Accident Coverage

Accident programs can complement existing Medical coverage and help fill financial gaps caused by out-of-pocket expenses including deductibles, co-insurance, non-covered medical expenses and personal expenses.

Accident Insurance from MetLife helps relieve financial strain for employees in the event of a covered accident, while also helping to curb costs. Claims payments are made in flat amounts based on services incurred during an accident. Lump sum benefits payable for medical treatment provided for on-the-job and off-the-job accidents.

Benefits payable for:

• Dislocations/Fractures/Lacerations/Burns
• Hospital Admissions
• Accidental Death
• Accidental Dismemberment
  
  

Please refer to the carrier benefit summary for complete details, limitations, and exclusions OR click here for a MetLife Benefit summary. Click here to view a full Certificate of Voluntary Accident Coverage.

Download a Group Accident Claim Form.

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• If this is an Initial Claim for an accident, please complete each section in its entirety. (An accident is not considered reported to us until a claim form is received).
• If this is an additional claim for an accident previously reported (i.e. – initial claim previously submitted and additional services were incurred), no claim form is required. Please provide itemized bills or treatment notes for the additional services. Include your claim number and/or certificate number on all pages of your submission.

• Please provide supporting documentation from the healthcare provider related to the injuries and services received for which a claim is being made.
  • The supporting documents MUST include 1) patient’s name, 2) service dates, 3) diagnosis, 4) specific procedure or treatment.
• Documentation that might be helpful to MetLife in making a claim decision includes the following items: Itemized invoices received for services as a result of this accident. You may need to ask your healthcare provider to provide you with a UB-04 form or other documentation. If you have an Explanation of Benefits (EOB), please also include this documentation.
• If treated in an emergency room, please provide a copy of the discharge papers from the hospital.
• If admitted to a hospital, provide documentation from the hospital that details admission and discharge dates, diagnosis and room assignment (ICU and/or Non ICU).
• If you were tested for alcohol or drugs in connection with an accident or injury please provide a copy of the drug screening or blood alcohol report.
• If the injury was the result of a motor vehicle accident, please provide a copy of the motor vehicle accident report.
• If the patient is deceased, we will need a copy of the death certificate.
• You must sign and submit the Authorization to Disclose Health Information form

Please return completed and signed form in one of the following ways:

• Online: https://mybenefits.metlife.com

• Mail: Metropolitan Life Insurance Company, Attn: Group Accident Insurance Product, P.O. Box 80826 Lincoln, NE 68501-0826

• Fax: 1-855-306-7350 (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)