Make a Claim

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For Medical Cash Claims Submission:

What do you need to submit?

A complete Medical Cash Claim Form & a scanned copy of the claimant’s Medical Card Attaching the following requirements based on the type of claim submitted.
 

The Physical claim can be sent to the Claims Department or you can submit the scanned copy of the claim requirements through the MetLife eServices Mobile Application or the eServices Website
 

*original documents May be requested

Cash Medical Claim

  • Physician’s prescription showing the insured’s name and diagnosis.
  • Official receipt showing the attending physicians detailed charges along with their stamp and signature
  • In cases of non-availability of an official report, the doctor’s declaration of amount charged should be stated on the stamped prescription*

*Prescription should contain physician’s name – commercial registration number – tax card number – your phone number.  

  • Copy of physician’s prescription showing the insured name and diagnosis
  • Official and stamped itemized pharmacy invoice* showing the date of purchase, name of patient, quantity and name of drugs.

*Invoice should contain: (pharmacy / shop name) – commercial registration number – tax card number 

  • The respective physician’s request to undergo examinations and copies of the result of examinations undertaken.
  • Official receipt showing detailed charges with breakdown for each of the laboratory test, X-ray films and other examinations undertaken. 

  • The respective physician’s request to undergo physiotherapy sessions
  • Official receipt showing detailed charges
  • Copy of follow up card 

  • Copy of the eye test showing the insured’s name, date of service and cost of eye test
  • Official stamped detailed invoice* from the optical store showing the insured’s name, date of purchase, shop address and the type of products (eyeglasses, lenses, frame)

*Invoice should contain: (pharmacy / shop name) – commercial registration number – tax card number 

  • Official stamped detailed invoice* showing the insured’s name, date of treatment, breakdown of treatments received with associated cost
  • In case of non-availability of official receipt, the doctor’s declaration of amount charged should be stated on the stamped invoice

*Invoice should contain: (pharmacy / shop name) – commercial registration number – tax card number 

  • Copy of ultrasound sonography or pregnancy test, medical report showing insured name, date of service, date of inception and last menstrual period date 

  • Official stamped detailed hospital invoice supported by an official stamped hospital receipt showing total amount paid
  • Official receipt showing attending physician’s or surgeon’s charges / anesthesiologist’s charges along with his stamp and signature
  • Detailed hospital discharge medical report

*All documents must clearly show dates and name of insured 

  • Official stamped detailed hospital invoice, supported by an official stamped hospital receipt showing total amount paid
  • Official receipt showing Attending Physician’s or Surgeon charges along with their stamp and signature
  • Detailed hospital discharge report
  • Copy of prior approval acquired “in non-emergency cases”
  • All claim documents should clearly show dates of service and name of patient
  • All this documentation whether for the Attending Physician / Pharmacy / Laboratory need to include and clearly specify the following:

o   Insured Member’s name
o   Date of service
o   Diagnosis
o   Receipt of total amount paid with proof of payment (official and stamped) 

For Life Claims Submission:

Life Claims

For surgical, Inpatient Hospitalization accident medical reimbursement and medical expenses coverage Under an Individual or Personal Accident policy

  • Detailed medical report, completed and signed by you and your treating physician.
  • Original hospital bill and emergency ambulance bill, if applicable.
  • Original hospital receipt. This is the proof of payment based on the bill issued.
  • Copy of your medical report detailing your sickness or accident and the date it started/happened.
  • A copy of all relevant x-rays/echography/MRIs and reports. These should show your name and the date they were taken.
  • A copy of all lab tests and reports related to the incident.
  • A copy of the police report, if your claim relates to an accident.
  • A copy of your passport showing the dates of exit and entry, if the incident happened outside your country of residence.
  • Certified copy of your hospital bill or a discharge summary to determine the number of days spent in hospital.

Forms to be used:

o   Final Proof of Loss for Accidental medical reimbursement claims
o   Inpatient Medical Reimbursement for surgical Claims

  • Proof of Death Claimant's statement. Each beneficiary should complete a separate claimant’s statement. In the case of minor beneficiaries, the guardian must sign the claimant’s statement on their behalf. Each form must be notarized by a notary public or signed in front of the MetLife employee.
  • Proof of Death Physician’s statement. This form should be completed by the Physician who treated the insured during their last illness.
  • Detailed medical report stating the cause of death.
  • Copy of the passport/ or ID of the deceased and copies of passports, ID cards or birth certificates of the beneficiaries.
  • Original death certificate.
  • Original succession certificate. This is required in cases where the names of the beneficiaries are mentioned as legal heir. (This is needed for all types of claims in case of paying the benefit to beneficiaries)
  • Original guardianship/tutorship certificate issued by the court and specifying the powers given to the guardian or tutor if there are minors among the beneficiaries. The claim can only be paid to the guardian or tutor entitled by law or order of court to “cash proceeds and give valid discharge”. (This is needed for all types of claims in case of paying the benefit to beneficiaries)
  • Original policy document. The terms and conditions after the death of the Insured state that the contract terminates and the policy contract must be returned to us. (for Insureds under Individual Policy)
  • Originally stamped Copy of the police report, if the death was the result of an accident, murder or whenever a report is issued because of specific circumstances as such.
  • Post-mortem/autopsy or coroner’s report.
  • The exact addresses and telephone numbers of all beneficiaries.
  • Letter from the employer stating the last date the deceased reported to work on a full-time basis, as well as the date of when the deceased’s contract was ended by the company. (for Insureds under Group Policy)
  • Salary slip showing the last monthly basic salary drawn by the late Insured.  (for Insureds under Group Policy)
  • Detailed Sick leaves consumed during Insured’s Coverage. (for Insureds under Group Policy)
  • In certain cases, we may contact the beneficiaries/ Policy Holder and request further documents.
  • Death Claimant's statement for (Credit Life). This form should be completed by the bank along with the following documents needed from the bank for the credit death claims:
    • Loan/Credit Card Application
    • Bank Statement
    • Health declaration
    • Bank Confirmation letter

  • If insured suffered from an injury that prevent him from performing his job duties  
  • Accidental Benefits Employer Statement for Accidental Weekly Income claims should follow the detail medical report at the end of the disability period
  • Copy of all relevant x-rays/lab tests and reports. These should show your name and the date they were taken.
  • Copy of the police report, if applicable.
  • Copy of physician’s statement or medical report detailing the nature and date of the accident.

  • Disability claimant’s statement and Disability physician’s statement for total disability or partial disability). This must be completed and signed by you and your treating physician.
  • Copy of all relevant x-rays/lab tests and reports. These should show your name and the date they were taken.
  • Medical report detailing the nature and date of the sickness/ accident that lead to the disability.
  • You will be referred to Medical Examination for disability assessment & confirmation.
  • If you are eligible for the waived premium benefit, you’ll also have to provide regular medical reports showing the status of your disability. In certain cases, we may need you to attend a medical examination, or provide more details through a doctor or a medical committee.
  • Copy of the police report, if your claim relates to an accident.
  • Letter from the employer stating the last date the deceased reported to work on a full-time basis, as well as the date of when the deceased’s contract was ended by the company. (for Insureds under Group Policy)
  • Salary slip showing the last monthly basic salary drawn by the late Insured.  (for Insureds under Group Policy)
  • Detailed Sick leaves consumed during Insured’s Coverage. (for Insureds under Group Policy)
  • Loan/Credit Card Application(for Insureds under Credit Policy)
  • Bank Statement(for Insureds under Credit Policy)
  • Health declaration(for Insureds under Credit Policy)
  • Bank Confirmation letter(for Insureds under Credit Policy)

For Recovery Benefit Plan or Critical Care Coverage.

  • Recovery Benefit Plan claim form.
  • Copy of your physician’s statement or medical report detailing the nature and date of the onset of the sickness, as well as a history of risk factors.
  • Copy of All relevant medical reports.
  • Copy of all relevant pathology reports/lab tests/x-rays/MRIs or CT scans. These should show your name and the date they were taken.
  • In certain cases, we may request a copy of other documents.

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