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Was performed. Please check your policy for specific benefits covered under your policy. Do not write on form except as instructed. Incomplete forms cannot be processed and will be returned. Please do not fax this completed form to Aflac. Mark only wellness exam box es for test s that you had performed. American Family Life Assurance Company of Columbus Aflac Attn Claims Department 1932 Wynnton Road Columbus GA 31999-7251 1-800-99-AFLAC 1-800-992-3522 aflac.com 1-800-SI-AFLAC 1-800-742-3522 en espa ol Z06197AD NJ Some of the tests listed may not be covered under the Wellness Benefit of your policy. DUCK ACCIDENT WELLNESS BENEFIT CLAIM FORM Please read all instructions. Failure to follow these instructions will delay the processing of your claim* Do not include receipts statements or other documentation with this form* Your Aflac policy provides one Wellness Benefit per policy year. To receive your Wellness Benefit complete the form by following the instructions provided* Please keep a ....

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1If all documentation is not available upon initial claim filing, you may upload the documents later by clicking “Upload Documents” on the mobile app or “MyClaims” on desktop. Register or Log in: Go to aflac.com/myaflac or download the Aflac SmartClaim Mobile app from the App Store or Google Play Store. One Day Pay*.

1If all documentation is not available upon initial claim filing, you may upload the documents later by clicking “Upload Documents” on the mobile app or “MyClaims” on desktop. Register or Log in: Go to aflac.com/myaflac or download the Aflac SmartClaim Mobile app from the App Store or Google Play Store. One Day Pay*.

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.

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.

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.

It will depend on the type of claim filed whether you'll receive lump sum payment or payments throughout treatment. Either way, if filing online and assuming all necessary documentation is present, payment turnaround should be 24-48 hrs. If filing via fax or mail, it will be longer.

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.

You may also fax your claim form to our claims department at 866.849. 2970 or scan and email your claim form to groupclaimfiling@aflac.com.

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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
Content Takedown 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:
+1 833 426 79 33
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