AFLAC Complaint - Ripped off by AFLAC
LOS ANGELES, CALIFORNIA -- AFLAC is it real or too good to be true. Every firefighter has been approached by several insurance representatives that have claimed that they have the right product for your needs. We all have seen the commercials where you see an injured person in a cast sitting there and the AFLAC quack with money. If you are injured and cannot work, AFLAC will take care of those little things. This may be true for some but not for many.
I have always paid my premiums on time, believed if you do the right thing it will come back. What you are not told by AFLAC is that you need to maintain your personal medical records and when you have a claim and the documentation your claim may be denied. This specifically is what you need for an accident claim.
• Follow-up care (included a list of treatment dates on the doctors letterhead or prescription note pad…this includes copies of the medical bills).
• Physical Therapy (Include a list of physical therapy treatment dates on a doctor’s letterhead or prescription pad and copies of the bills).
• Employer’s Report or Occupational Report – 166’s (if your injury happened IOD).
• X-Ray Report – (if there was a fracture).
• Police Report – (if you were driving a vehicle involved in a traffic accident)
• Ambulance (Proof of such an ambulance bill or service invoice).
• Crutches, Wheelchairs, Leg braces, Back Braces – Include proof of any ambulatory device.
• Hospitalization – (Itemized billing from the business office of the hospital if you were there for over 24 hours due to an accident).
• Operative report – Include this report from your doctor if surgery was required to treat your injuries).
• Accidental Death- (Include a copy of the death certificate).
What they do not tell you is that you will only get reimbursed for six doctor visits and six physical therapy visits. I was not informed of this till I gathered 45 physical therapy visits and 15 doctor visits for one shoulder incident. I still have several years of two bad knees to battle with them.
If you have an IOD accident they may pay your claim. Personally it took over three months to get copies of billing and doctor’s reports from TriStar. In the event of a death of a member you must prove that you have the durable power of attorney, copies of marriage certificates just to access records.
If you have a Personal Recovery Plus policy, you need all of the above in addition, it is up to you or your family to see that all of the paperwork is completed and still the claim may be denied. The Personal Recovery Plus policy only covers Heart attacks, stroke, coronary artery bypass surgery, end-stage renal failure, major organ transplants, major third degree burns (not 1st & 2nd ), coma and paralysis. Please note that there is a difference between a heart attack and cardiac arrest and cardiopulmonary arrest and that is only one will pay you on your claim. The money is not much but the principle is. My advice to you is to check your policies very close so your families will not have to endure more losses. The loss of my husband is devastating and knowing he wanted me to be taken care of and not taken to the cleaners by AFLAC. If you do not like what you see only you can change it. I did and cancelled my remaining policies with them.