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Ts attached must be clear and legible. 2. The Total Dependent Care Reimbursement requested box must be completed. 5. Allow 48 business hours to check status of reimbursement request. 3. The Medical Care Total requested box must be completed. 6. Please maintain copies of all receipts for your records. Check here if address change Employee Information Participant s Social Security Number (Optional) Last Name Employer Name First Name Street Address Middle Initial Participant's E-Mail A.

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Log in to your account to check the status of your claim. From there, you'll be able to check claim status, upload additional supporting documents if needed, and view your explanation of benefits. You may also check claim status by chat or phone by calling us at 800.992.3522.

Send to: Phone:(800) 433-3036. Fax:(866) 849-2970. Email: groupclaimfiling@aflac.com.

Date and description of injury. Location of the injury. Patient's name and date of birth. Patient's relationship to policyholder.

Aflac Aflac cannot process claims until they have the employee's statement, physician's statement, employer statement and the authorization page. Claims approval process takes 5 days to process and pay out claims.

To file a claim, simply select the appropriate claim form for your specific product and mail or fax it to us at the address on the form. Download the form. Fill it out. Send it in to: PO Box 60676, Worcester, MA 01606.

How to File an Insurance Claim Step 1: Call the Police if Necessary. If a crime was committed, someone was hurt in an accident, or there is significant damage, don't just stand there. ... Step 2: Document Everything and Exchange Information. ... Step 3: Contact Your Insurance Company. ... Step 4: Filing Your Insurance Claim.

How do I get my money back from Aflac? Additional reimbursement forms can be obtained at aflac.com or via the IVR at 1-877-353-9487. Fax your completed Flex One Request for Reimbursement Form and all documentation to: 1-877-FLEX-CLM (1-877-353-9256).

Fax this form to 1-877-442-3522 or return the form to Aflac, Attn: Claims Department, Worldwide Headquarters, 1932 Wynnton Road, Columbus, GA 31999, as soon as possible in order to expedite claim review.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232