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  • 4 - Pdf_claimforms_hf004_dental - Aflac

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Policy #: INSTRUCTIONS FOR FILING DENTAL CLAIMS PLEASE DO NOT SUBMIT THIS FORM FOR PRECERTIFICATION. AFLAC DOES NOT REQUIRE PRECERTIFICATIONS AND WILL NOT COMPLETE THE FORM FOR PRECERTIFICATION. 1.

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Dental Claim.pdf - Benefits Your Way
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WELLNESS BENEFIT (a preventive benefit; the Accidental-Death, Dismemberment, or Injury of a Covered Person is not required for this benefit to be payable): Aflac will pay $60 if you or any one Covered Person undergoes routine examinations or other preventive testing during the Calendar Year.

This means, you'll be paid in just a day. How will I receive my claim funds? There are two ways you can receive your funds: Direct Deposit: If you've already signed up with Aflac for Direct Deposit, your funds will be deposited into the financial institution of your choice the next business day after filing your claim.

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.

How long do I have to file a claim? A. There is a one-year timely filing provision in your certificate. Please review the provision and call us with any questions.

One Day Pay is Aflac's way of making sure your claim gets processed the same day you submit it. ... One Day Pay is available to policyholders who file claims online through the Aflac SmartClaim process and all required documentation is electronically uploaded Monday through Friday by 3 p.m. Eastern time.

Orthodontic Benefit (Rider A82050) After rider in force 24 months, Aflac will pay $500 for initial treatment of one of eligible orthodontic procedures. ... Maximum payment of one treatment/month up to 18 treatments. Lifetime maximum $1,400 per covered person. Maximum amount payable: $2,600 per policy year.

If more than one Loss per Covered Person occurs on the same day, only the highest eligible benefit will be paid. Aflac will not accept an assignment of these benefits. All benefits will be payable to you. Any accrued benefits unpaid at your death will be paid to your estate.

Aflac will pay $3,000 upon a covered person's onset date of carcinoma in situ. This benefit is payable once per covered person, per lifetime. Aflac will pay 25 percent of the Internal Cancer Benefit amount when a covered person suffers a cancer-related death. CANCER-RELATED DEATH: death as a result of internal cancer.

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.

ACCIDENT SPECIFIC-SUM INJURIES BENEFITS: When a Covered Person receives treatment under the care of a Physician for Injuries sustained in a covered accident, Aflac will pay specified benefits ranging from $35 $12,500 for dislocations, burns, skin grafts, eye injuries, lacerations, fractures, concussion, emergency ...

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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
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