Get New Claim Form Pdfs For Web - S00224 - Aflac

Filing a claim is an essential step in accessing your long-term care benefits. This guide is designed to assist you in accurately completing the New Claim Form PDFs For WEB - S00224 - Aflac online, ensuring that all required information is provided to prevent any delays in processing your claim.

Follow the steps to fill out the New Claim form online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
2. Begin by entering your policy number in the designated field. This is essential for identifying your claim.
3. Complete the policyholder information section. Fill in required fields, including your last name, first name, middle initial, date of birth, and home address.
4. Provide your telephone number in the specified format for any follow-up communications.
5. Indicate whether there is a change in your permanent address by checking the appropriate box.
6. Next, fill in the patient information section, entering the patient's last name, first name, and date of birth.
7. Select the patient's sex and relationship to the policyholder.
8. Complete the Long Term Care Checklist. It is vital to attach a bill from the healthcare provider verifying that services were rendered.
9. Provide the name, address, and phone number of the patient's primary treating physician, and indicate if the patient is deceased.
10. Sign the form at the bottom, indicating your relationship to the patient if you are not the policyholder, and enter the date.
11. Review the entire form for completeness and accuracy before submission.
12. Save your changes, download the completed form, or print it for submission. You can also share it with your healthcare provider if needed.

Begin your claim process now by completing the New Claim Form online.