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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:

Access Online Change of Address Form

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!

ExpressIT Authorization Form

Recurring Credit Card

We will charge your credit 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.

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 10342
Des Moines, IA 50306 - 0342
Fax: 1-877-547-9669

Change of Beneficiary
To correct, change or designate your beneficiaries.
PDF version (52k)

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.
PDF version (52k)

Change Owner's Name on Record
To correct or update an Owner's name, address, or phone number. This form is not to be used for changes in Ownership, which require a Policy service request form.
PDF version (52k)

Request a Nursing Care Provision Withdrawal
Use if your account is eligible for this benefit.
PDF version (52k)

Annuity Withdrawal Form
Use to request a partial withdrawal or full surrender from a Non-Qualified, Traditonal, SEP, Simple or Roth IRA annuity account. Do not use for 1035 exchanges or Qualified Transfers.
PDF version (52k)

Qualified Transfer Request
Client authorization for current provider or administrator to directly transfer or rollover amounts to a new or existing MetLIfe IRA or Non Qualified annuity. Do not use for 1035 Exchanges.
PDF version (52k)

Required Minimum Distribution RMD Form -- MET
This form is to be used to request a Required Minimum Distribution (RMD) for a MetLife annuity.
PDF version (52k)

Non-Qualified Transfer 1035 Exchange Request
Used to perform a partial or full surrender tax-favored exchange from a whole life policy or endowment or non-qualified annuity to a new or existing MetLife non-qualified annuity.
PDF version (52k)

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
To correct, change or designate your beneficiaries.
PDF version (52k)

Make Corrections to Group Participant Information
For use by an Adminstrator to change Group Participant information(i.e., name changes, deletions, corrects, etc.).
PDF version (52k)

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

403B Beneficiary Change
Used for change of Beneficiary and Spousal Consent for ERISA or Non-ERISA 403B.
PDF version (52k)

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.

PDF Version (41k)

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.

PDF version (237k)

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
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 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.

PDF version (41k)

Mail Above form to:
Metropolitan Life Insurance Company
Attn: MetLife Disability Claims
PO Box 14590
Lexington, KY 40511-4590
Fax: 1-800-230-9531

If you would like to perform these service transactions online, please register or log in to eSERVICE.

Change of Beneficiary Form

Change the beneficiary of your policy with this easy to use form.
PDF version (340 KB)

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.

Policy Surrender Form

This form is used to request a full cash surrender on your life insurance policy.
PDF version (237 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)

Individual Life Death Claim

This form is used to claim individual life insurance proceeds. It also provides a description of the claim process including the manner in which we pay claims.
PDF version (247 KB)


To serve you best with the following requests, please contact a customer service representative at 1-800-638-5000.

Request for Change in the Planned Premium Payment

To request an increase or decrease in the planned premium amount, please call 1-800-638-5000.

Reinstatement Application

To reinstate a policy when lapsed, please call 1-800-638-5000.

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 form to:

Metropolitan Life Insurance Company

Total Control Account
PO Box 6300
Scranton, PA 18505-6300

    

Change Accountholder’s Name or Address of Record

To change or correct TCA accountholder name and address.

Mail form to:

Metropolitan Life Insurance Company

Total Control Account
PO Box 6300
Scranton, PA 18505-6300

    

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 form previously sent to you by MetLife upon the death of a TCA Accountholder.

Mail form to:

Metropolitan Life Insurance Company

Total Control Account
PO Box 6300
Scranton, PA 18505-6300

    

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 Accountholder resided in NY at time of death, and or beneficiary resides in NY at time of death. Please call 800-638-7283 for questions.)

Mail form to:

Metropolitan Life Insurance Company

Total Control Account
PO Box 6300
Scranton, PA 18505-6300

    

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