Metlife Absolute Assignment Form PDF Details

Life insurance policies are important financial tools that provide security and peace of mind for both the policyholder and their loved ones. At times, circumstances may necessitate the transfer of these policies through a process known as absolute assignment. The MetLife Absolute Assignment form, specifically tailored for such transfers under the Metropolitan Life Insurance Company's programs, offers a structured way to execute this transition. With particular emphasis on viatical settlements—a situation where the policy is sold to a third party due to the insured's terminal or chronic illness—this form lays out a comprehensive procedure for transferring all rights, interests, and ownership of the insured's group life insurance. It includes necessary waivers and consents, the obligation to inform about community property rights where applicable, and instructions for assigning and designating beneficiaries post-assignment. Given the legal and financial implications of such a process, the form advises consults with legal and tax professionals to ensure a thorough understanding and correct execution. This document not only serves as a critical financial tool for those in immediate need but stresses the importance of precision and legal compliance in the transfer of insurance policy ownership.

QuestionAnswer
Form NameMetlife Absolute Assignment Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesLouisiana, Viator, yy, absolute assignment

Form Preview Example

Metropolitan Life Insurance Company, New York, NY

Absolute Assignment Pursuant to a Viatical Settlement

With Waivers and Consents

Please read instructions on page 3 before completing and executing this form.

Group Life Insurance Program (“Program”) of

 

 

 

 

 

 

 

 

Name of Employer/Policyholder

 

 

 

Insured’s Social Security No.

 

/

 

/

 

Name of Insured

 

 

 

 

Insured’s Address

 

 

 

 

 

 

 

 

Insured's Phone Number

 

 

 

Group Policy No.

 

 

 

 

 

 

Group Certificate No. (if known)

 

 

“Certificate”

Has a Continued Protection (Waiver of Premium) claim been approved for the insured?

Yes

No

Spouse Waiver for Assignment of Group Life Benefits

(To Be Completed If Applicable)

Please Read the Following Section Carefully:

The spouse of the assignor should sign below IF the assignor is making an assignment to a person other than his/her spouse, AND the assignor is a resident of one of the following community property jurisdictions: Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Puerto Rico, Texas, Washington, Wisconsin.

I, spouse of the assignor, hereby consent to this assignment and waive and release any and all community property rights in and to the subject matter of the assignment.

Name of SpouseSignature of SpouseDate

I Hereby Assign To

Name of Assignee

 

Assignee Phone Number

 

 

 

 

 

Address of Assignee: Street

City

State

Zip Code

and Assignee’s assigns, all right, title, interest and incidents of ownership, both present and future, relating to the insured’s group life insurance under the Program, including but not limited to: the right to make any requisite contributions for the coverage under said Program, the privilege of obtaining an individual policy of life insurance on the insured’s life, the right, to the extent permissible to change the beneficiary(ies) and the right to elect any available settlement option. This assignment relates to the existing coverages now being assigned under the insurance policy (policies) and any replacement or substitute policy of the same or another insurance company providing insurance under the Program, and any amended or successor Program provided by the Employer.

Sign your name only by the line of coverage(s) you intend to assign:

Basic Life Insurance, if any

Supplemental Life Insurance, if any

Voluntary Accidental Death and Dismemberment Insurance, if any

Accidental Death and Dismemberment Insurance, if any

Supplemental Accidental Death and Dismemberment Insurance, if any

Survivor Monthly Income Benefits, if any

It is understood and agreed that neither MetLife nor the Program assume any obligation as to the validity or sufficiency of this assignment and that the assignment will not be binding upon them until filed with and accepted by the Program and MetLife.

Dated at

 

in the State of

 

 

 

this

 

day of

 

 

,

.

 

City

 

State

 

 

 

Day

 

Month

 

 

Year

 

 

 

 

 

 

 

 

 

 

 

 

Name of Assignor /Owner

 

 

 

Name of Witness

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Assignor /Owner

 

 

 

Signature of Witness

 

 

 

 

 

 

G1205-C-V-TERM

 

 

 

 

 

 

 

 

JE1105.SCRE (11/12)

Absolute Assignment Pursuant to a Viatical Settlement

With Waivers and Consents

Assignee’s Designation of Beneficiary

Effective as of the date of this assignment, I hereby (1) revoke any previous beneficiary designation as to the above-named Insured under the Group Policy, and (2) revocably designate as beneficiary thereunder:

Primary Beneficiary(ies)

(Total shares must equal 100%)

 

 

 

Full Name

Relationship

Date of

SSN

Phone

Address

Share

(Last, First, Middle Initial)

Birth

Number

(Street, City, State, Zip Code)

Percentage

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Contingent Beneficiary(ies)

(Total shares must equal 100%)

 

 

 

Full Name

Relationship

Date of

SSN

Phone

Address

Share

(Last, First, Middle Initial)

Birth

Number

(Street, City, State, Zip Code)

Percentage

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unless otherwise provided above, payment to two or more primary beneficiaries or two or more contingent beneficiaries shall be made in equal shares or to the survivors in equal shares or all to the last survivor. If there is no primary or contingent beneficiary living at the death of the insured, the amount of benefits payable because of the insured’s death shall be payable to the assignee if living at the insured’s death or to the assignee’s estate if the assignee is not living at the insured’s death.

It is understood and agreed that this designation will in no way apply in respect of any Survivor life insurance benefits if the Group Policy providing for such benefits makes no provision whatever for a beneficiary designation and that in such event the Survivor life insurance benefits will be payable only as provided in the Group Policy, this assignment notwithstanding.

Name of Assignee /Owner

Signature of Assignee /Owner

Date

Waivers and Consents

With respect to this assignment only, the Group Policyholder and MetLife hereby (1) waive with respect to the Group Policy and certificate, any provision therein against assignment for the above referenced coverage(s), and (2) consent to this assignment and to the exercise by the assignee of all of the aforesaid right, title, interest and incidents of ownership.

To Be Completed By

To Be Completed By

The Group Policyholder (Must be signed by an officer)

MetLife (Must be signed by an officer)

 

 

 

 

 

Metropolitan Life Insurance Company

Name of Group Policyholder

 

 

 

 

By

 

 

By

 

Title

 

 

Title

 

Date

 

 

Date

 

G1205-C-V-TERM

JE1105.SCRE (11/12)

INSTRUCTIONS

Do not erase or attempt to make corrections. Use a new form.

MetLife must receive the form within 60 days of when the assignor signs and dates the form.

This form only applies to coverages insured by MetLife.

MetLife will only process assignments to licensed viatical settlement providers in accordance with applicable state law.

Unless and until the assignee designates a new beneficiary, any existing beneficiary designation on file at the time the assignment is made will remain on record and the life insurance proceeds will be paid accordingly upon receipt of a properly supported claim.

The gift provisions of the policy will not be waived for collateral assignments.

The following definitions may be helpful in completing your assignment form.

Assignor/Owner:

An individual or entity who absolutely assigns all right, title, interest and incidents of ownership of an insured’s life insurance coverage. The assignor is the owner of the coverage.

Viator:

In general, an assignor who is a terminally ill or chronically ill insured who absolutely assigns all right, title, interest and incidents of ownership of his/her life insurance coverage to a viatical settlement provider. A viator is a type of assignor.

Assignee:

The individual or entity to whom a transfer of all right, title, interest and incidents of ownership of an insured’s life insurance coverage is made. For a viatical assignment, the assignee is the viatical settlement provider. For a viatical reassignment, the assignee may be an individual, entity, or another viatical settlement provider.

Viatical Settlement Provider:

The person, or entity, that pays the viator/assignor a discounted amount of the life insurance benefit.

Viatical Assignment:

A viatical assignment is made when a viator absolutely assigns all right, title, interest and incidents of ownership of his/her life insurance benefit to a viatical settlement provider. The viatical settlement provider pays the insured a discounted amount of the life insurance benefit.

Viatical Reassignment:

A viatical reassignment (i.e., an assignment of previously viaticated coverage) is made when the viatical settlement provider, as the assignor/owner of the life insurance coverage, absolutely reassigns all right, title, interest and incidents of ownership of the insured’s life insurance coverage to an individual, entity, or another viatical settlement provider.

General Information on Viatical Licensure:

Many states require viatical settlement providers to be licensed and to provide certain disclosures to persons who are considering assigning their benefits to such providers.

The absolute assignment of a life insurance certificate has legal and tax implications. The assignor/owner may want to consult with a personal legal or tax advisor. Neither MetLife nor its representatives or agents are permitted to give legal or tax advice. Any information included in or related to this form is for general informational purposes only and should not be considered legal or tax advice. You should consult with and rely on your own legal and tax advisors.

G1205-C-V-TERM

JE1105.SCRE (11/12)

How to Edit Metlife Absolute Assignment Form Online for Free

You'll be able to fill in Insureds effectively in our online PDF tool. The tool is continually upgraded by our team, getting powerful functions and turning out to be much more versatile. All it takes is several simple steps:

Step 1: First, open the editor by pressing the "Get Form Button" in the top section of this page.

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This form will require some specific information; to guarantee consistency, don't hesitate to pay attention to the following tips:

1. You have to complete the Insureds properly, so pay close attention while working with the segments containing all of these blanks:

Writing segment 1 of metlife insurance absolute assignment form

2. Given that the last part is done, you're ready to include the required details in Name of Spouse, Signature of Spouse, Date, I Hereby Assign To, Name of Assignee, Address of Assignee Street, Assignee Phone Number, City, State, Zip Code, and Assignees assigns all right, Basic Life Insurance if any, Supplemental Life Insurance if any, Voluntary Accidental Death and, and Accidental Death and Dismemberment so that you can proceed to the next step.

Assignee Phone Number, Name of Spouse, and Address of Assignee Street inside metlife insurance absolute assignment form

3. This subsequent step should also be relatively straightforward, Dated at, City, Name of Assignor Owner, Signature of Assignor Owner, GCVTERM, in the State of, this, day of, State, Day, Month, Year, Name of Witness, Signature of Witness, and JESCRE - every one of these form fields has to be filled in here.

Filling in section 3 of metlife insurance absolute assignment form

4. The form's fourth subsection arrives with all of the following form blanks to type in your information in: Full Name, Last First Middle Initial, Relationship, Date of, Birth, SSN, Phone Number, Address, Street City State Zip Code, Share, Percentage, Contingent Beneficiaryies, Total shares must equal, Full Name, and Last First Middle Initial.

Completing part 4 in metlife insurance absolute assignment form

People often get some things incorrect when filling in SSN in this area. You should go over what you type in right here.

5. To finish your form, the final part incorporates several extra fields. Filling out It is understood and agreed that, Name of Assignee Owner, Signature of Assignee Owner, Date, Waivers and Consents With respect, To Be Completed By, To Be Completed By, The Group Policyholder Must be, Name of Group Policyholder, Metropolitan Life Insurance Company, Title, Date, Title, Date, and GCVTERM is going to finalize the process and you'll surely be done before you know it!

Waivers and Consents With respect, Signature of Assignee Owner, and GCVTERM inside metlife insurance absolute assignment form

Step 3: Right after double-checking the entries, click "Done" and you are all set! Right after creating afree trial account here, it will be possible to download Insureds or email it directly. The form will also be accessible via your personal cabinet with all your adjustments. Here at FormsPal.com, we endeavor to make sure that all your details are kept secure.