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Aflac accident claim form

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If you are filing for disability please complete the Initial Disability Claim Form S00224. Forms are available on our web site at aflac.com. All bills should include the diagnosis services rendered and actual charges for the service. ACCIDENTAL INJURY CLAIM FORM Failure to complete this form in its entirety may result in a delay in processing this claim* Complete Policyholder/Patient Information and sign your claim form* Have the treating physician complete Section B Physician s Statement and s ...

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Versions	Form popularity	Fillable & printable
2014	4.9 Satisfied (28 Votes)
2008	4.3 Satisfied (211 Votes)
2005	4 Satisfied (30 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is proof of loss for Aflac?

Proof of Loss: Written proof that is required to be furnished to the insurer about a loss to help determine the extent of insurer liability. Provider: A facility, licensed as such, that provides health services for an individual.

What information is needed to file an Aflac claim?

Policy number. Policyholder's name. ... Policyholder's address. Date of injury or when symptoms first occurred. ... Definitions & acronyms. ER visit. Surgery. Operative report - Must include the type of procedure or procedure code. ... My Claims.

How many years back can you file an Aflac claim?

How long do I have to file a claim? A. There is a one-year timely filing provision in your certificate.

How long do you have to file a claim for Aflac?

How long do I have to file a claim? A. There is a one-year timely filing provision in your certificate. Please review the provision and call us with any questions.

How do I get an Aflac claim form?

Please print a separate form for each additional family member or call 1-800-99-AFLAC (1-800-992-3522) to request additional forms. Claims for all other benefits covered under this policy must be filed separately using the claim forms available at aflac.com or by calling 1-800-99-AFLAC (1-800-992-3522).

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