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NUMBER OF PAGES INCLUDING COVER: DATE: AFLAC CLAIMS DEPT. TO: INBOUND FAX IMAGING 187744AFLAC (18774423522) FROM: PHONE: FAX : Policyholder: Associate Writing Number: Policy Number(s): Send check.

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Aflac pays cash benefits directly to you, unless otherwise assigned, for covered hospital expenses. We provide you with financial resources to help you overcome some of the unexpected expenses associated with a visit to the hospital, giving you less to worry about so you can focus your energy on getting better.

$50.00 annual wellness benefit for qualified health screenings for employees and covered dependents. Transportation and lodging benefit. Emergency room treatment benefit. Fast claims payment - most claims are processed in about four business days.

Wellness Benefit After the policy has been in force for 12 months, Aflac will pay $60 if you or any one family member undergoes routine examinations or other preventive testing during the following policy year.

In the event of a covered accident, the plan pays cash benefits fast to help with the costs associated with out-of-pocket expenses and bills—expenses major medical may not take care of, including: • Ambulance rides. Wheelchairs, crutches, and other medical appliances. Emergency room visits. Surgery and anesthesia.

Without accident and injury coverage, expenses for these incidents can be devastating to pay out of pocket. Because of the extensive list of covered conditions, we'd certainly say that Aflac's accident insurance is indeed worth it.

OUTPATIENT SURGERY AND ANESTHESIA (performed in hospital or ambulatory surgical center) Payable for each day that, due to a covered accidental injury or sickness, an insured has an outpatient surgical procedure performed by a doctor in a hospital on an outpatient basis or ambulatory surgical center.

Cost Calculator Accidentup to $2,450Hospitalup to $2,450Short-Term Disabilityup to $2,720Critical Care & Recoveryup to $9,859Cancer/Specified-Diseaseup to $9,859

This benefit is limited to one payment per calendar year, per covered person. No lifetime maximum. Surgical Benefit Aflac will pay $100–$2,000 when a covered person has surgery performed for a covered sickness in a hospital or ambulatory surgical center based upon the Schedule of Operations in the policy.

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© Copyright 1997-2025
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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
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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