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Aflac Dental Policy: Not Worth It
Posted by on
MYRTLE BEACH, SOUTH CAROLINA -- I have AFLAC for my dental policy and although they are very easy to file a claim with, what you get back is pennies compared to what you spend. I had 1200 dollars worth of work done on 2 teeth and they only reimbursed me $75.00. Also I think that the way AFLAC works is insane. The fact that you have to pay in full for all your services first and then file a claim with AFLAC is crap. That is not the point of insurance. If I have the money to pay for my services why the hell do I need the insurance?! It just doesn't make sense.

AFLAC needs to redo how they work things. My policy is up in April and I am cancelling immediately.
     
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saj80 on 2009-03-09:
Isn't AFLAC just supplemental insurance? If so, then they have set amounts they will reimburse for.
AFLAC Dental: Not worth it on 2009-03-14:
Yes it is supplemental, however their amounts they reimburse you for are still way too low.
Nohandle on 2009-03-14:
I don't have AFLAC, but the company I'm with offers it to those employees interested. It is intended as a supplimental, not primary insurance. If anyone feels the amount paid for a claim is not adequate then by all means cancel the coverage. I have a co-worker who was treated for thyroid cancer. Her Blue Cross paid for her surgery and follow up treatments, sick pay took care of her lost wages and AFLAC sent her a check which was far more than the premiums she had paid through the years.

I'm curious AFLAC dental, does AFLAC state the amount they will pay for a given claim in their policy?
timjdd on 2009-06-15:
Aflac Dental has different levels of coverage, the cheapest of which is intended to be a supplement to other dental insurance (most group plans have very low annual limits on benefits, thus the need for a supplement for some employees who anticipate heavy use of dental insurance). Because Aflac is sold as an individual, not group, policy, there are waiting periods on all but the most basic of benefits (the $75 the rater received was most likely a Wellness or X-ray benefit which is not subject to a waiting period). The policy itself spells out exactly how much it will pay for each American Dental Association (ADA) code that typical dentists use in filing claims with any insurance company. When dental insurance is offered as an individual and not a group policy, the insurance company already knows that only people who intend to use the coverage in the near future will sign up, intending to keep the insurance only so long as they are undergoing treatment. Once treatment ends, many people simply intend to cancel their coverage, meaning that they will have received far more in benefits than they ever paid in premiums. Since this is an obvious losing proposition, Aflac imposes waiting periods for actual dental treatments, and the more extensive and expensive the treatment, the longer the waiting period. I suspect the original rater filed a claim for services performed before the waiting period had expired. A good agent would have explained in detail the concept and need for waiting periods during the sales presentation and before any buying decision had been made (that is, if he or she wanted to actually maintain good client relations--the waiting periods are the most glaring potential minefield for client dissatisfaction).
I have been an Aflac agent for over 12 years, and only a very few of my employer clients use our Dental options. While they understand that their employees want to have a dental option, they are not willing to pay for a group plan, because the vast majority of group plans impose guaranteed levels of employee participation (some as high as 60-70%) which are difficult to achieve with voluntary products, as there are rarely that many employees expecting to need dental work at any one time, and so they don't choose to spend their money in that way.
HD on 2012-03-18:
Hi, thank you for this review - so far I've found its just easier to pay for the whole thing in cash. Insurance seems a waste of time for sure.
Brian Paden on 2014-05-22:
Not to assume that you are mistaken but AFLAC is not a policy to pay your bills...dont you see the commercials...it is to pay other things or just put money in your pocket, or pay what your primary insurance doesnt pay. If you got AFLAC as a dental insurance then either someone fed you a line of crap or you misunderstood something. AFLAC is a supplemental policy and that it is period.
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AFLAC DOES NOT PAY as THEY SAY THEY DO!!
Posted by on
Rating: 1/51
COLUMBIA, SOUTH CAROLINA -- I too heard the long drawn out sales pitch from an AFLAC representative who came to my work. I purchased 4 different coverages that they had covering everything from short-term disability to critical care. I became ill prior to 10/1/13 and missed my first day of work that day. I have been to specialists and had tons of tests in order to locate my health problem. I have filled out paperwork after paperwork with all of the doctors that I saw. In 3 months and 8 days I have received 1 check for $433.00. They request paperwork, I complete or have completed and fax in. All of their letters state that claims will be processed within 7-14 days. Basically what that means is within that time they will figure out how else they can put you off without paying you.
I contacted them today requesting the status of the money they owe me. They told me it would be 30 days and the last paperwork I sent them was on Dec. 27.
So, other-words, DO NOT count on getting your monies owed within a reasonable time at all. All of their commercials are a JOKE if you do not have money in the bank you are screwed because you will definitely be starving and have had your power turned off and your car repossessed before that day comes. My health condition means that I will probably not be able to go back to work so counting on any type of peace of mind by having AFLAC is definitely out of the question and a complete farce!! Good luck if you bought into their crap and hope and pray that you will never have to use them.
Company Response 01/10/2014:
Hi Electriclade, I’m Aflac Phyllis, an Aflac worldwide headquarters employee here to help. I'm so sorry that you're having an unpleasant Aflac experience. Please email your contact information to us at aflacservice@aflac.com so we can assist you immediately. Please copy and paste the following in the subject line of your email:
Electriclade 2014-01-09 mythreecents.com post.
In the body of the email, please include your contact information, and any other pertinent information so can assist you super fast.
Thank you,
Aflac Phyllis
     
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Obsfucation on 2014-01-09:
This is pretty much the same reasons my company dropped them after a year.
clutzycook on 2014-01-10:
We have then through my husband's company and they've always paid us fairly promptly. They even let me submit claims from 2 years earlier at the end of last year with no problems.
AflacPhyllis on 2014-01-10:
Hi Electriclade, I’m Aflac Phyllis, an Aflac worldwide headquarters employee here to help. I'm so sorry that you are having an unpleasant Aflac experience. Please email your contact information to us at aflacservice@aflac.com so we can assist you immediately. Please copy and paste the following in the subject line of your email:
electriclade January 9, 2014 my3cents.com post.
In the body of the email, please include your contact information, and any other pertinent information so can assist you super fast.
Thank you,
Aflac Phyllis
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Lies, Lies and More Lies
Posted by on
Rating: 1/51
COLUMBIA, SOUTH CAROLINA -- In November 2011 I signed up for the Aflac critical illness and hospital indemnity plans after hearing their spill during my company insurance sign up. At the time I was seeing a cancer doctor for MDS [a form of bone marrow cancer] and informed the sales reps of it and was told if I signed up during the registration Aflac was waiving all pre-existing conditions but if I did had a pre-existing condition I would need to wait 6 months before filing a claim. In January I was diagnosed with MDS and filed a claim in May 2012. My claim was denied because Aflac stated there was no evidence to support my condition as being malignant. I appealed and was denied a 2nd time because of it being a pre-existing condition because I was being seen by a doctor at the time I signed up.

I contacted my company representative for Aflac back in November 2012 and was told I was misinformed but to send her the paperwork and she'd try to push my 2nd appeal through.

As of March 18th nothing has been done, so on the 24th I filed complaints with the BBB, Idaho Department of Insurance, Idaho Attorney General, and my company HR department. I also sent my complaint to a local TV investigative team. I am telling others about this because I believe a company should stand behind their what they say and Aflac isn't.

I have even sent Aflac 2 letters from individuals present in the meeting that heard the sales reps tell me Aflac would waive any pre-existing conditions.
     
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Obsfucation on 2013-03-29:
We had AFLAC where I work. Everyone who filed a claim experienced pretty much what you did. After a year, my employer gave them the boot.
madconsumer on 2013-03-29:
since you enrolled in November for open enrollment, your new coverage starts in January. the 6 month clock starts jan. 1
Susan on 2013-03-29:
What did the paperwork you were given when you signed up say about pre-existing conditions? The sales people that come to companies representing insurance companies are just that - sales people. The contract overrides what they say every time.
JR in Orlando on 2013-03-29:
To me it is unclear how AFLAC did not do exactly what they said, and AFLAC certainly did not lie. As the op states he was told: "if I signed up during the registration Aflac was waiving all pre-existing conditions but if I did had a pre-existing condition I would need to wait 6 months before filing a claim."

A reasonable interpretation of this is that AFLAC was providing coverage, even if one had a pre-existing condition: ""if I signed up during the registration Aflac was waiving all pre-existing conditions"

However, if one had a pre-existing condition, one could not file a claim for 6 months: "if I did had a pre-existing condition I would need to wait 6 months before filing a claim." As madconsumer said, the six months started on January 1st, the claim was filed in May - within six months--denied because within 6 months. How exactly did AFLAC not do what they said?




Avis on 2013-05-10:
After an extensive search and emails to AFLAC, I am unable to find a consumer rating for this company. What are they hiding?
Aflac on 2013-08-03:
A rated company and voted to the World's Most Ethical Companies List over 6 years in a row.
Karna on 2014-01-10:
The real question is: Who is voting for the world's most ethical company ? Seems fishy to me. I have worked for 3 companies in 27 years. All 3 companies fired Aflac.
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Beware - Aflac only pays out for certain accidents
Posted by on
Rating: 1/51
GLENDORA, CALIFORNIA -- I have the accident policy from Aflac for my whole family that essentially amounts to supplemental insurance over and above my regular Blue Cross plan. My 8 year old son broke out some front teeth doing flips on our trampoline this past year. A clear accident. We rushed him to the hospital to stop the bleeding, and then were sent to an orthodon'tist to handle the dental trauma. After my Blue Cross paid, I was out $3,800 out of pocket. Upon submitting all paperwork and doctor's reports, Aflac only paid $105, citing the accident required dental treatment, which they do not cover. The agent stated, "If your son had broken his arm, we would have paid $3,500 for this claim, but broken teeth, only $105". Thanks Aflac for nothing! A complete waste of money.
     
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Skye on 2012-03-27:
Your review is a good reminder, to know exactly what will be and will not be covered before signing up for any type of policy.

Sorry your son was injured.
Anonymous on 2012-03-27:
Aflac does have a dental policy. Not their fault you didn't purchase one.
MDSasquatch on 2012-03-28:
I have heard A LOT of horror stories about AFLAC; their #1 policy seems to be avoid paying at all cost, but it is important for a customer to know what they are buying. I got a supplemental policy through along with my auto policy at State Farm, my agent explained everything and it has been as expected the four times I used it.
AflacPhyllis on 2012-07-11:
@N8watkins Hi, I'm AflacPhyllis, an Aflac worldwide headquarters employee here to help. I am so sorry that your son was injured. I hope he is okay now. I can look into your concerns. Please email me at AflacPhyllis@aflac.com.
Thank you
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Do not work for them
Posted by on
I worked for Aflac and after a few months a few agents started getting scared because I did to much business so they started slandering me in government emails which is highly illegal. I have federal laws that protect me but they are so stupid it is sick. I am a native American doing business on my own reservation and they still fired me because they are too darn stupid to look at the federal laws. Now they are sending me a bill saying I owe them even though there are thousands of dollars of my policies in force. They are so chicken sh*t they have a clause in their contract that they can fire you for no reason. Now they claim they are going to sue me if I don't pay it! What a bunch of losers!! Can't wait to see them in court because I will fight them SOB's tooth and nail. If this happened to anybody out there lets get a lawsuit against them unethical SOB's!!
     
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trmn8r on 2011-04-25:
Most companies these days can fire an employee for any reason.

One sure-fire way of fighting this trend is to become a school teacher.
Darnellion on 2012-08-10:
So What are u doing for a living? if I may ask
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Better to Aflac policies
Posted by on
There seems to be two problems I have found with Aflac. 1. They seem to roll through a number of agents. 2. Their claims services seems designed to wear down the claimant. I believe company greed causes both of these observed problems to occur. Without the agent who sold you the policy actively engaged, you have no local service representative. You will find you are on your own when the event you bought the insurance arises. I was asked to have Doctors fill out forms and re-file and explain details and get additional information on three separate occasions with weeks going by between company requests. Their claims service as well as their company goal is to not aid in paying claims. They spend an inordinate amount of money advertising when compared to other similar companies and I expect them to continue do so, but not with my money.
     
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leet60 on 2011-04-14:
You hit two points right on the money:

"Their claims services seems designed to wear down the claimant."

"Their claims service as well as their company goal is to not aid in paying claims. "

Despite what any insurance agent will tell you when trying to sell you a policy, the company is in business to make a profit. Claims representatives receive training from most companies in how to find criteria to deny a claim, making it as difficult as possible for the insured to receive benefits.

This is not only Aflac, but most insurers.
Anonymous on 2011-04-17:
I'm sorry but it sounds like you did not send in the information needed. What information are they asking for? They can request the information needed from the doctor but they need an authorization form due to Federal privacy regulations. Leet60 does not know what he or she is talking about. Were you there for there training? No you were not, but I was. They are instructed to find every reason to pay. I am no longer there due to moving out of town but I've noticed something about customers in every industry. There are going to be those that have to complain when it they have no valid complaint.
leet60 on 2011-04-19:
@sjacobs3377. You are correct, I was not there with AFLAC for the training. I worked for other insurers, as a claims representative for over 12 years, and without exception, across 4 different insurers, this is exactly what I experienced.

While legally this is a "bad faith" practice it is more widespread than most believe. Several of the companies I worked for paid bonuses and incentives to lowball and/or deny claims. Many states have began to legislate against this practice.

There is good information here if you want a reference:

http://www.senmorgancarroll.com/blog/sb10-076-insurance-bonuses-to-deny-claims
Anonymous on 2011-04-19:
leet60, I apologize for how my comment sounded. I didn't mean any offense. I can understand where you are coming from but I can assure that Aflac does not do that. I read the webpage you provided the link. I don't understand how the companies could get away with it. I was not there so I can't say about other companies, I can only say about my experience. I can see were you are coming from. But in my experience, most people don't take the time to read the coverage they sign up for. For example, people getting upset because they have an accident policy and they were treated for a flu. No insurance covers everything and people need to know what they are paying for before they have to use it. We are all guilty for not reading policies, contracts, etc. And it is difficult to help someone over the phone because they tell you one thing and you help them based on that and then what they send in is completely different from what they told and then they are upset because it is not covered. I can go on and on. But my point is that they are an ethical company and more people have had a positive experience than negative and the negative is not the company's fault.
jktshff1 on 2011-04-19:
sia, how are you able to "assure" that Aflac does not do that"?
Anonymous on 2011-04-19:
I used to work there.
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Failure To Tell
Posted by on
Dot your I's and cross your T's with these people, they only tell you what they want you to know just to get you to sign up...For example Your taken while on the job but it's not a work injury, your taken to the local hospital ER. Then your put out of work for 5 days, the doctor puts you back to work for about two weeks then takes you back out and so on for 3 months.

Guess what your stuck with the in this case some are more than $810.00 ambulance ride, and because the Doctor does not keep you out for 15 days straight you nothing. You must be out for 14 or 15 consecutive days before you get a dime..

Good luck with these people ...
     
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Anonymous on 2011-04-13:
You should have read your policy. After singing up a copy of the policy is mailed to you. There is no fine print but big bold print. No policy covers everything. Disability policies only cover disability, if it was on the job then that is for workers comp. If you have an accident policy then it only covers treatment for accidents. It is your responsibility to know what your cover is. Don't be made at the company because you paid without reading your policy. They made it available to you and you choose not to read it.
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Get The Aflacts!
Posted by on
[Note: Author is an Independent agent contracted with Aflac]

TO THE FEW AFLAC NAYSAYERS...I have read your reviews, but the negatives are so skewed:

AFLAC claims process is VERY simple, YES, documents are required but they have to be to support the claim and prevent fraud.

They are just the standard stuff: A simple 2 page claim for the claimant and physician to complete and authorization to release medical info page to be signed. And your AFLAC representative can do the rest ( they will make sure it's done right!), just give him or her the paperwork with proof of treatments (receipts), and to the AFLAC Claims Department it goes, BY FAX...CLAIMS are paid QUICKLY, in as little as three days (5 day average)Plus, the Accident plan has 20+ cash benefits with only a few limitations, up to 6 follow-up treatment visits and 10 phys. therapy treatments... but you can file multiple claims, there are specific sum injury payouts, accidental life-insurance, and a wellness benefit to offset some premium.

Family coverage is also available to children up to age 25, no student requirement!

They are all outlined in the brochure given to you, and the agent is accessible for questions, before or after the presentation, etc.

There is too much to mention here but all in all they are a a GREAT long-term investment with stable rates and the ease of administration and service is great.

AND if you cannot reach you agent for some reason, call AFLAC directly and or visit www.Aflac.com.

So before you criticize, get the AFLACTS!

*******It's Insurance for Daily Living*******

- Illness is the number one reason for bankruptcy

- 100,000 families went bankrupt last year as a direct result of cancer

- 1/3 of people battling cancer last year were in financial distress

- In 2007, 72 million working-age Americans struggled to pay medical bills

- People don't realize that they need to shoulder 20% of thousands of dollars

********AFLAC HELPS********
Dianne/NJ
     
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Anonymous on 2009-06-10:
We had AFLAC where I work, but after a year, the dissatisfaction was so high that we severed all ties. So plug them if you will, the reality doesn't support the claims.
njduckling on 2009-06-10:
If you don't have a claim, of course it doen't pay but that is the whole idea, you pay for peace of mind, just like having homeowners to protect against fire, etc.

You can't evaluate a plan based on having it for a year because you didn't have an accident or illness. That is a good thing, but you can still collect the wellness benefit once a year and if an unexpected event happens, you will receive cash benefits to help. That's why it's optional, voluntary, affordale and rate-stable...people like to protect their most valuable asset, their income. Dianne
Anonymous on 2009-06-10:
The reason we booted them was that whenever an employee had a legitimate claim, AFLAC went to extreme lengths to NOT pay the claim, and only did so when forced to by the facts. It just wasn't worth problems that came with it.
njduckling on 2009-06-10:
Well, sorry it didn't work out for you and you had claims problems. This is not the norm...some people confuse disability with accident coverage and there are coverage differences, like on and off the job or maybe you did not have a good agent to service your account and handle the claims correctly.
All my clients had their claims paid quickly. I had one that was initially denied because the doctor's office did not enter the proper diagnosis code. They referenced office visit and infected hair follicle which was a secondary infection to the bite and not covered , so they corrected this...dr. used spider bite code (covered under Aflac's Accident plan) refaxed it to me and got paid the following week..she received $120, plus $70 in follow up benefits and still have another $60 in wellness to collect. This plan cost her about $250 for the year and two weeks in, filed her first claim. Dianne

Tired of crooks on 2010-03-22:
I didn't read all of the "njduckling" comments, so I don't know if they ever admit to being an Aflac employee, but it's pretty obvious they are.
If people quit sending Aflac money every week, they go under. Of course they are going to defend their employer. Nobody want to lose their job. Let's not forget Aflac is an insurance company. Period.
njduckling on 2010-03-23:
Tired....I am not an employee of Aflac. I am an Independent agent contracted with Aflac and other top Carriers to ensure my clients have access to all great plans. I support their great supplemental products and service. iam proud to represent the Duck, a top-notch company since 1955....not a great fit for all but for most.~D [snip - no solicitations please]
PepperElf on 2010-03-23:
actually since you ARE contracted by Aflac
this really is more of a review of a company you still represent
which means it's an advertisement really...
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AFLAC Truly a Life Saver!
Posted by on
NORFOLK -- Our bright, energetic, handsome son graduated from college as a Mechanical Engineer at only 22 and began interview with numerous companies. He noticed when he would put on a tie, a small lump in his neck. The doctors thought it was a clogged lymphnode, and a round of antibiotics would take care of it. In the meantime, he landed a fantastic engineering position with a Fortune 500 company, rented a beautiful apartment, bought an expensive new car. Once settled into his new life..he opted to have that bothersome lump removed. There are no words to explain the feelings you go through when the news of Cancer is delivered, especially when the diagnosis is your child's. It was aggressive, and after a year of numerous surgeries and treatments, it had moved to the vocal cords, then to the lympnodes, then tumors appeared in the neck, and the cancer was spreading into his shoulder. We were losing the fight, we were losing our son. AFLAC has benefits that allows their policyholders to be seen at a major Cancer Center, and pays for experimental treatments. We chose DUKE Cancer Center, and AFLAC was with us the whole way. They paid $300 for EVERY single treatment, they paid $300 for EVERY day in hospital, they paid thousands towards surgeries, they paid for 1 pill that cost over $5,000, they paid the co pays, they paid the deductibles, they even paid for our hotel room while we were away from home.

THEY PAID US OVER $30,000 THOUSAND DOLLARS!!! They allowed us to be seen at one of the best hospitals, by one of the best surgeons, and receive the best treatment in the US that has allowed us to have our son here today...Cancer free after a 2 year fight for life. The money also paid for that apartment, and new expensive car...because those bills come monthly regardless of your ability to pay. AFLAC is truly a Life Saver!
     
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Anonymous on 2009-03-12:
It was delightful to read your post. I'm glad AFLAC came through for you. For many insureds and providers...it seldom does. I hate to rain on your parade. But even a broken clock shows the correct time at least twice a day.
Mary Margaret on 2009-03-16:
AFLAC paid their policyholders $5.5 billion dollars in claims last year.....AFLAC paid more than the next 8 companies that also offer supplemental coverages. Obviously, AFLAC pays their claims.
*Brenda* on 2009-03-16:
Interesting. I've been waiting over a year for them to pay my husband's claims.
Alain on 2009-03-16:
My wife is covered by AFLAC for short term disability. She had a broken ankle a while back and they were very good about providing fast service and payment. Wonder if service varies by state or region, Brenda? With some insurance companies it does.
*Brenda* on 2009-03-16:
Could be Alain, we're in PA... how abouts you?
Mary Margaret on 2009-03-16:
Hi Brenda I e-mailed you some information on how to get assistance in filing your claim. AFLAC pays most claims in 4 business days, so you do not have to wait a year! You can resubmit the claim information, and in most cases have your benefit check the following week. It's worth checking into!
*Brenda* on 2009-03-16:
I KNEW IT! You're an AFLAC rep trying to promote! So is the sob story real or did you make that up?
cattree on 2009-06-06:
Moved From Other Review: Your story was so heartwarming. It was so nice to see something positive on this site. It seems in our dailey life people rarely take the time to compliment a Company. It's always negativeness we here. The good things that were done are completely throwen out with 1 bad action either by an Agent or by The Policy holder theirself. As with any healthcare organization you have to know how to work it. ALWAYS HAVING A GOOD REPOR WITH YOUR AGENT(as well with your Dr.& his/her Nurse) is a must. Sending a card to your agent to say hi, or just making a quick call to say it can ONLY HELP THEM (Dr's, nurses etc.)TO REMEMBER YOU & WANT TO TAKE CARE OF YOU. Refferals are everything to Aflac. So do your part & they will do theirs. BIG SMILE ON MY FACE! BTW, no, I do not work for Aflec nordo I know anybody who does. I just know customer service & sales and what people want. I also know what I want & ,what I need to due to get it. KINDNESS WILL GET YOU FURTHER IN LIFE THEN THE OTHER.
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Aflac The Worst
Posted by on
Rating: 1/51
AUSTIN, TEXAS -- Its funny they advertise approving claims within 4 days. Took them a month to say they got the paperwork I had sent in twice. Maybe 20 phone calls and at least 10 different reasons of why they did not have it or one of the times they said they only received a claim form and no other paperwork. Then later on another call they said they had received the paperwork.They finally send a check for 500.00 and I they did not pay for something I sent paperwork in for. I called again and she goes your right we did not pay you for that. So a week or 2 later I get another check of 250.00. Someone I know who had the same exact accident and surgery has received or 1000.00 so far and he did not submit the paperwork they had for got to pay me for. AFLAC IS A WASTE OF TIME AND MONEY YOU WOULD BE BETTER OFF SAVING MONEY IN YOUR OWN ACCOUNT THAN PAYING THEM.
     
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