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Your life insurance claim kit (MetLife)

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U.S. Life Insurance Claims
GR-LTR-TCA-E (06/18)
Page 1 of 1
Fs/f
Metropolitan Life Insurance Company
Your life insurance claim kit
On behalf of MetLife, please accept our sincere condolences during this difficult time.
Helping you submit your claim
We’ve enclosed a “Guide to making your claim” which describes the steps to submit your claim. You have the
option to receive the proceeds of your claim deposited into a convenient Total Control Account that we’ll open
for you, or as a check. You’ll find more details in the enclosed document, “About the Total Control Account.”
We’re here to help
We recognize this may be a challenging time for you. If you have questions, or need help preparing your claim,
call us at 1-800-MET-6420 (1-800-638-6420). Our Customer Service Center is open Monday through
Thursday, 8:00 a.m. to 8:00 p.m. EST, and Friday 8:00 a.m. to 5:00 p.m. EST.
Sincerely,
MetLife
U.S. Life Insurance Claims
U.S. Life Insurance Claims
GR-CLAIM-GUIDE (06/18)
Page 1 of 1
Fs/f
Guide to making your claim
What you’ll find in this package
• Life insurance claim form – You’ll need to complete and return this to us with the death certificate.
• About the Total Control Account – This explains the option you have to receive your claim proceeds.
To submit your claim, follow these steps:
1. Decide
You have the following options to receive your life insurance proceeds:
• A Total Control Account that we open for you to hold your claim proceeds, or
• A check that we mail to you
Please read the enclosed About the Total Control Account for details. Please indicate your choice when
completing the claim form. If you do not choose an option, you will receive a Total Control Account in most
states unless state law requires us to pay you by check.
2. Complete
Complete the enclosed Life insurance claim form by following the instructions on the form. Please provide
all the information requested so we may process your claim as quickly as possible.
3. Return
Please send us your completed claim form and the documents we ask for in Section 5 of the form.
What to expect after you submit your claim
We’re committed to processing your claim as quickly as possible. Once we receive all your information, we’re
able to process a typical claim within 5-7 business days.
If we approve your claim and you chose to receive a check, or your proceeds are less than $5,000, we’ll mail
you the check.
If you choose to receive your proceeds in a Total Control Account, we’ll:
• Open a Total Control Account in your name
• Place the proceeds from your claim into your account, and
• Mail you a package, that includes account details and a book of personalized drafts (like checks)
GR-TCA-E (08/21)
Page 1 of 2
L0621014239[exp0622][All States][DC,GU,MP,PR,VI]
Your security and peace of mind is here —
Total Control Account
®
MetLife’s Total Control Account
®
(TCA) takes away the worry of having to make financial
decisions while grieving the loss of a loved one and provides you the time you need to best
decide how to use your proceeds. TCA offers the same advantages as a checking or
Money Market Account does, but it’s so much more…
Benefits of using TCA
Immediate access to funds Simple and flexible
Valuable account features Ongoing support and
service
Easy to set up and manage
• Earn interest from day one
1
• Guaranteed minimum interest
of .50%
2
• No need for a separate bank
account
• Fee-free Visa debit card/ATM card
• Ability to link to popular payment
apps/services such as PayPal
®
,
Venmo
®
or Square Cash
SM
• Transfer funds from your TCA at
any time without fees through ACH
and bank to bank wires
• No monthly maintenance or
service fees
3
• No ATM fees or charges for
writing drafts, reordering drafts or
making withdrawals
• Dedicated US-based customer
service team
• View current balances, recent
statements and transactions any
time via our online portal
File your claim a
nd receive proceeds
Once your claim is approved, MetLife will place the insurance proceeds into the new TCA
account and send out an informational TCA Welcome Kit immediately.
Access funds easily
Access your insurance proceeds immediately through either the TCA Visa debit card or
by writing a draft. You can use your TCA debit card at the ATM, with PayPal, Venmo or
Square Cash. With your TCA debit card, there's no minimum transaction amount and we'll
even credit any fees you incur using your TCA debit card right back to your account! If
you prefer drafts, you can access your funds in any amount of $250
4
or more. You can
use your TCA account to pay your bills online or by phone and even set up recurring
payments for things like your mortgage, car payment, gym membership and more!
Manage your account
Receive monthly account statements
5
. You can also designate a beneficiary for your new
TCA account, as well.
STEP 1
STEP 2
STEP 3
GR-TCA-E (08/21)
Other important information
Your Total Control Account is backed by the financial strength of MetLife. The assets backing the funds are
held in MetLife's general account and are subject to MetLife's creditors. In addition, while the funds in your
account are not insured by the FDIC, they are guaranteed by your state insurance guarantee association. The
coverage limits vary by state. Please contact the National Organization of Life and Health Insurance Guaranty
Associations (www.NOLHGA.com or 703-481-5206) to learn more. FOR FURTHER INFORMATION, PLEASE
CONTACT YOUR STATE DEPARTME
NT OF INSURANCE.
If there is no activity on your account for a period of time (typically three years, but this may vary by state),
state regulations may require that we contact you at the address we have on file. If we aren't able to reach
you, we may
be required to close your account and transfer the funds to the stat
e.
We may limit or suspend your access to the funds in your account if we suspect fraud or if there was an error
in opening your account.
We use the services of The Bank of New York Mellon, 701 Market Street, Philadelphia, PA 19106, for Total
Control Account recordkeeping and draft clearing.
You may move all or a portion of your Account balance (subject to applicable minimums) into any other
settlement option for which you then qualify.
A TCA generally is not available if your claim is less than $5,000, you reside in a foreign country, or if the
claimant is a corporation or similar entity.
We may receive investment earnings from operating the Total Control Account. The performance results of
any investments we make do not affect the interest rate we pay you.
To learn more about TCA, please call us at 800-638-7283 or write us at Metropolitan Life Insurance Company,
Total Control Account, PO Box 6300, Scranton, PA 18505-6300.
1
The interest rate on your account is set weekly and will always be the greater of the guaranteed rate stated in your TCA package, or the rate
established by one of two indices monitored by MetLife. We calculate interest daily and compound it, so you earn interest on your interest. The
interest is added to your account monthly. The interest earnings generally are taxable so you should speak with your tax advisor.
2
Refer to your Customer Agreement for more details.
3
You may be charged for special services or an overdrawn TCA, and the current fees (subject to change) for those services are: draft copy $2;
stop payment $10; overdrawn TCA $15; overnight delivery service $25.
4
Processing time is similar to check processing.
5
If your account has no activity, we'll send you a statement once every three months.
MetLife Services and Solutions, LLC provides administrative services for Total Control Accounts (TCAs),
Guaranteed Interest Certificates (GICs), and Minor on Deposit Accounts (MODAs) established in connection with
policies issued by Metropolitan Life Insurance Company (MLIC), certain of MLIC's insurance company affiliates,
and certain non-affiliates.
Page 2 of 2
L0621014239[exp0622][All States][DC,GU,MP,PR,VI]
U.S. Life Insurance Claims
GR-CLAIM-FRAUD (11/20)
Page 1 of 2
Fs/f
Fraud Warnings
Before signing this claim form, please read the warning for the state where you reside and for the state where
the insurance policy under which you are claiming a benefit was issued.
Alabama, Arkansas, District of Columbia, Louisiana, Massachusetts, Minnesota, New Mexico, Ohio,
Rhode Island and West Virginia: Any person who knowingly presents a false or fraudulent claim for payment
of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime
and may be subject to fines and confinement in prison.
Alaska: A person who knowingly and with intent to injure, defraud, or deceive an insurance company files a
claim containing false, incomplete or misleading information may be prosecuted under state law.
Arizona: For your protection, Arizona law requires the following statement to appear on this
form. Any person who knowingly presents a false or fraudulent claim for payment of a loss is
subject to criminal and civil penalties.
California: For your protection, California law requires the following to appear on this form: Any person who
knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject
to fines and confinement in state prison.
Colorado: It is unlawful to knowingly provide false, incomplete or misleading facts or information to an
insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include
imprisonment, fines, denial of insurance and civil damages. Any insurance company or agent of an insurance
company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or
claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a
settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance
within the Department of Regulatory Agencies to the extent required by applicable law.
Delaware, Idaho, Indiana and Oklahoma: WARNING: Any person who knowingly, and with intent to injure,
defraud or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false,
incomplete or misleading information is guilty of a felony.
Florida: Any person who knowingly and with intent to injure, defraud or deceive any insurance company files a
statement of claim or an application containing any false, incomplete or misleading information is guilty of a
felony of the third degree.
Kentucky: Any person who knowingly and with intent to defraud any insurance company or other person files a
statement of claim containing any materially false information or conceals, for the purpose of misleading,
information concerning any fact material thereto commits a fraudulent insurance act, which is a crime.
Maine, Tennessee and Washington: It is a crime to knowingly provide false, incomplete or misleading
information to an insurance company for the purpose of defrauding the company. Penalties may include
imprisonment, fines or a denial of insurance benefits.
Maryland: Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or
benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime
and may be subject to fines and confinement in prison.
New Hampshire: Any person who, with a purpose to injure, defraud or deceive any insurance company, files a
statement of claim containing any false, incomplete, or misleading information is subject to prosecution and
punishment for insurance fraud as provided in RSA 638:20.
New Jersey: Any person who knowingly files a statement of claim containing any false or misleading
information is subject to criminal and civil penalties.
Oregon: Any person who knowingly presents a materially false statement of claim may be guilty of a criminal
offense and may be subject to penalties under state law.
Puerto Rico: Any person who knowingly and with the intention to defraud includes false information in an
application for insurance or files, assists or abets in the filing of a fraudulent claim to obtain payment of a loss or
other benefit, or files more than one claim for the same loss or damage, commits a felony and if found guilty
shall be punished for each violation with a fine of no less than five thousand dollars ($5,000), not to exceed ten
thousand dollars ($10,000); or imprisoned for a fixed term of three (3) years, or both. If aggravating
circumstances exist, the fixed jail term may be increased to a maximum of five (5) years; and if mitigating
circumstances are present, the jail term may be reduced to a minimum of two (2) years.
Texas: Any person who knowingly presents a false or fraudulent claim for the payment of a loss is guilty of a
crime and may be subject to fines and confinement in state prison.
Vermont: Any person who knowingly presents a false statement of claim for insurance may be guilty of a
criminal offense and subject to penalties under state law.
Page 2 of 2
Fs/f
GR-CLAIM-FRAUD (11/20)
Virginia: Any person who, with the intent to defraud or knowing that he is facilitating a fraud against an insurer,
submits an application or files a claim containing a false or deceptive statement may have violated the state law.
Pennsylvania and all other states: Any person who knowingly and with intent to defraud any insurance
company or other person files an application for insurance or statement of claim containing any materially false
information or conceals for the purpose of misleading, information concerning any fact material thereto commits
a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.
CS-GL-FORM-B (12/19)
Page 1 of 4
Fs/f
U.S. Life Insurance Claims
Metropolitan Life Insurance Company
Life insurance claim form
Use this form to submit your claim for a life insurance policy payment.
Things to know before you begin
• Each beneficiary submitting a claim must complete and sign a
separate claim form. However, we only need one death certificate
indicating the cause and manner of death.
• A signature is required for this claim to be processed.
• Please answer each question fully and accurately. If you return this
form with missing or incorrect information, it will delay your claim.
• You may have to send us other documents with this claim. See the
list in Section 5: How to submit this form.
• For assistance, or if you need help preparing your claim, call us
at 1-800-MET-6420 (1-800-638-6420), then press 2. Our Customer
Service Center is open Monday through Thursday, 8:00 a.m. to
8:00 p.m. ET, and Friday 8:00 a.m. to 5:00 p.m. ET.
Please correct and initial
any errors on the form.
A signature is required
for this claim to be
processed
SECTION 1: About you
Tell us in what capacity you’re making a claim (check one):
Individual beneficiary or Representative of a trust, estate or Charity
Your relationship to the person who died (check one):
Spouse/Partner Parent Child
Trust/Estate Representative/Charity
Other (please explain)
Your name (first, middle, last) - Please print your name the way you want it to appear on your payment.
First Middle Last
Maiden or other names (if applicable)
Mailing address (Street number and name, apartment or suite)
Phone number
City State ZIP code
Date of birth (mm/dd/yyyy)
Sex (M/F)
Social Security number Country of Citizenship
Only complete if making a claim on behalf of a Trust, Estate or Charity
Name of Trust/Estate/Charity
Date of Trust (mm/dd/yyyy)
Tax Identification Number (For the Trust, Estate, or other Charity)
Page 2 of 4
Fs/fCS-GL-FORM-B (12/19)
Insured Employee/Member Information
First name Middle name Last name
Employer name
I consent to receive claim status e-mails and text messages as indicated below.
Please see the enclosed About Electronic Statusing for more details.
Please tell us if you would like to receive claim statuses electronically
Cell phone number Email address
Have you signed a document with a funeral home that authorizes us to make a payment directly to them?
This document is usually referred to as a funeral home assignment.
No Yes – If yes, please send us a copy of the document with this claim form.
SECTION 2: About the deceased
Name (first, middle, last)
First Middle Last
Maiden or other names (if known, optional)
Residence address (Street number and name, apartment or suite)
City State ZIP code
Date of birth (mm/dd/yyyy) Date of death (mm/dd/yyyy)
Social Security number
Marital status (check one)
Single Married Divorced Separated Widow/widower
SECTION 3: Tell us how you want to receive your claim payment
Check one:
You’d like us to put your payment into a Total Control Account that we’ll open for you.
You’d like to receive a check for your payment.
• For more information about the Total Control Account, please read “About the Total Control Account.”
• Keep in mind that once you receive a check you cannot get a Total Control Account.
• If your payment is less than $5,000, or you are not a U.S. citizen or resident for tax purposes, we will
automatically pay you by check.
• If you do not select a payment option, in most states you will receive a Total Control Account, unless MetLife
is required by state law, rule or regulation to pay you by check.
Please remember to sign and date the form on the next page
Page 3 of 4
Fs/fCS-GL-FORM-B (12/19)
Insured Employee/Member Information
First name Middle name Last name
Employer name
SECTION 4: Certification and signature
By signing this claim form, you certify that:
• All the information you have given is true and complete to the best of your knowledge.
• Any contributions owed by the insured will be deducted from the insurance proceeds paid to me.
• If we overpay you, we have the right to recover the amount we overpaid. This can happen if we find we’ve
paid you more than you’re entitled to under this life insurance claim, or if we paid you when we should have
paid someone else. You agree to repay us the amount we overpaid. You also understand that if you do not
repay us, we may take steps, including legal action, to recover the overpayment.
• You have read the Claim Fraud Warnings included with this form. New York residents: Any person who
knowingly and with intent to defraud any insurance company or other person files an application for
insurance or statement of claim containing any materially false information, or conceals for the purpose of
misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a
crime, and shall also be subject to civil penalty not to exceed five thousand dollars and the stated value of
the claim for each such violation
Under the penalties of perjury I certify:
1. That the number shown as my Social Security Number or Tax Identification Number in “Section 1: About you”
above is my correct taxpayer identification number, and
2. That I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have
not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of
a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to
backup withholding, and
3. I am a U.S. citizen, resident alien, or other U.S. person*, and
4. I am not subject to FATCA reporting because I am a U.S. person* and the account is located within the
United States.
(Please note: You must cross out Item 2 above if the IRS has notified you that you are currently subject to
backup withholding because you failed to report all interest or dividend income on your tax return.)
*If you are not a U.S. Citizen, a U.S. resident alien or other U.S. person for tax purposes, please cross out
items 3 and 4 above, and complete and submit form W-8BEN (individuals) or W-8BEN-E (entities).
The Internal Revenue Service does not require your consent to any provision of this document other than the
certifications required to avoid backup withholding. You must complete this certification to avoid 24%
withholding with respect to taxable amounts.
Date signed (mm/dd/yyyy)
Signature of person making the claim
Some services in connection with your coverage may be performed by our affiliate, MetLife Services and Solutions,
LLC. These service arrangements in no way alter Metropolitan Life Insurance Company’s obligation to you.
Page 4 of 4
Fs/fCS-GL-FORM-B (12/19)
Insured Employee/Member Information
First name Middle name Last name
Employer name
SECTION 5: How to submit this form
5A. Check off the additional items you’re sending with this claim form
A death certificate. We require a copy of the death certificate. The funeral director taking care of the
funeral arrangements can usually provide a copy of the death certificate (indicating the cause and manner
of death). We only require one death certificate – if you’re aware of another claimant who’s sending one,
you don’t have to send it.
If you signed a document with a funeral home that authorizes us to make a payment directly to them, a
copy of that document.
If the beneficiary is the estate and you are a representative of an estate, a copy of the appointment papers
issued by the courts.
If the beneficiary is a trust and you are a trustee, a notarized statement that the trust is still in effect and you
are authorized to act under the trust. If you are not the original trustee, a copy of the page naming you as
the successor trustee.
If you are submitting the claim as Power of Attorney for the beneficiary, a copy of the POA papers for the
beneficiary must be provided.
5B. Submission instructions
Unless you have been advised of different instructions by the administrator/employer, return this signed claim
form and the documents you’ve checked off above in the envelope included with this package, or mail/fax them to:
Mail:
MetLife Group Life Claims
P.O. Box 6100
Scranton, PA 18505-6100
Email:
Lifeclaimsubmit@metlife.com
Fax:
1-570-558-8645
If faxing, please remember to
fax both front and back sides
of the signed claim form.
Allow two (2) hours for
documents to be received.
Please note: Most claims are reviewed within five (5) business days.
We're here to help
For assistance, or if you need help preparing your claim, call us at 1-800-MET-6420
(1-800-638-6420), then press 2. Our Customer Service Center is open Monday through Thursday,
8:00 a.m. to 8:00 p.m. ET, and Friday 8:00 a.m. to 5:00 p.m. ET.
About Electronic Statusing
MetLife provides electronic statusing as a convenience to you. Please review the following terms and conditions
carefully before providing (a) your agreement to them, and (b) your consent to receiving electronic statuses.
By agreeing to the terms of this Agreement, you are consenting to receive claims statuses in one or more of
the following ways:
1. When a change has been made to your claim, we will send you an email advising you that we have made
such a change;
Such e-mails will be sent to the current e-mail address we have on file for you. In addition, we can notify you
about the availability of claim statuses by text message (SMS - Short Messaging Service). If you agree to
receive notification of the availability of claim status messages by text message, you acknowledge and agree
that any charges associated with your receipt of these messages are fully your obligation and are not
reimbursable by MetLife or any of its affiliates. There may be other third party costs for Internet access fees or
text message (SMS) charges that are not reimbursable by MetLife or any of its affiliates.
We will continue to deliver information in writing to you by U.S. mail.
2. You may withdraw your consent, change your delivery preferences, and update information we need to
contact you electronically at any time by replying "stop" to a text message from us or by calling our Customer
Service Department.
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Completed 8 February 2022

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