
Mail Above form to:
MetLife and Affiliates
Total Control Account
PO Box 6511
Utica, NY 13504-6511
Fax: 315-792-5813
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