Aflac initial disability claim form s00224 2009-2025

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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. The maximum period for which you can collect the Hospital Confinement Benefit for the same injury is 365 days.
Please submit the pathology report used in the diagnosis of a malignant cancer, the claimants birth certificate, and any itemized medical bills with the diagnosis and procedure codes, as well as a signed and dated Authorization for Disclosure of Health Information (HIPAA form).
Aflac will not pay benefits for an illness, disease, infection, or disorder that is diagnosed or treated by a Physician within the first 30 days after the Effective Date of coverage, unless the resulting disability begins more than 12 months after the Effective Date of coverage.
Q. How long do I have to file a claim? A. There is a one-year timely filing provision in your certificate.
Every short-term disability insurance plan has its own benefit period. While several months is typical, some plans offer benefits for as long as a year. If youd like long-term coverage, youll need to invest in a long-term disability plan.
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