Aflac

The hospital indemnity policy paid me each time I gave birth. I think for regular deliveries you get a basic $200 reimbursement. But my pregnancy had complications, I was in the hospital for a week with treatments and Aflac ended up paying me almost $3000 - which helped me cover the portion of the hospital bill that my insurance didn’t cover - with some left over. It was a bit of a pain to get my hospital records to the Aflac claims department - but as soon as I did - I got a big check signing 10 days. Much less hassle than I would expect for such a big claim. I’ve since started my own business and miss having Aflac coverage already. I will be signing up my business for this insurance as soon as I can afford to. The best testament a a business is a returning customer right? Thanks Aflac for being so easy to use.

My claim is finally being done now 10/17/2019. Know that after today and for anyone filing after me.. the claims dept. is on mandatory overtime working till midnight instead of 5.. trying to get caught up. But they are falling farther behind as more claims are coming in than can be handled at this point. So if filing for disability after this post expect a month waiting period. But try to be better and nicer than I was. They are trying to catch up.

March 17th: I call AFLAC. I find out I was still not in the system and was told to speak with my company about it, maybe there was a problem on their end? So, I went to my HR dept. My HR rep said she would speak with the AFLAC rep and get it settled. March 19th: I have surgery. March 23rd: I call AFLAC to file my claim. Still not in the system. I email my HR rep, who was shocked that it was still an issue. I was told they were going to get it fixed and I would hear something soon. March 31st: I email again. Same answer. Still waiting on it to get fixed.

April 16th: I left my company on April 13th. I emailed my HR rep again and was told their AFLAC representative had submitted my information and was only waiting on one signature. I was told their AFLAC rep would be in contact that day. One week later, and I still have heard nothing from him. I emailed my old HR rep asking for his contact information. Still waiting. April 22: I contacted AFLAC to see if I was in the system. Nope! I spoke with a rep who had to draft a letter to send to the group insurance organizer to outline the problem. She was nice enough, but I have to wait yet another week to hear anything.

I am extremely disappointed in AFLAC/whoever their rep is for my former company. It should NEVER be a hassle to get benefits YOU'VE paid for. EVER. Thank god I am not in a financial bind like so many people, but I paid for my benefit, and I want my money. I've paid out of pocket over $700 for my surgery copay and subsequent Physical Therapy sessions. At this point, I can't even file a claim because I don't have a policy number!

I will update this review as I go, but right now, I am beyond irritated. Be VERY careful when you sign up. It seems their representatives are hit or miss in their work ethic and job responsibilities. They don't consider the fact that clients come with claims, not just commissions, and it is their duty to make sure they are put into the system from the very beginning.

Mid-October 2019 - I attempt to complete claim online. Website will not permit me to upload my documents. I call and I am instructed to continue without the documents and then email those separately. Nov 5, 2019 - I was checking on the claim because there was no way to get a status update if this is a group policy through your employer. Ryan tells me that what I provided was not sufficient, I need to send a UV4 form. I try to request one, but all the hospital will send to me is an itemized statement in place of a UV4. I email the form.

Nov 7, 2019 - Letter from Aflac says they need additional information for my Hospital Indemnity claim and required supporting documentation was not provided. Nov 8, 2019 - Another letter from Aflac denying my Accident Claim because it was not an accident. That would because it was a HOSPITAL INDEMNITY CLAIM. Nov 12, 2019 - Another letter. They cannot process without a diagnosis code. Please submit codes with supporting documentation.

Nov 13, 2019 - I speak to Laurie. I will need to have a signed authorization form for Aflac to retrieve the diagnosis code from the hospital and must state in my cover letter to please use the authorization to obtain any documentation needed. The form must be signed in ink by my now adult daughter who lives 4 hours away. Even though I am sending PDF files, they will not accept electronic secured signatures. Off in the mail it goes to my daughter. While I wait for the signed form, Aflac closes the claim.

Dec 16, 2019 - I open a NEW claim and send the same documentation I have in the past along with the additional requested cover letter and release authorization form. Jan 24, 2020 - I call to check on the claim status because it has been over a month and group policyholders cannot have online access to their accounts (you have to call). They still need the diagnosis code. (???) I explain that I know that, which is why I included the additional forms for authorization to allow them to get it from the hospital. Documents are located that I sent and my claim is being sent back to the AUDITOR (remember this, because it shows up again).

Jan 27, 2020 - I get a letter dated for Jan 23 that states the claim is closed because requested documentation was never received and claim was incomplete. To add insult to injury, it further states the submission does not support room and board (they had an itemized bill for everything including lines such as "private telemetry room and care" for a 5 day hospital stay). MOREOVER, it says they made several failed attempts to contact me. (No, they did not).

Feb 6, 2020 - I spoke to Tamika to check the claim status after my call from Jan 24 to verify that the claim did indeed go back to an AUDITOR. I have a note that the last update was on Feb 4 - an email to Lynn, a case manager. I needed to allow more time for the hospital to respond to Aflac's request for documentation. Feb 28, 2020 - I spoke to Garret to check the claim status. He says they are still awaiting the diagnosis code. The hospital wants their own form completed for release of information. He states they are awaiting that to be returned from ME. I tell him that it has not come to me. I verify my email, mailing address and phone number with him. He returns the claim to the AUDITOR.

Apr 1, 2020 - I spoke to Brea at 11:56 am. She states that they are still waiting for me to return the hospital's authorization form. Have I received it? NOPE! I verify my phone, email, and mailing address again with Brea. She returns the claim to the AUDITOR. Have you seen a pattern here yet? The claim has been denied 2 (possibly 3) times for various reasons, and the only time they EVER contact me, is to tell me that the claim is denied for their own oversite or because they need more information - EXCEPT when it comes to sending me this hospital authorization form that I never get. No one emails me. No one calls me. No one sends this form to me.

I am been trying to get this claim paid for 6 months. Those ads on TV about needing your money now? Forget it. We needed this money in January. We probably will not see it until July, if ever. Run as fast as you can. Put the money you would have paid thieves and liars into a bank account for these situations when you actually need it, instead of throwing it away to con artists.