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Get Aflac Accident Injury Claim Form

ACCIDENTAL INJURY CLAIM FORM Failure to complete this form in its entirety may result in a delay in processing this claim. Complete Policyholder/Patient Information and sign your claim form. Have.

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Download the form. Fill it out. Send it in to: PO Box 60676, Worcester, MA 01606.

Your Aflac wellness claim pays you money for staying on top of your health by getting yearly checkups and medical screenings such as physicals, dental exams and eye tests. Most Aflac accident, hospital indemnity and cancer insurance policies have a wellness benefit to pay you for staying on top of your health.

Benefits are payable for a covered person's death, dismemberment, or injury caused by a covered accident that occurs on or off the job. ... Initial Accident Hospitalization Benefit Aflac will pay $1,000 when a covered person is confined to a hospital for at least 24 hours for injuries sustained in a covered accident.

Accident insurance covers qualifying injuries, which might include a broken limb, loss of a limb, burns, lacerations, or paralysis. In the event of your accidental death, accident insurance pays out money to your designated beneficiary.

When you use Aflac SmartClaim ®filing your claim online is an easy way to get paid fast.

Download the form. Fill it out. Send it in to: PO Box 60676, Worcester, MA 01606.

* Starting at $25 per month is based off an average annual premium of $349.44 for Individual Accident Insurance coverage for industry classification A for a policyholder aged 18-64 in the state of CA. The information provided in the Benefits Estimator is illustrative only.

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.

Page 1. Your Aflac wellness claim pays you money for staying on top of your health by getting yearly checkups and medical screenings such as physicals, dental exams and eye tests. Most Aflac accident, hospital indemnity and cancer insurance policies have a wellness benefit to pay you for staying on top of your health.

Accident Emergency Treatment Benefit Aflac will pay $120 for the insured and the spouse, and $70 for children if a covered person receives treatment for injuries sustained in a covered accident. This benefit is payable for X-rays, treatment by a physician, or treatment received in a hospital emergency room.

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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