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Cancer Claim Form - American Fidelity

Cancer Claim Form - American Fidelity 2025

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The document provides detailed filing instructions for cancer-related insurance claims, including requirements for submitting a Statement of Insured, itemized bills, an Attending Physician's Statement, and pathology reports. It outlines special instructions for residents of specific states and certain policy types, emphasizing the need for Explanations of Benefits (EOB) from primary medical coverage. Additionally, it includes warnings about insurance fraud and an authorization form for disclosing protected health information.

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Click ‘Get Form’ to open the Cancer Claim Form in the editor.
Begin by completing the 'STATEMENT OF INSURED' section on page 3. Fill in your personal details, including your name, date of birth, and social security number.
Attach itemized bills from each healthcare provider. Ensure that these bills include a complete breakdown of charges for each date of service.
Have your physician complete the 'ATTENDING PHYSICIAN’S STATEMENT' found on page 3. This includes diagnosis and treatment dates.
If applicable, include a copy of the pathology report from the first procedure where cancer was diagnosed. This is essential for processing your claim.
For residents in GA, OK, SC, or TX with specific policies (C3, C4, C5), attach corresponding Explanations of Benefits (EOB) from your primary medical coverage.

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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.

How long does it take for American Fidelity to pay a claim?

Covered critical illness events include Heart Attack, permanent damage due to a stroke, and major organ failure. The second occurrence date must be separated by at least 180 days following the first occurrence date of that same critical illness.

What is covered under a cancer policy?

Cancer Insurance benefits are paid for hospital stays, radiation, chemotherapy, surgery, medications, prosthesis and other associated treatments.

What does AIG cancer policy cover?

Well only cover a primary cancer that is malignant. A primary cancer is where the original, or first, tumour is found in the body. Malignant tumours can grow and spread to other parts of your body and invade tissue. Well also cover blood cancers, leukaemia, sarcoma and lymphoma as primary cancers.

What medical expenses does cancer insurance not cover?

Cancer or its treatment may lead to other health problems, such as infection, diabetes or pneumonia. Some cancer policies might not cover these other conditions. Some policies require waiting periods of up to 30 days. If cancer is diagnosed during the waiting period, you may not be covered.

What does American Fidelity cancer policy cover?

Weve got the support you need right now. Follow this simple process to file a claim for your American Fidelity benefits. Claims are usually processed within seven business days once all required documentation is received.

What does American Fidelity cover?

0:14 0:50 Goes with many accident plans youre covered both on. And off the job. Plus your plan could cover anMoreGoes with many accident plans youre covered both on. And off the job. Plus your plan could cover an annual screening benefit for completing routine checkups.

How to file a cancer claim with American Fidelity?

Online or AFmobile Log in to your online account or open your AFmobile app. Click the File a Claim button. Select the type of claim you would like to file. Follow the prompts to provide claim details and required documentation. Check the acknowledgment box and click the Submit button.

Cancer Claim Form - American Fidelity 2025

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