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MassMutual
life and annuities death claims
To obtain a claim packet on an annuity contract or life insurance policy, please complete the form below.

If you are unsure of your product type or do not have a policy/contract number, please call 1(800) 272-2216 for assistance.
* required fields
* type of claim (you may select one or both)
  Policy/Contract Number(s):
Annuity Death Claim to add multiple Annuity Policies/Contracts
Life Insurance Death Claim to add multiple Life Policies/Contracts
insured/annuitant information
 * First Name M.I.  * Last Name
 * Date of Birth (mm/dd/yyyy)
 * Date of Death (mm/dd/yyyy)
Type of Death (if known)
Natural
Accidental
information for individual reporting claim
 * First Name M.I.  * Last Name
 * Relationship to Insured
 * Telephone Number
()--
E-mail Address
who would you like the claims packet sent to?
 * First Name M.I.  * Last Name
 * Address
 * City  * State  * Zip Code
 * Relationship to Insured
 * how would you like the claims packet sent?
Mail   Fax ()--
This form is for annuity contracts and life insurance policies only. If you wish to report a different type of claim, please use the appropriate telephone number below.

Benefit Management Account: 1(800) 548-0705
Disability: 1(800) 272-2216 option 3
Long Term Care: 1(800) 272-2216 option 4
Oppenheimer: Mutual Funds 1(800) 525-7048, 401K 1(800) 411-6971
Retirement: Pensions 1(800) 788-8781, 401K 1(800) 309-3539
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