Accident Policy – Workers Comp. Claims
Required
forms (click on each form to open and print):
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. If you required hospitalization or surgery
you should follow the instructions under the link Major Accident
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, and the attached Authorization to Obtain Information. Be sure to complete all sections.
2. Sections B, C and D do not need to be completed for Workers
Compensation claims.
3. Please be sure to include the
following backup documentation to support your claim. This would include any of
the following that apply to your injury.
This is not an all inclusive
list – please consult your policy for a complete list of benefits and then
provide corresponding documentation:
Include a copy of the First Report of Injury from your
employer
Records
of physical therapy
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 completed or provided the following:
1.
Have you completed Section A and the Authorization to
Obtain
Information?
2.
Have you included proof of ER and all doctor visits
(including physical
therapy)?
3.
Have you included a copy of the First Report of Injury?
4.
Have you included your policy number? If you do not have
your
policy
number, please call 800-992-3522 to be provided with it. It is
important
to remember that each policy has a separate policy number.
5.
Before faxing to our Claims Department have you included your
information on the fax cover sheet?