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
Dental Claim Form
We recommend that you bring a claim form with you when you visit your dentist for an appointment.
Dental Claim Form
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.
Medical Authorization/Disclosure of 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
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.
Attending Physician Statement
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.
Health Care Provider Certification-FMLA
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.
Electronic Funds Transfer (EFT) Authorization Form
Mail Above form to:
Metropolitan Life Insurance Company
Attn: MetLife Disability Claims
PO Box 14590
Lexington, KY 40511-4590
Fax: 1-800-230-9531
Change of Beneficiary
To correct, change or designate your beneficiaries.
Annuity (purchased individually) - Change of Beneficiary
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.
Change or Name a New Owner or Joint Owner
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.
Change Owner's Name on Record
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.
Request a Nursing Care Provision Withdrawal
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.
Change of Beneficiary
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.)
Make Corrections to Group Participant Information
Mail Above form to:
MetLife
PO Box 10356
Des Moines, IA 50306 - 0356
Fax: 1-908-552-3403
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.
Electronic Payment (EP) Account Agreement
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.
Change of Beneficiary Form
Mail Above form to:
MetLife
Attn: Beneficiary and Assignment Unit
PO Box 313
Warwick, RI 02887-0313
ExpressIT SM Authorization and Agreement
Save time and money with the ExpressIT automatic payment plan. With ExpressIT, premium payments are automatically withdrawn from your checking account each month by electronic funds transfer (EFT). You can select one of the four predetermined deduction dates that best meets your budgeting needs. To find out more about this payment option, contact your agent or a customer service representative.
ExpressITSM Authorization and Agreement
Mail Above form to:
If your policy is serviced by an independent agent:
Freeport Service Center
Attention: Correspondence Unit
PO Box 441
Freeport, IL 61032-0441
Fax: 1-888-540-9915
Mail Above form to:
All Others:
Dayton Service Center
Attention: Correspondence Unit
PO Box 48020
Dayton, OH 45475-0020
Fax: 1-866-743-4891
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