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Metlife reimbursement form 2026
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- Click ‘Get Form’ to open the MetLife Reimbursement Form in our editor.
- Begin by filling out the Employee’s Section. Enter your full name, date of birth, nationality, contact number, policy number, and email address in CAPITAL LETTERS as instructed.
- Next, provide the Patient’s information including their full name and date of birth. Ensure all fields are completed accurately.
- Select your preferred reimbursement method (Cheque or Wire Transfer) and specify the total amount claimed. If choosing Wire Transfer, ensure your bank details are updated on e-services.
- In the Authorization Statement section, read through the terms carefully. Sign and date the form to confirm your agreement.
- Complete the Attending Physician Section by having your physician fill in their details and sign where required.
- Finally, review all entries for accuracy before submitting your claim along with any required supporting documents as per the checklist provided.
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To request reimbursement, complete this form (in blue or black ink), enclose a legible copy of your itemized receipt(s), and send them to the following address.
1. Complete your section of the claim form (items 1 through 21) in full to assure positive identification and prompt payment. Please print or type.Read more