AFLAC CANCER CLAIM FORM - core-docs s3 amazonaws 2026

1. Click ‘Get Form’ to open the AFLAC CANCER CLAIM FORM in the editor.
2. Begin by filling out the 'Statement of Insured' section. Enter your full name, date of birth, social security number, and account number. Ensure your mailing address and contact information are accurate.
3. In the 'Patient Information' section, indicate for whom you are making this request (yourself, spouse, child, etc.) and provide their relevant details including diagnosis and treatment dates.
4. Complete the 'Authorization to Disclose Information' section. This allows American Fidelity to access necessary health information. Make sure to sign and date this authorization.
5. Attach all required documentation such as itemized bills and Explanation of Benefits (EOB) if applicable. Review the special instructions based on your state or policy type.
6. Once completed, save your form and submit it via mail or fax to American Fidelity at the provided address or fax number.

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