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MassMutual Disability Insurance Application for California

Apply for a MassMutual individual disability insurance policy.

Due to the complexity of the form, it is expected that your submission will be an incomplete draft, which will then be revised by the agent after some discussion and prepared for e-signature.

Tip: The easiest method of applying is to request a proposal. The request

For use in the following states: CA

MassMutual DI application for CA
Download Application Form (PDF)


Will I qualify?

If you have reason to believe that qualifying might be a challenge, submit an incomplete application. Submitting an incomplete application will guarantee a pause to discuss forseeable challenges before anything official gets underway.

Medical Questions

There is no need to fill this out. Later in the process, you will be asked to complete this online or by telephone. Use this form to get a sneak peek of the kind of medical questions you might be asked, and talk about them informally with your agent to get an indication of probable outcome.

Medical Questionnaire for Guardian individual disability insurance
Medical Questions

Evidence of earnings might be requested

A copy of a recent paystub or tax returns might be requested to validate stated earnings on the application. This is because the insurer wants to avoid issuing a policy that is oversized relative to earnings. Whether financial documentation will be necessary depends on your insurance history, the nature of your occupation, your employment stability, the amount of monthly benefit you might like, and more. After your application has been reviewed by your agent, this prediction can be made.

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