CHECKLIST OF RECORDS NECESSARY TO FILE YOUR CLAIM

							CHECKLIST OF RECORDS NECESSARY TO FILE YOUR CLAIM


               MATERNITY DISABILITY CLAIMS!



   Section ‘A’ of the AFLAC Claim Form
    (Patient and Policyholder Information)

   Section ‘B’ of the AFLAC Claim Form must be completed in full
    including the diagnosis, Physician’s signature and date

   Section ‘C’ of the AFLAC Claim Form – Disability section to be
    completed in full by the Physician – ONLY if filing for disability
    income benefits

   Section ‘D’ of the AFLAC Claim Form to be completed in full by
    your Employer – ONLY if filing for disability income benefits




  Send all of the above back to KCI Financial Services, Inc. at the
  address below:

                      KCI Financial Services, Inc.
                     Attention: Claims Department
                    11011 Sheridan Street, Suite 202
                        Cooper City, FL 33026

  Call us with any questions that you may have at (954) 443-4443

                               Thank You.