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My husband learned he had blood cancer around April 1st of 2022. As the spouse, filing of claims has landed on my back along with everything else. He hasn’t worked for almost a year and I have been filing claims for nine months. His cancer required a trip out of state for a diagnosis and then a stem cell transplant that required 40 days in the hospital over 100 miles from our home. I’m still waiting for payment for our trip to Minnesota for the diagnosis. We received payment for proof that he has cancer after much back and forth as they were demanding a tumor biopsy – something that doesn’t exist for blood cancer.
Somehow; they managed to pay for the 39 days in the hospital but are denying the stem cell transplant payment; now the latest letter says they are closing the claim because I didn’t provide proof of lodging??? Claims are very hard to track for a cancer claim as you have many claims and they are assigned numbers only; I have a spreadsheet to try and keep track of where they are in the process. Documents are uploaded and they disappear. Status of claims is posted on your portal and then next time you go there they are gone. That makes it hard to dispute something when you don’t have any of the information there. Claims are denied for reasons that are totally unrelated to what I have filed for.
I have to believe that thousands of people are just giving up and leaving money on the table because they can’t make it through the process. Talking to a person is near impossible and disputing a claim means faxing them all your information or sending it via the U. S. mail. I want to know who has a fax machine and a landline anymore – have they heard about email and scanning? The hospital bill alone is over 100 pages – do you think I want to print and mail all that paper just for another denial? I’ve already uploaded it twice and it disappears.
My agent has refiled claims for me and he doesn't get any better service than I have gotten. I have 180 days to dispute a denied claim but I think they just dragging you along until the 180 expires. I have average or above computer skills so my inability to maneuver their system is not because I don't have any computer experience. I've asked that a case worker be assigned to review my claims and they said they don't do that. Each claim is handled separately by the first person available.
I have been paying on Aflac for over 3 years. I purchased this for peace of mind like they advertise and told me in person. I have accidental and critical illness for me and my family. My wife was recently admitted for Myxedema coma. She was in a coma for 4 days. She was admitted and stayed in the hospital for a week and a half. I contacted Aflac prior to filing a claim and they said it falls under the critical illness as she was in a thyroid coma. I filed once 10/14/22 and was denied. They said I didn't send in the requested material from the hospital stay and that I can send it through text. I did that. No response. I then filed a new claim on 10/26/22 and uploaded the Dr and hospital notes and stay with break down of all the lab tests as requested.
I called a week later. The person answering the phone said the critical illness needs to be an accident..? I told them I was filling under critical illness as Accidental insurance was not what I was filling it under. Needless to say they denied it again. I pay all this money for 3 years and they wiggle themselves out of paying any claim like cheap car insurance. I spoke to my HR benefits dept. My corporation stated they had many complaints and they are cancelling Aflac the first of the year(2023). Even the Dr's in the hospital stated that her stay would fall under critical illness. ***UPDATE*** They responded to my BBB complaint and said she had to be in a coma for over 10 days to file the claim and that it needed to be one of 3 comas they cover... What nonsense. Each time I have contacted Aflac I received a different reason on why they denied me. What about hospital stay? Nope, we didn't get a dime.
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I Ruptured my Achilles. I had outpatient surgery at a hospital. AFLAC only paid $325.00. Outpatient claim was denied, and hospital claim was partially denied because I wasn't in the hospital 24 hours. Accident claim was denied because there was no indication as to how I ruptured my achilles. AFLAC is a joke. $325 for a surgery?? And I am out of work for at least 6 weeks. I am considering cancelling my policy.
Claim was filed early November. There was a discrepancy with the physician form. I corrected then resubmitted. Two weeks later there was another discrepancy with the corrected form. Why didn’t the claim manager take their time initially when I first submitted the claim to identify all discrepancies. Then submitted corrected forms twice to be denied about 5 weeks after in December but my claim date was in early November.
I think that it is unfair that the claimant can not speak with the claims department or the claim manager directly. If they have someone reach out to us instead of solely relying on their email system, the claims process would be less stressful for the paying policy holders. I don’t always receive an email message from Aflac about my claim. I have to login every other day to check for any updates. I am truly disappointed with my recent experience with Aflac. I am now second guessing if I should continue with my policy. I don’t have the mental strength to go through this back and forth.
Filed claim a month ago with all inpatient records showing proof. Then they ask for more proof of over 24 hour issues, sent that from 2 doctors 1.5 weeks ago. Still nothing!!!! Fist page of hospital records proved it lasted over 24 hours. Customer service staff has been patient and kind, but Aflac audit must have only one auditor that works one hour a week. I have sent over 50 pages of proof. This also happened when I filed a claim in 2017. Had to get sales rep to get involved back then. Told every time I send more documentation process starts all over. Filed Nov 7 and they show Nov 30. Also told today auditor has not been assigned - over 4 weeks! Do not believe the ads that say 24 hours to a week to get paid. NOT true!
I had major surgery, after filling out form after form they are trying to short pay me by $ 5,000.00. Ten years paying into this and first claim they are trying to push me around. TERRIBLE customer service by phone and even in the chats.
My father died August 2022, and I sent in ALL information they’ve asked me for. EVERY time I call for an update on the claim, I’m given a different answer. They’re very unorganized & I want my claim paid ASAP!!!! This is highly unethical and if I don’t receive what’s owed to me soon, I will hire an attorney to assist me with this!!
I would like to say I'm a customer who doesn't use this benefit often, but it has been great in the past. However, today when I called and spoke with a customer service agent the experience was horrible. Michelle offered no compassion nor information for me. She also went on to say, I don't pay for my coverage, my employer does. Why would she indicate this without knowledge that it's paid through an employer, but the premium is deducted from my check. Horrible experience for a family that recently experienced a recent unplanned emergency that required a surgical procedure. (I called 11/28 around 3pm).
While I understood she had limited information, I at least expected her to guide me in the right direction. I asked specifically about my benefit coverage and she kept referring me to the admitting hospital. When I asked to speak with someone else, she stated that there's no one that could help me... Please review the call for my experience, I pray no one else has this experience. I felt like I was begging her or at her mercy of her willingness to review my benefit coverage and explain the issue.
TLDR: My company has short-term disability/maternity leave through AFLAC. They opened two policies for me, overpaid me approximately $5,000, and then demanded it back. DO NOT USE. If you have a choice of providers, do not use AFLAC. If your company uses them for short-term disability or maternity leave, make sure you are micro-managing your case because they won't.
A few months before I had my baby, I started calling AFLAC to get information on my maternity leave. I should've known something was wrong when I got different information every time I called. I had my baby, and the checks started to come in. I feel like an idiot now because I should've known it was too much money, but due to my new mommy haze and lack of sleep, I didn't think to question anything: I was just happy to buy diapers and pay medical bills. About a month in, I was suspicious they weren't withholding my federal taxes as requested, so I called and the representative told me that my withholding paperwork was in one file but not another. Did this not send up a red flag with them? Again, in my fog, I didn't think anything of it. Fast-forward a month after my file(s) had closed, and I get an email at 5:30 AM letting me know they overpaid me because they opened two maternity leave files for me and they demanded I pay it back in 10 business days.
Did my case manager not see that I had two open maternity leave files? Who has two simultaneous maternity leave policies at the same time? How did they not notice this seconds after it happened, but rather over a month after the files closed? The overpayment representative had the gaul to tell me the company knew about the overpayment a month earlier, she just "hadn't gotten around" to sending out the overpayment letters. I guess it wasn't a big deal to HER. When I told them it was their fault, all they could say was "sorry." As a huge corporation, I know the money means nothing to them, but so much to me. Didn't even offer a payment plan. I wanted to pay online since I wanted the whole thing to be over, but no: you have to pay via check via mail. I can honestly say they made NOTHING about a HORRIBLE situation easy. DO NOT USE IF YOU CAN HELP IT. You're just paying them to mismanage your case.
I have had 4 policies with Aflac for 20+ years. This year I was hospitalized three times, had two surgeries, 2 ct scans, 2 ultrasounds, multiple xrays, labs and meds given. I sent in the claim, waited 3 weeks to call to check the status of the claim I was told they needed a UB04 form, I submitted that, took them another 3 weeks to even look at my claim. When I called to check the status they tell me I was only being issued a $200 check. They claim my hospital stays were "obervation" when I was hospitalized for 3 days the first time and 5 days the second time. Clearly not observation. They did not pay for any of my surgeries or any of the diagnostic testing I had done. Total piece of garbage now!! They just take your money and do not care about anything else! Was out of work for 2 weeks and thought this would help, NOT! I WILL BE CANCELING ALL OF MY POLICIES WITH THEM. TOTAL PIECE OF GARBAGE THEY ARE NOW!!!
Aflac author review by Matthew Brodsky
Aflac is one of the best known American insurance companies. It offers various types of insurance, including disability insurance.
Real cost calculator online: Users can calculate the probable cost of medical care for injuries or illnesses prior to beginning a claim.
Health insurance as well as disability insurance: Users can purchase insurance to cover specific medical conditions or general medical care as well as disability insurance.
Short-term disability insurance available: sers can get short-term insurance to cover them when a temporarily disabling condition hits.
Lump-sum policies cover long-term illness: Although Aflac doesn't offer long-term disability insurance, users can get a lump-sum benefit for a critical illness, allowing them to continue to support themselves.
Rapid online claims processing: Users can file claims online and upload documents to get their benefits within 24 hours.
Aflac Company Information
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- 1932 Wynnton Rd
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- United States
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