Aflac Claim Forms by jwi15414


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									1. Where do I get a Claim Form?

   You can download a Claim Form from the AFLAC webs site – If you do not have access to
   the web, contact our Account Manager (Edwin A. Vega) at (410) 903-2314 or email him at

2. When do I file my Claim? Accident claims can be filed immediately following the accident. Disability claims
   can be filed on or after your 1st day of disability. No need to feel rushed – you have 12 months to file your

3. In addition to the claim form, what additional documentation is needed?

   Accident Claim:
   A copy of either the emergency room, doctor’s, or hospital bill showing diagnosis and dates of treatment.
   Any other bills relative to a benefit you are filing for, i.e., ambulance bill, physical therapy bill, etc.
   If you are the driver of a car involved in a car accident, a copy of the accident report is required.

   Disability Claim:
   Your completed Claim Form is generally all that is needed for a disability claim. This means the Doctor has
   completed Sections B & C, and your Employer has completed Section D and signed the form. If additional
   information is needed, AFLAC will either contact you or your doctor directly.

   Cancer Claim:
   In addition to the Cancer Claim Form (S-2029)
   A pathology report is required for the First Occurrence Benefit.
   For each other benefit you are filing for, you will need to provide a bill relative to that benefit, i.e., hospital
   bill showing days you were hospitalized, anesthesia bill, radiation/chemo bill showing dates of treatment,
   ambulance bill, etc.

   ALL CLAIMS MUST INCLUDE THE HIPAA-COMPLIANT Authorization to Obtain Information
   form. This form is included when you download from the net or when forms are obtained from (Edwin A.

4. Who do I contact if I have Questions?

   Contact our Account Manager, (Edwin A. Vega) at (410) 903-2314 or email him at
5. Where do I send the completed form? Fax your form to (Edwin A.Vega) – Fax (301) 513-0815 or mail to:
   (Edwin A. Vega) AFLAC, (8957 Edmonston Rd. Ste. Q. Greenbelt Md. 20770)

   Edwin will review your form to insure that the form is completed correctly and that all required information is
   included. Your form will than be faxed to AFLAC for processing. Claims are normally processed in 7-10
   working days. Checks are mailed directly to the insured. To check on the status of your claim, you will need
   to contact AFLAC Claims Department Directly at 1-800-462-3522. You will be prompted from there.

6. Is there an Appeals Process if the claim is denied?

   If you feel that you were wrongfully denied a claim, there is an Appeals Process.
   Contact (Edwin) and he will assist you in filing your appeal.
   How to File an AFLAC Claim

1. Download claim form from Web or

  Contact Account Manager Edwin A. Vega
  (410) 903-2314 or email:

2. Once form is completed and signed by
   both you and your doctor, fax form to
   Edwin A. Vega (410) 903-2314 or mail to
   Edwin A. Vega, 8957 Edmonston Rd. Ste. Q.
                  Greenbelt Md. 20770

3. Please contact Edwin at the above phone
   or email for any questions or assistance
   in filing your claim.

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