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Aflac accident claim form

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Policy Number Policyholder Information This denotes a required field. Last Name Suffix Date of Birth mm/dd/yy / First Name MI Telephone Number where we can reach you - Home Address City State Zip Code Check box if this is a permanent address change. Patient Information Sex Male Relationship Female Primary Policyholder Spouse Dependent Child Accidental Injury Checklist Date of the injury Describe how the injury occurred Was this injury caused by an incident that occurred while performing the du ...

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

How long does it take Aflac to pay an accident claim?

It will depend on the type of claim filed whether youll receive lump sum payment or payments throughout treatment. Either way, if filing online and assuming all necessary documentation is present, payment turnaround should be 24-48 hrs. If filing via fax or mail, it will be longer.

How much will Aflac pay me?

ACCIDENT SPECIFIC-SUM INJURIES BENEFITS: When a Covered Person receives treatment for Injuries sustained in a covered accident, Aflac will pay specified benefits ranging from $20$7,500 for dislocations, burns, skin grafts, eye injuries, lacerations, fractures, concussion, emergency dental work, coma, paralysis, and

What is considered an accidental injury?

Accidental injury. Physical bodily injury resulting from an external force, blow or fall, or the ingestion of a foreign body or harmful substance, requiring immediate medical treatment. Accidental injury also includes animal and insect bites and sunstrokes.

Is there a time limit to file Aflac claim?

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

How much does Aflac payout for a surgery?

No lifetime maximum. Surgical Benefit Aflac will pay $100$2,000 when a covered person has surgery performed for a covered sickness in a hospital or ambulatory surgical center based upon the Schedule of Operations in the policy.

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How long do you have to report an injury to Aflac?

We will pay the amount shown when, because of a covered accident, you are injured and those injuries cause confinement to a hospital for at least 24 hours within 90 days after the accident date.

How much will Aflac pay me for hospital stay?

Treatment or confinement in a U.S. government hospital does not require a charge for benefits to be payable. $1,000 Aflac will pay a Hospital Confinement Benefit of $1,000 when a covered person requires hospital confinement for 23 or more hours for a covered sickness or accidental injury and a charge is incurred.

How much does Aflac payout for a surgery?

What form do I need from the hospital for an Aflac claim?

UB04 (itemized hospital bill).

What will Aflac pay for?

Aflac pays cash benefits directly to you (unless you specify otherwise) to help with things like out-of-pocket medical expenses, the rent or mortgage, groceries, or utility bills. Helping you with the medical expenses that major medical doesnt coverand much more.

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