Aflac
Reviews and Complaints

Basically you wanted them to pay you just because you said so. I only know AFLAC by the claims of mine that have been paid. But you naturally don't have the form when going to ER..ok, makes sense. And ER docs will NOT fill out AND form if you didn't have it with you during treatment.. why you ask? Because by the time you show back up to ER with the form can be hours, days or even weeks later. In the meantime, he/she has seen hundreds of patients and the doc doesn't know or recognize you. So, to get the form filled out, you need to go see your regular doc for a follow up appt, but you won't do that. REGARDLESS that you were to GET a followup and didn't want to PLUS you can get ur form done than.
Wow!
And YOU are upset that they won't pay basically just because YOU SAID SO!
READ YOU PLAN, FOLLOW THE RULES, and you be pleasantly surprised!

Its the duck's fault.

Aflac is a great company. You just need to know how to file forms and what documents you need to get from your providers. You also are given policies in the mail that you need to actually read. Aflac gives you a ten day free look to make sure you understand what you are buying. They also have a wonderful website full of information and their customer service department are very helpful. Ok. If you go to the emergency room of a hospital with or without admission, the hospital uses a form that you can get a copy of after about a week called a UB04. These form shows the charges for everything you had done...ambulance ride, tests, medicines, lab work, treatments, equipment, admission/discharge date, surgery, days in hospital, intensive care, just ER visit, etc. Submit this with your Aflac form and generally that will be all you need for that visit. If you are treated by a physician or urgent care then you need the 1500
HEALTH INSURANCE CLAIM FORM to go with the claim form. This form basically has the same type information as the UB04. Both forms include diagnoses. Again, you would normally have to wait about a week or two before requesting copies of the forms. Normally, I just tell the providers that I want the forms for my medical records if they ask. They do not charge for a copy of today. That could be different in your area. Once I submit that form by fax, and my claim form, thru Aflac's website because it is easier, my check/s are in my hands within a week or so. Hope this helps. Remember, read your policies. Once I learned what Aflac needed to verify my claim, it was easy. I wouldn't expect my homeowners insurance to pay me for a damaged house without coming out to see it and do an estimate of value. With these forms, I find that I end up getting paid more money on things I didn't know would be covered because Aflac has the total information and because I have multiple policies, they cross check my coverages and pays me on all of them that it applies to the incident, even though I didn't file a separate claim on the others.

I have paid for accident insurance for years. On a Friday, I fell and had a burst fracture in my spine. The doctor said I needed surgery and they put screws and a cage around 3 vertabra with a hook for support. On the day of my accident, I fell, and was in excrutiating pain. My husband called an ambulance which took me to the emergency room, and I had surgery a couple days later. Aflac is now denying my claim stating it was not caused by an accident, but rather an illness. I fell, fractured my vertabra in my spine. I have previously had no illness, no broken bones, and when I fell, I literally felt the horrible pain of my fracture, and I knew what had happened. In some tests, my bones were found to be a little soft, but, not osteoporosis, and it has never culminated in any bones breaking, and I have fallen, been in car accident, I skate, jump on trampolines, ride thrill rides, but because one comment the doctor made, AFLAC jumped on a band wagon stating it was not caused by an accident. I wish they could feel what it is like to fall and fracture a vertabra when they impact with garden stones on the ground bending spine so hard, and waiting in pain for an ambulance. I fell hard, and it was an accident. If not for this accident, I would not have a fractured spine. I don't know what to do. They give you no information whatsoever, just a denial letter. So frustrating. Be wary about paying for accident insurance that does not pay, when you have a terrible accident!

Aflac is a great company. You just need to know how to file forms and what documents you need to get from your providers. You also are given policies in the mail that you need to actually read. Aflac gives you a ten day free look to make sure you understand what you are buying. They also have a wonderful website full of information and their customer service department are very helpful. Ok. If you go to the emergency room of a hospital with or without admission, the hospital uses a form that you can get a copy of after about a week called a UB04. These form shows the charges for everything you had done...ambulance ride, tests, medicines, lab work, treatments, equipment, admission/discharge date, surgery, days in hospital, intensive care, just ER visit, etc. Submit this with your Aflac form and generally that will be all you need for that visit. If you are treated by a physician or urgent care then you need the 1500
HEALTH INSURANCE CLAIM FORM to go with the claim form. This form basically has the same type information as the UB04. Both forms include diagnoses. Again, you would normally have to wait about a week or two before requesting copies of the forms. Normally, I just tell the providers that I want the forms for my medical records if they ask. They do not charge for a copy of today. That could be different in your area. Once I submit that form by fax, and my claim form, thru Aflac's website because it is easier, my check/s are in my hands within a week or so. Hope this helps. Remember, read your policies. Once I learned what Aflac needed to verify my claim, it was easy. I wouldn't expect my homeowners insurance to pay me for a damaged house without coming out to see it and do an estimate of value. With these forms, I find that I end up getting paid more money on things I didn't know would be covered because Aflac has the total information and because I have multiple policies, they cross check my coverages and pays me on all of them that it applies to the incident, even though I didn't file a separate claim on the others.

I had surgery back in June and filed my hospital indemnity claim. I sent in ALL necessary paperwork for the claim. It is now September and I have received NOTHING. When I contact them, they state they are waiting on doctor statement though it was included in the original claim. I am sick and tired of AFLAC not wanting to do good on their claims. I have been reading sooooo many complaints online on this company. I had no idea other people were dealing with this too. They sucker us poor people who are just looking for additional cover as a "just in case". It is not fair or right. I agree with this complaint.

Yes Aflac is not paying my claim either and now I am locked into paying via payroll deductuion until next open enrollment when I can dump this policy.

I called twice to make sure they would pay the claim if I stayed overnight in the hospital I was told yes twice but they would not give me anytig in writing. Now they say that even though I stayed overnight in the hosptial they need a itemized bill with the room charge on it. The hospital said the surgery I had includes a room for the night and they don't split it out. But they can itemize a pill I took for 70.00 but they can't itemize what the room charge was. How ridiculous. They said the surgery was like a package deal all one price which includes the room - it shows a admit date and a discharge date and that isn't enought to verify I stayed overnight. Looks like it is time to get an attorney.

Short Term Disability pays when you are out of work for 30 days to 3 months. 3 weeks is only 21 days. What Aflac did was legal and outlined explicitly in your policy. 3 weeks off the job doesn't give you a claim on STD. However - an illness policy would have paid you cash for all dr visits, the diagnosis and and cash for each diagnostic exam!

Ask to see a copy of the form that the doctor submitted. May be just a clerical error from doctor's office.

Sorry to hear of your disatisfaction, however there may be many reasons for the amount that your husband recieved which might explain why it was not as much as you need. First and most importantly, disability is not intended to entirely replace lost income. The amount is often determined by state law
Your husbands benefit amount is determined by his salary, however he may have chosen a lesser amount as that is a choice that some make to at least cover some of their bills.
Another factor that may apply is your husbands "elimination period", which is the length of time you must be off work before your benefit period starts. Generally for a sickness, which is what your husbands surgery would be classified as, that period is 7 or 14 days. Some people choose longer elimination periods if they have sick leave.
Another possible reason for the amount is that the claim is paid based on how the doctor fills out the claim form. There are two questions on the form that are used to determine the EDOS (end date of service) which is the last day that the claim is paid for. The claim is paid for either, 1. the date of expected return to work or 2. the date of the next appointment. If your husbands doctor said that he could be off for 8 weeks but also put down that his next appointment was 4 weeks then the claim will be paid to the next appointment date. You can check on this by examing the EOB (explanation of benefits) which is attached to the check you recieved. You may also call your agent and ask them to determine those dates or other points that I have previously mentioned.
I hope that this will help you to understand, and possibly gain more money from your husbands claim.

[protected]

Aflac Job harrassment has happened to me as well and it goes beyond several email spams per week that I mark as SPAM, forward to goverment anti-spam email addresses and try to unsubscribe, if possible. Many friends/colleagues and myself have experienced this harrassment after posting our resumes to online job sites, even securely when our contact info is not viewable, such as careerbuilder, monster, etc.

I also get CALLED at least once or more a week, usually in the evenings, sometimes two separate people calling the same night. They obviously don't read my resume or care, they just want me to "start a new career by working my way up and come in for an interview". They call you for an interview which is in fact a "seminar" where you and other people are shoved in a room with a video and pep talk about selling their insurance. The job has nothing to do with my current resume objectives, past positions or experience.

I've emailed and asked on the phone to be removed from their call and email lists and to be put on their DO NOT CALL list, but to no avail. Recently, I've been getting emails from silverman.region.hr@gmail.com, with replies sent to aflac-recruiting@yahoo.com.

Tonight was deplorable! A man from Silverman Region Insurance, an AFLAC affiliate/subsidiary, and American Family Life Assurance Company of Columbus, was very unprofessional and rude. When I asked to be removed from the list, I was yelled at to "THEN REMOVE YOUR RESUME FROM ONLINE!" and then the unprofessional male hung up on me.

He mumbled his name but his cell phone number is [protected]. I tried to call back, but there is a generic voicemail with no name or company, just the cell phone number. I was able to trace the number to a Baltimore address.

I've had major job boards try to block Aflac (and their subsidaries/afflilates, like Silverman, American Life ). However, many job boards require you to "unsubscribe" from the emails themselves, but most Aflac "reps" remove the unsubscribe. The latest email I received was signed, April Kennedy, Aflac Regional Recruiter, April_kennedy@us.aflac.com and had an unsubscribe. I did unsubscribe and will forward this message to her for escalation/resolution and see if anything can or will be done.

I'm so sorry you of all people have to go through this. It all boils down to 1. do you know what is covered? 2. do you know what is owed prior to submitting claim? and 3. do you know how to argue? I'm telling you with EACH AND EVERY CLAIM - EACH AND EVERY CLAIM (can't stress that enough) I'm underpaid or denied - then I have to call them out on their BS (gosh I wanna spell that out in all caps) and they "fix" it. Not to mention they won't "call" you and say "hey, something wrong with your claim" noooooooooooooo you have to wait for them to "mail" you something...oh no no no...I call up THE NEXT DAY after submitting now and say "I sent you this, do you need anything else?" You have to know what is covered, what they owe you and you have to run your own collections department. I can't believe that would be too easy in your case - but it sounds to me you're a true fighter! :) God Bless. Praying for full restoration!

I am so sorry to hear about your illness. I cannot imagine what you are going through. It really sucks that you have to fight with this company and customer no service. I will say in my experience, this is the first bad thing I have heard about AFLAC. I would call and request a different supervisor if that one is not available. Also, do you have an agent? Agents can be extremely helpful in these cases. They are more than happy to do the leg work for you. Please get well soon. I am rooting for you.

I filed a claim on 6/4/12 and still haven't received my money! It's 7/4/12 today (Happy 4th) Aflac keeps dragging their feet. Keep telling my claim approved and give me a check # but no check! Maybe sent it pony express cause they said it was dated 6/14. Really?

I'm so sorry for your battle, but I have asssited with many cancer claims for my clients - a bit of advise - Make sure you resent the initial claim form first page EVERY time you send in information and make sure it clearly state continuation of a claim. Not being devils advocate but Aflac processes about 4 million in claims daily and that is a lot of paper to shuffle. If the receive information from you and think it is a new claim, you get the messages you have. Make sure that your situation is ongoing and you are routed to the correct dept. Ask you agent to help - you don't need the extra pressure and he/she should know what aflac looks for. Chemo and Radiation must be coded and $ on some plans for the chemo. Easily obtained by your md. For surgical proceedures I normally ask for the surgeons notes - makes it very clear and then the Itezmized bills show inpatient vs out and so on. Wish I was close enough to help you - lost my Dad and he had nothing! Sold a lot of cancer coverage and seen A Lot of $ sent out. You should receive everything in your plan, read it - and I'll bet the first check was more than you have invested. Know you are in a though time, been there - but Aflac works.

Aflac has been and continues to scam North Carolina residents with its alleged accident only policy it says accident -- then when you have an accident Aflac complains whether your accident arose from an injury independent of sickness or disease. Policy says accident only nothing about it does not cover sickness. The exclusions and limitations are written so that whether injury is sequential or concurrent no coverage. The North Carolina Attorney General should pursue punitive damages.

It always helps to work with the agent who sold you the policy if you are filing a claim. I wouldn't dream of going it on my own, even tho I'm computer savvy and know quite a bit about insurance.

I was sold a sickness accident and cancer policy at work. The agent never said there was a 10 month waiting period before a claim could be made against the sickness policy. My wife had an operation 3 months after the policy started not covered our daughter had a newborn oh that's not covered trust me put the money in the bank and if something happens pay yourself you will be further ahead. Also the agent never returns calls but he sure was a pest when selling the policy!

I have been diagnosed with a stage 2 brain tumor and Epilepsy. I am no longer able to work due to these factors. I have been signed up for AFLAC's 6 month short- term- disability plan well before this all started. I wanted this in place figuring that amount of time would cover the gap while waiting for Social Security to come through if something like this were to happen. Unfortunately it has happened. They are refusing to honor the policy they sold me. They seem to be only full of excuses now. We have been contesting this since it began for almost 4 months now. We have also contacted the Tennessee Insurance Commissioner on the matter. He assures us that they are in the wrong here and will contact them on our behalf. We are still being refused by AFLAC. I have always had good experiences with AFLAC's accident policies in the past. This is the reason I was comfortable signing up for their disability plan as well. Never again for anything they offer in the future! If anyone out there has any additional ideas/suggestions for us to try, it would be greatly appreciated. Thanks for your time and attention. I hope your luck goes better than ours. Nathan Kazenske

FRANK MCDOWELL ; I have 4 polises one of them is shert term disability and thay are tring to get out of paying me i have had thes polises for about 4 years without useing them you thenk thay would wount to keep paing custermers happy.Thats ok becouse starting monday i'm going to call them AGGEN and if i don't get enewair i am going to the better bisnes buro then i am going to call chanel 2 newes news and see if thay will help me!

THEY KEEP BEATING AROUND THE BUSH WITH MY CASE TOO. I HAVE SENT ALL THE PAPERWORK THE WANTED FROM ME AND MY DOCTORS AND THEY STILL WANT MORE VERIFICATION ATLEAST THATS WHAT THEY CALL IT.

umm it sound to me like you should be mad at your employer, not Aflac

Aflac is a scam, my short term disability policy has been under review for 2 months. It takes about 15 days to get a letter from them when they need additional information, but two days when they need your premimum.

I had learned my employer made the deductions for the coveraged but failed to pay Aflac in time. Once I got that worked out, i had to have surgery. I was told prior to my surgery and this was after being insured for 6 months, that I had coverage and not to worry. I come home from a major surgery, which requires 3-4 mandatory bed rest only to get a letter stating my policy had be cancelled because my employer did not get the money to them in time.

Now we get that straighten out, and it takes them 30 days to review the documents, I was told on Thursday by one of their Supervisors my claim had been approved. Than on Friday at 4:35 pm I get a call from the same woman telling me my claim had been denied, management reversed the decsion because they wanted additional information. My agent does not return phone calls. This has effected my recovery to the point I was rushed to a cardiologist because my resting heart rate was off the charts. My physicians are mad as hell. This company is despicable. Buyer beware. I hae not given up, but be careful very careful they lie, cheat and will do what ever they can not to pay a claim.

Aflac can't keep your FSA money because it's illegal and because they don't have it. When the money is deducted from you check it stays in your employer's bank account. Aflac just proccess your fequest and reimbures you from that bank account. If there is any money remaining from your FSA at the end of the year your employer keeps that money. Aflac makes no money at all from administering your FSA and receives no benefit what so ever from denying you access to your FSA funds.

LESLIE CHARLES GILROY (corrupt cop)
in company with
LLOYD STEPHEN GANZERLA
BELINDA JANE GANZERLA
EUGENE CLEVELAND GANZERLA
TRACEY ANNE GANZERLA
and others, robbed my wife and I
See the whole story here
http://austlawpublish.com/forum/viewforum.php?f=2

Hello,

I'm also having trouble with an old AFLAC long term health care policy. My mother has Alzheimer's and needs 24/7 supervision, yet Aflac claims that she does not qualify for her benefits since the room she's in is not in the nursing home wing of the care center. It's sad because my parents counted on this insurance paying at least 3 years and now we find out it won't unless we move her.

Susan from Iowa

were you working for Aflac and Nathan was your Boss? Can you tell me more? I am very close to taking this insurance class for NY so I can sell their insurance and I want to know from you what your advice is other than dont do it.