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  • Aflac Accident Claim Form 2016

Get Aflac Accident Claim Form 2016-2025

ACCIDENT CLAIM FORM INSTRUCTIONS To avoid delays in processing of your claim form, complete each section attaching documentation below when it applies.Supporting Documentation Needed Itemized bill.

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How to fill out the Aflac Accident Claim Form online

Completing the Aflac Accident Claim Form online is an essential process for users seeking benefits after an accident. This guide provides straightforward, step-by-step instructions to ensure your claim is processed smoothly and efficiently.

Follow the steps to complete your claim form accurately.

  1. Click ‘Get Form’ button to access the Aflac Accident Claim Form and open it in your preferred editor.
  2. Fill in the policyholder and patient information, including names, addresses, relationships, and contact details. Ensure all provided information is accurate to prevent delays.
  3. Indicate the details of the accident, such as the date, how the injury occurred, and the location. If applicable, mention if the injury was due to a motor vehicle accident and if a worker’s compensation claim has been filed.
  4. Complete the section regarding hospital confinement, ambulance transport, and any medical equipment required as a result of the injury. Attach relevant documentation as required.
  5. Document all treatments related to the injury by listing dates and attaching all necessary medical records. Ensure you include any follow-up visits.
  6. Sign and date the certification statements, ensuring that all provided information reflects your honest perspective to avoid potential fraud.
  7. Before submitting, review all entries for completeness and accuracy. Save changes, then either download, print, or share the completed form as needed.

Start filling out your Aflac Accident Claim Form online today to ensure swift processing of your claim.

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Please print a separate form for each additional family member or call 1-800-99-AFLAC (1-800-992-3522) to request additional forms. Claims for all other benefits covered under this policy must be filed separately using the claim forms available at aflac.com or by calling 1-800-99-AFLAC (1-800-992-3522).

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.

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

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.

The term accidental injury refers to various sudden, unexpected and external events occurring without the will of the injured party and causing injury in connection with a medical examination or treatment.

The maximum amount payable for the Fracture Benefit per covered accident is 150% the benefit amount for the fractured bone that has the higher dollar amount.

Date and description of injury. Location of the injury. Patient's name and date of birth. Patient's relationship to policyholder.

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.

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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
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
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 WorkFlow
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