Aflac review: refuse to pay on covered claim 40

I absolutely agree with you! I had a knee replacement in AUGUST 07 and I am STILL going around and around with them. Today I just got a letter stating that my claim had been CLOSED because they didn't get the info they needed which is BS because I faxed it myself! I just got done talking to the customer service for the last hour just to have them tell me that they haven't received it! WHATEVER! I am so mad right now I could just about spit tacks!

Some of my coworkers have complained about their claims paying process, while others, including myself have had no trouble. I have filed may claims (minor to major) in the past 3 years + of having Aflac and actually volunteer to help frustrated coworkers with their claims. I almost always find that there was something they weren't doing right. This isn't like health insurance. You have to follow the process.
If you don't take a claim form when you see the doctor or go to the hospital, you HAVE TO get documentation showing that you were treated!
You should keep your Aflac policy #(s) where ever you keep other important info, so you can fill out the claim form correctly.
You have to pull the right claim forms off the website www.aflac.com/claims
Aflac will pay claims if they receive the correct claim form filled out by you and the doctor/hospital (with your posicy #)
*OR* The correct claim form filled out by you accompanied by documentation from the facility that provided the treatment/care/appliances/therapy etc.

I can understand that the process can be confusing, especially since this is different. If things are done right, the $ will come promply...the way we need it!

I have had Aflac insurance since i could remember...i also got it at work...i do not remember a time that my claims were not paid. one of my claims took 60 days to pay but that was not aflac's fault...my doctor lost the form, then he could not find it after it was faxed again then finally after i had to sit in his office for a whole day he signed the form and i was able to get my claim paid. I have them all, i have the accident, cancer, heart attack one, intensive care, life, sickness with hospital and i have the disability. moriah is right if you just read the directions on how to fill out the claim form it would save you a lot of headaches...it does state on there exactly what aflac needs for you to send them...sometimes people just think about getting paid and do not think about that for every insurance company there are claim forms to be filled out...dont you have car insurance? or been in an auto accidnet? those are really bad...you have to wait till an claim investigator looks at your car to see if you would get paid or not...oh let the other driver not have insurance...guess what! you get stuck with a broken car! but aflac is not like that. they never say a percentage of what they are going to pay because they are on a fee schedule...you will never hear them say oh yeah your claim will get paid...they always tell you to allow more time for the claims department to process your claim. if your claim did not get paid is because: A. you did not fill out the paper work correctly. B. your doctor or your boss did not fill out there form. C. you didnt sign the entire claim packet. D. did not submit all the documentation that is needed (you can READ! the first page of the claim and it tells you what they need from you) or E. you got hurt on the job and as you know you are suppose to have been covered by workers comp, because the disability policy is only for injuries off the job or if you have to miss work because of a sickness...before you put blame...check in the mirror...the error, i guarantee it was on your part. thank you.

The funny thing about this post is this ... The person posting this comment sure likes to try and discredit Aflac. She indicates that Aflac sat on her claim for a month ... This is entirely untrue ... The insured submitted the claim information on 10/23/07. Her claim was paid on 10/29/07 ... a WHOPPING 4 business days later. Additionally, she received over $4, 000.00 in disability benefits. If you notice, she posted this complaint even before the claim was received by Aflac. The thing I don't understand is that she of course (even after the claim was paid and paid quickly) still canceled her policy. I don't understand how a person can receive $4, 000 in benefits and feel that this type of policy is not beneficial.

No disability insurance pays 80% of your income. The State does not even pay 80% of your income and neither does Unemployment pay 80% of your income.

I know how frustrating it can feel if you think you are getting the run around from a company, especially when it comes time for payment. My experience with Aflac is that they do pay claims promptly. The things that hold up claims are misinformation or lack of information. It seems as if the complaints mentioned are for short term disability, which can get held up if the doctor or employer does not fill out the paperwork correctly.

My recommendation is to put your Aflac agent to work for you to help when you have a claim. They have the ability to find out what is going on with your claim, and what Aflac needs to get it resolved.

I went thru my AFLAC agent for help that did not work. Last year Nov 1, I went to Baptist Hospital Urgent Care I was not feel well was not eating well, fever (feeling very hot putting ice help)and chills. Urgent Care rush me to Main Hospital by ambulance they diagnosis that I had kidney failure. Urgent Care was wrong after the hospital did so many tests and what they found that I had was infection from gallbladder to my kidney.

Because I have a history of hypertension and stroke in 1994. They trying to find a reason not to paid by saying that I lied of my application. And they sending questioner to a doctor that I have not in 4 years and no longer have my records

To all - two things to keep in mind. For the individual that said he expected to receive 80% of his salary if he became disabled - in their own training manual Aflac teaches their agents that if they submit any policy request that exceeds 70% (a total in combination with an employer's insurance), they will NOT issue the policy. Aflac also states in their training manuals that anything about 70% disability is a disincentive to return to work and they won't do that. If an agent promised 80% of salary, proof of this to Aflac will likely result in his/her dismissal or at least administrative discipline.

The second thing to keep in mind - is that many claims are handled by the writing agent unless a claimant files his/her own claim. The intent is to provide quick and accurate service but as will all people, some are simply more skilled, reliable, and competent than others regardless of intent. Any claim that is not getting serviced properly should be (a) called to the attention of the servicing agent (b) if that isn't working, contact Aflac claims department, and if THAT isn't resulting in progress - contact and lodge a complaint with your state's insurance commissioner. THAT - will get results if nothing else does.

No one and no company is perfect, but Aflac has far more individials and companies both here and abroad that testify to the fact that Aflac is not only a good corporate citizen, it also pays as it has promised it would do in its policies. Remember - an insurance policy IS A CONTRACT - and therefore subject to enforcement by the laws of the state in which the policyholder lives.

I am fighting with AFLAC to get benifits on a covered claim. I agree that they are becoming harder and harder to get to pay up on claims. always looking for an "out" to not pay off on. SCAMERS!

Here's my deal. I signed up with Aflac through work. All of my coworkers told me what a great deal it was and how they had never had any problems with them. So I signed on and because I thought that they they would be there when I had any medical prolems, I didn't sign up for a flexible spending account.
I had minor foot surgery 12/31/2008 for foot pain. I had put this off for awhile due to health problems with my husband. I told the agent that sold me this policy that I would eventually have to have this done. He told me no problem. Just let me know when you have the surgery done, send me the bills and I'll bring you a check.
It is now April 22, 2009 and I'm still fighting Aflac to get my claim paid. I have sent the bills, documentation from 2 physicians (one of whom had nothing to do with any of it other than he is my family doctor) and they still have my claim pending. It isn't even for a great deal of money, probably 300.00 dollars. I have called Aflac numerous times and talking to a person is almost impossible. My agent will not return my calls or emails most of the time.
So all of you people that think Aflac is so great, whatever. But my experience with them has sucked from the get go and I wouldn't wish them on my worst enemy.

The best advice I can give everyone is to NOT buy Alternative insurance! Not even the best attorney's can descramble the fine print. They're intent is to do everything under the sun to not pay you! Our rep told us a bunch of lies, which we discovered when we put in a claim, which I am sure you can probably guess was denied, suprise.

DONT BUY THIRD PARTY INSURANCE, its legalized crime.

To the folks that have an unpaid claim and feel that you have been scammed by Aflac or any insurance company for that matter, please keep in mind that all insurance companies whether it be a supplemental health policy, life insurance, car insurance, etc. must comply within the law or they get shut down. You can certainly file a complaint with the insurance commissioner within your state. They will investigate the issue for you. They are there to protect the general public.

My wife had to be taken to the emergence room for cutting her hand.So bad she had go in surgery for 6 and a half hours, kept her over night . I have a bill for over 30, 000 dollars aflac paid me about 1, 300 total and would not pay for overnight stay because she was only being observed. I pay about $500 dollars a year for 2 years threw my employer.I broke about even i rather bank my money! sorry aflac kiss my abserved not admited ###! Think about those poor souls that pay in to this for years and years and get peanuts for there injury my wife's hand will never work wright ever again for 1, 300 bucks what a deal!

i agree with the complaint my name is goodness and i made a disability claim over
months ago. i 've been out of work since 1/1/09 of this year . i gave them every thing
they ask for . i have bill's due and they were suppose to been paid by my disability
policy. It's best to go to police and fill out a greviance report . i have multiple spinal
cord injuries and in need of double surgery . yet they try to hold back monies to force us
to do some type of work that normally we would pay others to do with the monies from
our policy . that's fraud and breach of contract especially when dr's says you can only
do so much. but with out that help from your policy we are force to do certain things
to take care of our own house hold. I personally think that a class action complaint
should be done about this, lets get together and do something. both me and my wife don't work . i am on all kinds of pain medicine and await surgery, but i will not take it until
aflac pay's my policy due. they have showed me they are not loyal to their contract.
we can get them for breach of contract

NEVER BUY FROM AFLAC! They are more than happy to take your money, but will do everything possible to avoid paying your claim. I had a short-term disability policy (among others) and found out AFTER the policy was purchased that I had to have a total knee replacement, meaning I would be literally disabled short-term afterward. By the time of my surgery, I had paid 7 months of premiums. When I submitted my claim, I heard nothing from them for weeks. My agent was of no help and could give me no answers. After numerous emails and phone calls (at this point it is almost three months after the surgery) he told me they have denied the claim because the diagnosis was in the first 30 days of the policy. Hello? So, the money that I had counted on to help me while I was physically unable to work was denied. I would have been much better off keeping the premiums in my pocket. Well, BUYER BEWARE. They will only pay you if they can't figure a way out of it.

There has to be other circumstances surrounding some of these claims that are being denied. I have been with AFLAC for over 11 years and my father was with AFLAC for 33. I have never in that time had any complaints or legitamate claims get denied. I have had a few take longer than usual but it was because of the doctor not filling out the forms that needed to be filed. Most of the issues policyholders have when filing a claim is not having the correct paperwork or an agent that is not helping properly. Every State has multiple Regional offices and District offices, they should be in the in the phone book. Pick up the phone and talk to the Regional Coordinator and let them know that you need there help. If you do not contact someone locally to help you it can be difficult if you do not have the correct claim form. Disability is one policy you MUST have a claim form on. If you need any assistance as far as leading you in the right direction please let me know and I will be happy to help.

i got a hernia from some heavy lifting .i went to the doctor i send in cliam for aflac paid 120 for that and when i go for the repair next week the will pay 1200 and pay shot term dissabilty . my agent said after the surgery i have to get some kind of print out from the doctor and send it in i cant remeber what she called it does any one know what its called i cant get a hold of my agent right now my phone is not working . and my work acts like there not going to mess with it . also when i went to go see the surgen i seen his nurse first and i had a aflac form in my hand and she throw a fit blah blah aflac usally turns in to 6 pages of paper work and tells me you need to fill out as much as you can if you get this paper work because i dont fill it out and the doctor doesnt eather iam like its just a few dates and a signture kind of worried can they say no i wont fill that out its not like its fraud they just are lazy ### . i need help someone aflac agent or someone .

I agree with the fact that Aflac pays what they want to pay. I had an accident where I injured myself by pulling a ligament, the doctor took me off work for three days, well while in the process of being out of work and having had pulled that ligament I start having contraction and did not know it until I lost my baby 7 days later, I was 5months pregnant and Aflac still has not paid a penny on my accident policy they stated that a pulled ligament was not considered and accident but when i spoke to someone in the company i was told that it was. I cancelled all my policies with Aflac this happened in 8/09 and I am still fighting for my accident benefits and I had this policy for three years!

I'm not sure how many short term disabilities that AFLAC has but for the person who stated that it was up to 60%, I would like to state that mine is 80%. My policy is to pay 80% of my lost wages after one week of missed work from a disability.
NOW for the ones who have stated that it was "Operator" error (meaning that it can't possibly be AFLACS fault because you have never had an issue) The one thing to keep in mind is that Everyone has a different agent. And just because you agent might do it's job properly doesn't mean that someone elses does.
Now my 2 cents! I have short term dissability thru AFLAC. I was recently out of work for a month due to sickness. Due to my job I could not perform my duties. I took the correct paperwork to my job and had them fill it out. I then took it to my DR office and had them fill it out. I then filled out my part and faxed all of my papers to my agent. I then called her to see IF she had recieved the fax. It took a week for me to get her to return the call confirming that she had it. She confirmed that she had the fax and it was EVERYTHING that I needed. A week later the claim was still not in the system. I called her for 2 days with no reply. I then contacted corporate (via email) I recieved a call from my agent about a hour later. She told me that she was faxing in the claim right then (She recieved the fax a week prior). 3 days later the website showed where it was entered and in "Pending". I then recieved a call ONE week later from my agent telling me that she did not have all the information she needed. She asked for permission to contact my employer and doctor. The next day at an appt with my physican she mentioned that AFLAC sent her papers to fill out (The ones that she had already filled out) luckily she kept a copy and faxed them the first copy. They did the exact same thing for my work. They both faxed the papers in my presence. I called my agent to see if they had the new faxes. Again no returned call. I again emailed corporate and she called within a hour informing me that she had the faxes. A week later it is still in pending. I finally decided to call corporate and they informed me that my "Agent" had given them reason to doubt my claim. So in return they were asking for ALL medical records to prove that I was in the hospital and the test that had been ran by my doctor. When I called my agent concerning this (SHE AGAIN NEVER REPLIED). I emailed her stating what the corporate office had told me and her reply to me was "Just wanted to let you know I checked on your claim and it is still in pending, I will let you know when I hear of any change". I pay $160/mo for my policies with AFLAC. If I didn't have the policy and saved the money I have paid I wouldn't have to worry about my months of lost income. Maybe it isn't AFLAC directly but my agent represents them, therefore I do not care for the company. I am still waiting to see if my claim gets paid. I am giving them 30 days and I will contact the Insurance Commisioner and cancel my policy with AFLAC.

I denied my benefits from my AFLAC accident policy due to the verbiage used in the diagnosis. I was treated for my fall within the 72 hours timeframe AFLAC as an insurance company has setup. I was sent to two hospitals, went on two ambulances in the same day. And now due to that fact that one of the many doctors I saw stated what they saw as ‘Impaired Speech/ Facial Droop’ I have been denied? What about the fact that I fell very hard a hit my head VERY hard on the tile floor? What about asking me or maybe someone who witnessed the fall? I didn’t seek medical attention immediately as I did want to accrue any medical cost. But again I went within the 72 hour timeframe, and now that I did, I see that AFLAC is not standing behind me. This is all just wrong. I am doing the right thing. Going by AFLAC’s rules and I am the one who loses in the end.

AFLAC is terrible. I think they were good at one time. My experiences have been both good and down right terrible. Half the time when I fax a claim, it never makes it to the right hands. they claim they even r received it, even if I have a confirmaiton number! I have no clue who is on the receiving end, but it's terribly disorganized. most of the time I have to follow up, and waiting on hold is a racket. (I waited no less than 45 mins once) And all for a $100 claim. It's not worth the time or or money. ANd my agent doesn't even exhist. he doesn't answer his phone, return emails, or follow up. He even a distric manager! How terrible is that! I just cancelled, and I"m not looking back. I'd rather save my money, than rely on AFLAC to come though. Just my 2 cents.

I miss the old Aflac Duck on TV. I do not enjoy watching the new ads and have heard
lot of comments about it.

Aflac is B.S. They sure like taking your money.
But cannot seem to help...
Costemer service or agent
Had to deal with them for over two months, promissed coverage the day of signature, was not true they baled and said the accident happened before coverage
They were taking my money for a month
.They are A joke

They fu###d me over after time and 500 miles of driving and resubmitting claims they accept the disability part payout 30 percent of wages which was suppose to be 70 and deny the accident yep I meant to get hurt and go have surgery on my arm the agents sure sugar coated it when they sold me the policy.

I had a baby on March 22 and was put out of work early due to hypertension. 3 weeks later I still had not recd a ck when I emailed and called about this I was told my agent was on vacation. The girl covering claimed the dr had not sent in the paperwork. Come to find out she sent the papers to the wrong fax number. Thank God I did her job for her of following up. Now I am still out due to issues and my agent is once again on vacation. Aflac only paid me for 6 weeks but in their system they say they paid up until June and they have no answer on how that happend. Now everything has been sent back in and they are now saying they have paid full benefits and they haven't so now I have to request they re evaluate everything. I have done more work getting myself paid and I have not once been able to speak to my agent. I do not recommend them for short term at all

Been with AFLAC 15 years paid THOUSANDS of dollars for coverage - never filed a claim. Suffered a severe ankle sprain, could not work, had surgery, submitted all forms from Employer, Surgeon - Claim denied based on their beliefs the doctors procedures were done surgically on what they could deem an accident. Spoke with rep as soon as I learned it was denied, got a very rude and heartless rep.
I would suggest other alternatives to this company. They make you go through every possible piece of scrap paper for info and provide them with it, only to have them make you wait out the 4-7 business days and deny you.

Someone please Roast that Goose on a open pit!

my hubby had bypass surgery the 23rd of sept aflac turned us down saying it was preexisting disease that is far from the truth we paid on this faithfully for sometime now we hes got at least 5 -6 weeks more to recoup we need this reviewed and help is needed theres no way someone plans on having a heart attack and needed bypass surgery

I was doing yardwork and I had pain in my back I had an xray and an mri which revealed I had a ruptured disc after evaluation my Doctor scheduled me for surgery which I had. I also was scheduled for physical therapy. I filed a claim and was told by Klinette on March 20 2018 that I was not covered? I asked to be transferred to a manager which she would not do. For crying out loud I am on the phone for over an hour at this point. I told her I WANT TO CANCEL MY POLICY. She then has to transfer me? I get connected to Courtney and she says hold on and now I get connected to Kim, she wants to know why I want to cancel, I explain briefly an she says oh ok your policy will be cancelled on April 15th. What a joke then I go to the complaint site about Aflac and wow what a shame poor Phyllis works hard I guess all the money that is collected from consumers like myself pays for her overtime she must be overwhelmed. As a consumer I am disappointed and overwhelmed also. It seems like more time spent on hold with various calls and and no pay outs not even a call if something is in question.

I have a hospital policy was admitted from the emergency room to the hospital for 4 days first day I was impatient then I was put on observation they did not pay my claim because they said that I was not admitted, but admitted through the emergency room. I pay a lot through my job per year just to have aflac when I needed it they denied it I'm getting rid of it

I need to jump into this Aflac as This company has ruined my life. I have been fighting 3 years now to get 15 claims and way more . The only thing aflac does great is collect premiums. They even refuse to cancel this non working service and continue to start committing fraud on your credit card. Do not make the mistake of autopay and hope to stop when you realize you have been ripped off for years. I have full time help that I can't even pay after having horrible luck and broke my back for a third time. I had surgery last year and still need another. I might have been able to manage my business of 28 years if I had money coming in to pay my bills with this BS advertisement of same day pay. How about everything ever asked of me 20 times over to get emails for the 10th time that say your claim has been accepted but due to security reason we cannot mention the nature of your claim online. a letter will come to you with the information . Then nothing happens the whole piece of lies and garbage starts all over. I have worked on my story that is going public to all media outlet. The biggest liars and stallers of all are your agents or at least mine were. I read all of this before I got hurt and kept asking my agent the same questions the she has never answered. I told them when they did both presentations in my office they were being recorded on surveillance so they needed to be accurate on their answers. It was sort of a joking comment but my questions were so detailed as they seem to yes everything and make it sound so easy. After being in business 28 years and kicking Aflac out of my office at least once a year . They just did not seem to fit what I needed in case something happened. ^ years ago I crushed my hand with a forklift. Drove myself to the ER . I happen to know the top hand surgeon in the state if not country. She saved my butt when I was a teenager and again 6 years ago. she told me not to let then cut it off, just get a plastic surgeon to try and make it look like a hand and she will rebuild it. She did exactly that but it took a year of surgeries. That scared me enough to get supplemental insurance since I am raising my daughters myself. Aflac said all the right thing but delivered nothing. The more I read about this company being a scam the more I told my agent I was not comfortable giving that company that much money . She played me worst then all. I heard it all. I would not let a father I respect so much waste his money. to we are a fortune 500 company to my friend all get covered . Still never answered my first questions still played around throwing smoke screens on small claims that were never paid except the $25 BS doctor visit that no one should ever cash. That locks you into accepting their service you paid. perfect example after my first surgery when I was disabled and ran out of lies and excuses she actually offered me my money back which was substantially lower than what they owed me. I said ok I would rather take that then deal with yours and your companies lies forever. Then she changed it to I mean we can give you your money back to your last claim. lies again. I said that's fine I never cashed your $25 check. I read a while back from a previous agent never to make that mistake so yes I'll take the refund since you have not gotten one claim handled in over a year. Then the lies a BS got thicker. Here came the I'll walk you through everything fortune 500 blah blah blah. When they ran my company out of business I made sure to get her my credit card info so she couldn't use my payments as an excuse. She sat on that over a month with 4 email of mine saying I'm not seeing the aflac charges on my card what are you up to now. She responded your policy expired I can't do anything for you. That's funny I just recieved in the mail today from aflac that my company was no longer paying but to keep going without interruptions I had 30 days from now to set up payment. Then she tried several more lies to try and tell my what I paid for without skipping a beat was not going to be covered. Only i read all the complaints and tricks they would use I read the policies over and over making sure I understood everything she avoided telling me everytime I put her on the spot and asked the questions. Finally she just ignored after I sent her recording that I started conversations with this is being recorded. Her emails of lies and contradictions . Some other agent took over for her I already knew this guy would be a waste of time. i tried getting info on their dental policy for 6 weeks then this jerk says we don't really sell many of these. You couldn't tell me you were this useless 6 weeks ago? My friend took over as Aflac literally was putting me in the hospital with stress High BP created cushing's syndrome as I watched everything I ever built disappear due to a worthless service that owed me not one but 2 disability policies, hospital stay, how do you deny hospital stay ? talk about worthless. they make you chase down papers that take 6 weeks to get from the hospital . When you send that in they have to review and turn it down . It's incredible how horrible this company is. If anyone on here is praising this garbage company you either collected the $25 doctor visit and think wow this is the greatest deal . If you are one of those and cannot calculate how much premium that cost you than You belong as a client of these crooks . The others are either employees or paid to do it. which is probably $25. There is no way that This piece of lies and garbage company can so easily ruin my life and so many others rated 1 star have so many complaints get praising from anyone. They also owe me a TV. The balls they have putting their duck on TV advertising same day payout. I through a glass through the TV. The one thing that is going to happen if the legal system doesn't step in. I'm waiting for an attorney who has beaten them several times. Even better I ran into a friend in my industry a few weeks ago. We were talking I always make sure to mention why I'm in poverty so fast Never will I let the opportunity to mention Aflac's raping of my daughters college funds we needed to survive losing everything to lies and denials. He said I was thinking about them for my business. Not anymore he's not. Best part is he has over 200 employees. Don't you ever let anyone sign up with the devil duck.