Forms Library
These forms are required for:
- Pre-approvals from Medical Providers (for medical card holders)
- Submitting a Medical Claim Reimbursement Request (for medical card holders)
Where should I send the completed form(s)?
You can submit them through myMetLife desktop or mobile app (Android / iOS).
Once you login, all you need to do is:
- Complete the online claim form
- Upload your supporting documents
- Submit the online form
It's as simple as that!
If you are working offsite and do not have access to the internet, please contact your HR department to submit the documents.
Download Forms:
These forms are required for:
Submitting a Claim. Not sure which form to use? Click here to learn on how to make a claim
Where should I send the completed form(s)?
Copies can be emailed to lifeclaims@metlife.ae
Originals to be sent by mail to:
Claims Department MetLife, Ubora Office Tower, Business Bay, PO Box 371916, Dubai, UAE
Note: Original documents are required to process any claim.
Download Forms:
Accident Benefits - Employer's Statement (English) / (Arabic)
Baggage Delays / Baggage Loss Claim Form
Partial Disability / Accidental Dismemberment Claim Report – Physician & Claimant Statement Form - Form CL-20 (English) / (Arabic)
In Patient Medical Reimbursement Claim Form (English) /(Arabic)
Permanent Total Disability – Claimant Statement - Form 321 (English) / (Arabic)
Permanent Total Disability – Physician’s Statement - Form 322 (English) / (Arabic)
Proof of Death – Claimant Statement - Form CL-39 (English) / (Arabic)
Proof of Death – Physician’s Statement - Form CL-40 - (English) / (Arabic)
These forms are required for:
- Changing address
- Amending existing policy(ies)
- Taking advantage of some of your policy features (loan, partial surrender, etc...)
Where should I send the completed form(s)?
By mail to:
Customer Care MetLife, PO Box 371916, Dubai, UAE
Download Forms:
Declaration & Undertaking regarding a Lost Policy Form (English) / (Arabic)
Policy Loan Request Form (English) / (Arabic)
Policy Full Maturity and Release Form (English) / (Arabic)
Policy Partial Maturity and Release Form
Policy Partial Surrender and Release Form
Policy Full Surrender and Release
Request for addition of Recovery Benefit Plan Rider
Request for Policy Change - Life (Change of Name, Beneficiary, Method of premium payment) - (English) / (Arabic)
Request for Policy Change - Personal Accident (Change of Name, Beneficiary, Method of premium payment) - (English) / (Arabic)
This form is required for:
Delivery of your medications to your doorstep thanks to Aster Pharmacy
Where should I send the form & prescription(s)?
By email to Aster Pharmacy at metlife@asterpharmacy.com or by fax to +971 4 267 2946
Download form:
Circulars
The following documents are for your information and reference only:
HAAD Requirements Form for Group Medical Policies (designed by MetLife): This document provides you with all the information you may need to update the records for all your existing employees / dependents as well as any future employees / dependents.
Note: If you have any undeclared members who should be enrolled under a HAAD compliant scheme, kindly provide the required documentation as explained in the above document and send it to your respective insurance consultant’s email address.
HAAD Circular no. CEO/254/11: Document explaining the process related to Dependent Violation
HAAD Circular no. 32 (English) / (Arabic): Document providing details about theCertificate of Continuity of Health Insurance Scheme Coverage
HAAD Circular no. 35 (English) / (Arabic): Document providing details for the Issuance and Renewal of the Health Insurance Card
HAAD Circular no.41: Document providing details for the Issuance of the Health Insurance Card to newcomers
HAAD Circular no.DG48-14: Circular confirming that linking Emirates ID cards to the Pesonal Registration Database in "KEH" is now mandatory
Forms
The Forms, when completed, should be sent to your Insurance Consultant's e-mail address.
Declaration Form (to be signed, dated and stamped by your company): A mandatory form to be completed upon renewal for existing policies and on inception for new policy or new subgroup.
Undertaking Letter (to be printed on your company's letterhead): A document requested by HAAD to be completed by the employer or the sponsor for each "newcomer".
Dependent Violation Appeal Form: A HAAD document to be completed when appealing for a dependent violation
Updated Electronic Data Interchange (EDI): To be completed when amending any detail on the policy such as addition/deletion of an employee or dependent, salary update, etc...
Instructions to receive your funds by Wire Transfer (when applicable)
To prevent any delays in receiving your funds by Wire Transfer, please include the following details when confirming your payment instructions:
- Bank Name
- IBAN (Account Number if the country does not use IBAN)
Full name Swift code
Note: include IFSC if requesting the transfer to India.