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Log in or Register. Download MyAflac® mobile app. Understand what’s needed. Get filing requirements, supporting documentation details, and more. Learn more. File your claim via fax or mail. Consider filing online for faster claims payment! Download form. Have questions? Connect whenever you need us. Log in to to your account or Chat with us.
- Claims Checklists
In CA, CAIC does business as Continental American Life...
- Cancer Insurance
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- Get Paid Fast
Aflac offers swift claims payments of individuals or...
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An unplanned hospital visit can leave you with expenses not...
- Critical Illness Insurance
Aflac offers some critical illness insurance policies with...
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Aflac's supplemental health insurance plans pay out cash...
- File Via Fax Or Mail
To file your claim via fax or mail, simply download the...
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- Supplemental Insurance for Life, Health & More
Aflac provides supplemental insurance for individuals and...
- Claims Checklists
- Aflac Group Insurance Claim Forms
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- Aflac Group New York Claim Forms
- Aflac New York Group Additional Forms
File a Wellness Benefit Claim
1. Aflac is here to help. If you are filing for a health screening on your Hospital Indemnity, Accident, or Critical Illness plan for Coronavirus (COVID-19) testing, select Biometric Screening as your exam. Claims are subject to policy terms and conditions. File a Wellness Benefit Claim Online Simply select "File Online" below and follow the instructions. File Online File a Wellness Benefit via Fax or Mail Please fully complete the claim form for the Wellness Benefit. Please date and sign all...
File an Accident Claim
1. File an Accident Claim Online Simply select "File Online" below and follow the instructions. File Online File an Accident Claim via Fax or Mail Please provide a date and complete description of your accident. You can provide this information in the designated space on the claim form. If the accident resulted from the use of a motor vehicle(s), a copy of the police or accident report is required. If your injury occurred on the job, a first report of injury filed with your employer must be a...
File a BenExtend Claim
1. Group BenExtend Claims A BenExtend claim requires supporting documentation for review of benefits such as an itemized bill if there was a hospital stay, itemized bill from physician's office, surgical report if surgery took place, Xray/Diagnostic Test reports with dates and charges if applicable, accident report if applicable, and a signed and dated Authorization for Disclosure of Health Information (HIPAA form). Please date and sign all required forms where indicated. Forms: Group BenExte...
Authorization to Obtain Information Form
1. Authorization to Obtain Information Form Please date and sign all required forms where indicated. Forms: Authorization to Obtain Information Form
Direct Deposit of Claims Payment Form
1. Direct Deposit of Claims Payment Form To have your claims payment direct deposited, please download and fill out this Electronic Funds Transaction Authorization form. This form may be used on all product claims except Group Term Life, Group Whole Life and AD&D claims. Once complete, please return it to: Continental American Insurance Company Mail: Post Office Box 84075, Columbus, GA 31993 Phone: 800.433.3036 Fax: 866.849.2970 Email: groupclaimfiling@aflac.com Forms: For Direct Deposit of C...
Waiver of Premium Form
1. Waiver of Premium Form Please date and sign all required forms where indicated. Forms: Initial Waiver of Premium Form Waiver of Premium Form
File a Wellness Benefit Claim
1. File a Wellness Benefit Via Fax or Mail Please fully complete the claim form for the Wellness Benefit. Please date and sign all required forms where indicated. Forms: Accident Wellness Claim Form Critical Illness Wellness Claim Form
File an Accident Claim
1. File an Accident via Fax or Mail Please provide a date and complete description of your accident. You can provide this information in the designated space on the claim form. If the accident resulted from the use of a motor vehicle(s), a copy of the police or accident report is required. If your injury occurred on the job, a first report of injury filed with your employer must be attached to the completed claim form. If you were first treated in an emergency room, a copy of the hospital dis...
File a Critical Illness Claim
1. File a Critical Illness via Fax or Mail For critical illness claims, we need information from you and your attending physician. Please provide all information requested on the Insured's Statement portion of the claim form. The Attending Physician’s statement portion of the critical illness claim form is to be completed by the physician who first diagnosed your condition. Please submit required medical documentation for the specific covered critical illness, the claimant's birth certificate...
Authorization to Obtain Information Form
1. Authorization to Obtain Information Form Please date and sign all required forms where indicated. Forms: Authorization to Obtain Information Form
DATE. American Family Life Assurance Company of Columbus (Aflac) ATTN: Claims Department •1932 Wynnton Road •Columbus, GA 31999 For information or to check claim status, visit aflac.com or call 1-800-99-AFLAC (1-800-992-3522) Claims may be faxed to 1-877-44-AFLAC (1-877-442-3522) S00220. Page 2 of 2. 02/14.
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WELLNESS AND HEALTH SCREENING CLAIM FORM. Failure to complete all sections may result in delayed processing of this claim. Review your policy for specific benefits covered under your plan.
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SHORT TERM DISABILITY CLAIM FORM INSTRUCTIONS. To avoid delays in processing of your claim form, complete each section attaching documentation below when it applies. Note: This form is for initial filing of a disability claim. If your disability is being extended, you will need to complete the listed Supplemental Claim form.
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