Perspective from a customer service representative
As a customer service representative for Aflac for five years, I know how the internal processes within the company work. I see what is sent by the customers to be reviewed by the company, I see how quickly a claim can be processed but also see why a claim can be delayed.
The most general problem I see is insufficient information being sent by the policy holders when they file a claim. Each line of business, whether its a cancer policy, accident policy, etc., requires specific documentation to process a claim. What I also see are policy holders filing claims on a specific type of policy that doesn't fall in that line of business. For example, a visit to the emergency room for the flu will not be payable under an accident or a cancer policy.
I do understand the policy holders frustrations, based on the sheer volume of claims filed with the company. Every claim has to be looked over for the correct information, verified as being correct information, and processed. If the correct information is not received, the claim will be pended until that information is received, Aflac can contact the provider to assist getting it, but the provider will not comply without written authorization from the policy holder to release medical information, it is all tied up within the HIPAA laws, protecting personal medical documents. If the authorization is not submitted with the claim, then a letter is sent to the policy holder requesting said information.
As a customer service representative in Aflac, I don't get a lot of calls saying how bad a company we are, don't get me wrong, I get them, but is is usually a call that can be simply rectified with the correct information being received. I know faxes get lost, sometimes don't make it through for whatever reason, mail can be lost, it is inevitable with the sheer volume of requests sent to the company.
I deal with complaints the whole 8 hours I am on the phones taking calls from policy holders and agents. The system sure isn't perfect, but what system is? For every one call I get from an irate customer, I get 100 more from people who flatly state they would not know what they would have done without Aflac being there for them.
If I could give one piece of advice to policy holders, is this. PLEASE read your policy, know what you have benefits for. The Customer Service Center is not just about complaints, if you need assistance and can't find your agent, the Customer Call Center can instruct you of what benefits you have and exactly what documentation is needed to process a claim for you. If it isn't a claim, but policy information, or a problem with an account deduction from your paycheck but not submitting your premiums for payment in a timely manner, we can help you there as well.
One more piece of advice. As a Fortune 500 company with over 5,000 employees, there are many departments and many processes, which take time to complete. I understand that to any caller, I am Aflac and when I talk to them, I represent all 5,000 employees. I, however, am one small cog in a giant machine. It is the nature of the beast, I imagine all very large successful companies operate this way. I can do my best to help someone calling in with a problem, but 99% of the time, I personally cannot fix it, the request has to be sent to another department, escalated for sure, but everything takes time. Instant results are extremely rare when some type of problem arises.
We do our best, day in and day out. It isn't helpful to a Customer Service Representative to be screamed at and cursed upon, called names, that just elevates the Rep's level of frustration. What I see most is people calling in yelling and screaming, not giving the representative a chance to even find out what the problem is and trying to ascertain how to expedite a solution. If you called in for assistance, let us assist you!!!
I know there are policy holders out there that are unhappy, for every one of them, there are 1000 or more satisfied customers. If you are unhappy, try again calling to understand what happened, be patient, calm, explain the situation, let the customer service representative look back over the problem to see exactly what can be done, if anything, or explain why this event actually occurred.
Aflac is the best company I have every worked for. I bothers me that people out there bad mouth the company, and I can understand some of that, a policy holders frustration or anger could be the result of a problem that could be resolved simply.