AFLAC CANCER CLAIM FORM - core-docs s3 amazonaws 2025

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  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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You can check the status of your claim, including any supporting documents you provided, from the claim detail page. Go to My Claims choose the claim Claim Details.
AFLAC IS AN EXTRA MEASURE OF FINANCIAL PROTECTION. When youre sick or hurt, Aflac pays cash benefits directly to you to help you and your family with unexpected expenses. The benefits are predetermined and paid regardless of any other insurance you have. AFLAC PAYS YOU CASH BENEFITS TO USE AS YOU SEE FIT.
Aflac pays you cash benefits before, during, and after a cancer diagnosis. Most policies include a waiting period during which you are ineligible to submit a claim. Aflac cancer insurance has a 30-day waiting period in most states.
Your wellness benefit is paid once per year when you file a claim (Accident/Hospital Indemnity is once per year per policy and Cancer is once per year per covered person).
The above example is based on a scenario for Aflac Cancer Care Classic that includes the following benefit conditions: Physician visit (Cancer Wellness Benefit) of $75, bone marrow biopsy (Surgical/Anesthesia Benefit) of $125, NCI Evaluation/Consultation Benefit of $500, Initial Diagnosis Benefit of $4,000, venous