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Accident Claim – Accident with Disability

Use these instructions if claiming for both Accident and Disability benefits

 

Required forms (click on each form to open and print):

Accident Claim Form

Claims Department Fax Cover Sheet

 

After you have downloaded or printed the above forms, just print this page and follow these instructions.  For faster service fax directly to our claims department using the Claims Department fax cover sheet. If you mail anything, please keep copies of everything you mail until your claim is complete.  Please remember that disability caused by an accident must have occurred off the job.  On the job disabilities are covered by Workers Comp.

 

It is important to follow these instructions completely.  Failure to do so will result in a delay of the  processing of your claim.

 

1.      You (or the patient) need to personally complete Section A.  Be sure to complete all sections.

 

2.      Sections B and C need to be completed in full by the physician who treated you.  Please be sure no sections are left uncompleted unless they do not apply.  It is very important that the physician includes the date of the accident and a description of how the accident occurred (in Section B).  In many cases this information is not completed accurately and results in a delay of your claim because AFLAC must receive physician verification that the disability was caused by an accident.

 

3.      Section D is to be completed by your employer.

 

4.      Please be sure to include backup documentation that includes a diagnosis to support your claim. This would include any of the following that apply to your treatment.  This is not an all inclusive list – please consult your policy for a complete list of benefits and then provide corresponding documentation:

  ER discharge instructions

  Records of doctor visits

  Records of physical therapy

  Operative Report (if surgery was required)

  Itemized hospital bill (if confined) [Click here to see a sample]

  Ambulance bill

  Police Report (if you were injured in an auto accident)

This type of supporting information is very important because the claim cannot be processed without it.

 

After you have sent your claim, please deal directly with AFLAC Claims Department by calling 1-800-992-3522 from 8 a.m. to 6 p.m. Monday through Friday.  Please have your policy number ready so you can be assisted promptly.  Also, if you have any questions regarding your claim or if you simply want personal assistance please feel free to call me at 561-776-0098.

 

 

Reminder checklist – Please be sure you have you completed or provided the following:

 

·      Have you completed Section A and the Authorization to Obtain

     Information?

·      Has your physician answered each question in Sections B and C?

·      Have you included proof of ER and all doctor visits (including physical

     therapy)?

·      If you were confined in a hospital have you included a copy of the Itemized

     hospital bill?  This bill must show a room charge in order for

     benefits to be paid.  Please click the following link to view a sample:

     [Sample Itemized Hospital Bill]  A copy of this bill should be requested

     from the hospital billing or records department.

·      If surgery was required have you included a copy of the Operative

     Report?  This should be requested from your surgeon.

·      If you required an ambulance have you included a copy of the ambulance

     bill?

·      If this injury was caused by an auto accident have you included a copy of

     the police report?

·      Have you included your policy number(s)? If you do not have your

    policy number(s), please call 800-992-3522 to be provided with it. It is

    important to remember that each policy has a separate policy number.

·      Before faxing to our Claims Department have you included your

    information on the fax cover sheet?

 

 

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