How do I report an initial claim for an accident?

Please complete each section of the claim form in its entirety. An accident isn’t considered reported until a claim form is received.

What if I’m submitting an additional claim for an accident previously reported?

No claim form is required. Provide itemized bills or treatment notes for the additional services and include your claim number and/or certificate number on all pages of your submission.

What supporting documentation do I need to provide? 

Provide documentation from the healthcare provider related to the injuries and services received, including patient’s name, service dates, diagnosis, and specific procedure or treatment.

What other documentation might be helpful for MetLife to make a claim decision?

Examples include: Itemized invoices; UB-04 forms or other documentation from healthcare providers; Explanation of Benefits (EOB); discharge papers from emergency room visits; documentation of hospital admission/discharge for hospital stays; and other specific reports if applicable (e.g., motor vehicle accident reports).

Are there any specific requirements or additional documents needed for certain situations?

• If treated in an emergency room, provide discharge papers.
• If admitted to a hospital, provide documentation on admission/discharge dates, diagnosis, and room assignment.
• If the injury resulted from a motor vehicle accident, provide a copy of the accident report.
• You must sign and submit the Authorization to Disclose Health Information form.

Where can I find out what benefits are covered? 

Refer to the Schedule of Benefits for a list of specific benefits covered under your plan.