NATCHEZ, MISSISSIPPI -- My husband had open heart surgery in January at a cardiovascular hospital where all the beds were CCU but because the bill said regular bed they were not going to pay, the entire floor is the heart unit intensive care rooms, private with specialty cardiac nurses but these people still would not pay. Had to get the CEO's secretary to send them a description of entire hospital before these idiots finally paid, it took 8 months. Then I filed another claim for 5 more days at same place for another heart attack with stents placed in arteries in chest. They still have not paid but half of this and I again cannot get through to them that he was in cardiovascular unit. They still owe $600.
I am telling anyone who may be thinking of getting a policy with Aflac, don't do it, not worth it. Yes they drop the benefits to half at age 70 but you still pay same premiums, they do not drop them. Fair??? Don't think so. I am on hold now with claims and to drop this policy immediately. The effort to collect is not worth the money, the little they pay that is. I will tell anyone who will listen this company is horrible and I hope everyone will drop out and show them we can make a statement and not permit people to treat us like we are nothing, all they want is your money but don't bother trying to get any back. I will be reporting them to Better Business Bureau also. Just wanted what was due us, no more.
Also, we have had cancer policy since 1970's and intensive care policy since 1998, have made only 2 claims on the policy in this time until this claim for this year and has been a nightmare. People, not worth it. All the money we have paid in premiums for these years mean nothing to these people, THEY DO NOT WANT TO PAY AND WILL MAKE IT SO DIFFICULT FOR YOU. I am sure they hoped I would give up, not me but have had enough now. Not worth it.
FT COLLINS, CO -- I had a hysterectomy on May 4th. It is now May 30 and I still have not been paid for the disability. Here are the order that lead me to this massive headache. I called Aflac 4 weeks before my surgery to tell them what I was getting ready to have done, and to make sure my ducks were in a row so that I could heal after surgery and not have to worry about the money coming in. (Isn't that their bit, we pay your bills so you can recover.- don't hold your breath) I told them every form I had, and they told me that I was good. I asked if ANY additional information should be included on the claim and was assured I shouldn't.
After my surgery my doctor office filled out their required for with medical codes and all that and faxed the packet over on the 6th. About a week later I called to check up on my claim and they said they got the claim but not the employee information (it was included in the claim) So I asked my doctor's office to re-fax and they did, about 3 days later I called to make sure they got it. They said they didn't so I had to go to work to get another claim form filled out and fax this one myself. Which they still didn't get. So I had to send a picture after I called to check the next day. (Three faxes from two different sources went missing, interesting)
After that they needed a W-2 which I was told by the representative that my claim would be finished in about 24 hrs. (I still have the email) I then called over the next couple days to follow up with no information. Finally I was so frustrated I asked to speak with a manager after my 4th phone call with no information. He said that they claim should be good to go by the beginning of next week. (It isn't surprising)
They now need all 3 doctors notes from my visits. I have had this policy for about a year, I also work in the medical profession with insurance. It is absolutely ridiculous that they do this to people as if losing my uterus at 32 with no children isn't horrible enough. I have to deal with their nonsense. Please beware!
PUEBLO, COLORADO -- I was hospitalized 11/20/18 at 10 a.m., and released 11/21/18 at 2 p.m. Had a heart procedure done because they thought I had a heart attack. According to our policy verbiage, in order to make a claim, you need to be admitted for at least 24 hours. The procedure I had done, was listed as being covered. My wife made a claim, and whomever did the data entry, screwed up the hours of care, and the claim was denied.
My wife and I then started the journey of getting every document requested by doctor and hospital. The hours of care were even listed. They again denied the claim. As of now, I am cancelling my "policy" simply because they are committing fraud. I'm filing a complaint with the BBB and will attempt to get my money back from this fraudulent company. We are also filing a fraud complaint with our State AG.
WILLIAMSBURG, VIRGINIA -- Don't count on sending in your paperwork on time so that your claims can be processed efficiently. They always say their scanning department is behind on updating the system with paperwork that you send in. But first, they'll try to tell you that your paperwork was incomplete upon review. However, when informed that all paperwork was sent via fax AND email timely, they'll tell you that the email address they provide is just a general address so they don't get through the paperwork on time. We're going on 3 weeks with dealing with all of this. It's getting old.
MIAMI, FLORIDA -- 13 days hospitalized. Waiting two month to process claim after numerous documents requested and sent every one of them. AFLAC find the way to enforce the fine print and avoid to pay or process the claim, always asking for additional information until you get tired and throw the towel. My recommendation don't waste your hard earning salary been deducted so when you need it you'll find out that is lost. Worst experience ever.
CONROE, TEXAS -- I sprained my wrist and was out of work for two days, Aflac covered me and only in one day!!! They are an amazing company and does Exactly what they Promise!! I would recommend them to anyone and everyone!!! Thank You Aflac!!
GEORGIA -- My fiancé purchase Aflac's Critical Care Plan on his job as a supplemental insurance, the agent explain to employees that if they considered this policy it would pay $20,000 if they ever experience one of the following: Heart Attack, Stroke, Cancer and Organ Transplant. Well after having the policy for 4 year on December 2014 he had to have a pacemaker implanted in him due to the fact of him having complete heart block, or AV Block.
After his stay in the hospital we filed the Critical Care claim, at first we were thinking that in a couple of days (as little as 3 days, what a lie!) he would receive a check. We contacted Aflac after two week pass and were told that they needed more information; the usual paperwork needed so that the claim could be paid. We provided every item they requested and was assured that we would get a check in the mail totaling $20,000.
The next week we received a check Wellness check for $50, and afterward a letter arrived requesting more paperwork. I went here and there to retrieve what they said was needed, sent it in and waited. In about week we receive a letter stating that the claim would be denied base on the policy only covering him if he had actual had a serious heart attack that left him half dead.
I question them stating that his life was saved due to the emergency surgery and the pacemaker put in, I was then told "that he is not eligible for payment based upon the doctor was able to sustain his life" and we should be thankful. I then ask the agent what would have happen if he had died, she then told me that "there would be no need to file the claim if he had died he would not be critical."
We have submitted 2 claim forms stating that he had a MI, the doctor refuse to change it Aflac somehow contacted the doctor's office and they changed the claim form after 2 months. It is things like this that "BIG" insurance company depend on to help them practice "BAD FAITH." Nothing like have proof for your records.
I have received 20 letters explaining to me why the policy can not be paid, 1st we were told he didn't have a heart attack, to the point of he did not have a Myocardial Infarction but just a simple AV Block. We went back and forth and each time they use these same excuses. I contacted the GA Commission of Insurance and filed a claim against Aflac, of course they would agree with the bigger company rather than the little people.
So we have been going it alone with Aflac, one thing Aflac don't realize that people read and study - that's what I did concerning his diagnose and the medical terminology states that in order to have a Complete heart block, AV block or a 3rd Degree block a Myocardial Infarction would have had to occur.
We will hold firm to the claim regardless of how the doctors, GA Insurance Commission and Aflac work together. I have sent letters asking why the policy was denied when it meets all the qualification on the policy. What they sent to use was "Aflac will only pay for Myocardial Infarction or a Heart Attack" - this was mailed to us and highlighted.
I went to the medical website and looked up AV Block and what cause it and it stated that it was cause by one of two Myocardial Infarction, the seriously one requiring pacemaker to live. I too highlighted this and sent it to them, not sure what my outcome will be, regardless we will fight until Aflac pays to have the medical terminology changed. My fiancé has not return to work and we have doctor's bills coming from left to right. One thing I am proud to say is that his primary insurance company (BCBS) is true to the words, that's why they don't have to put "fake" advertisements on television.
It is our perceptions that Aflac never really intend to pay for these claim, they might pay small claims, but large claim they give the client the run around in hope that the client will roll over and take their tactics. Why pay for a claim and when you really need it, they find all kind of made up excuses to not pay.
COLUMBUS, GEORGIA -- My policy originally began on 9/12/12. Due to mishandling of my policies, both were terminated sometime in Feb. 2013 and then reactivated in March 5th 2013. On June 18th, I was informed by an AFLAC representative ** that both of my policies were again inactive/terminated. Caller stated it was because no payment was received for March, April, and May. I was advised to call my employer.
I spoke to the Human Resources Director at Wellington Retreat on this date, who informed me that they have proof of invoices paid to AFLAC through 4/1/13. Furthermore, she called AFLAC **, again payment on their end was verified. Please note: that on March 18th, I called into AFLAC and enrolled in AFLAC ALWAYS. I provided a VISA credit card and was ensured that payment deductions would be taken once my employer made their last invoice payment, which should have been in April's invoice. To my knowledge, payment was being made on my VISA. I have documentation to prove this.
I also spoke to a supervisor at AFLAC customer service, Mr. ** on this date, in attempts to gather more data. He stated that my credit card information was removed from the system and therefore, my policy was terminated. Please be advised: I NEVER REMOVED MY CREDIT CARD INFORMATION. In addition, this is contradictory of my previous call to AFLAC as stated above. I am currently 24 weeks pregnant and was depending on the moneys I would receive through my short term disability policy. At this time, I have no policy.
Lastly, I spoke with **, who is an AFLAC representative that originally enrolled me in these policies. She is aware of the continuous mishandling of my health care and offered me apology on behalf of AFLAC. This company has caused me a tremendous amount of unnecessary stress to both me and my unborn child. Furthermore, I do not feel comfortable having my health care in your hands.
At this time, I am requesting a FULL REFUND of payments provided to you since 9/2012. I have paid you a few hundred dollars and have had my policy inactive throughout most of the time. The constant confusion and mishandling has led me to believe that this company is not representing themselves as promised. I will not pay for something I never received, nor do I feel I should be held liable for your mishandling.
I have documents and proof that indicate I took the necessary actions to ensure my policy remain active. Also, I never received any kind of notice from AFLAC that my policy would be terminated. I do not want my policy active at this time, as I do not feel comfortable placing my health in the hands of this company.
On 6/27/13, I spoke with Escalation Services, who informed me that my request has been DENIED. My refund in the amount of $560.45 is being denied stating that, “I could have filed a claim.” The fact is, I couldn't have filed a claim because my policies were inactive most of the time I supposedly had them. Furthermore, they stated “they apologize that the system failed and did not register my Visa Credit Card and therefore, my account was terminated.
So because their system was not operating correctly, they have taken all of my money and have left me with no coverage for my short term disability (maternity leave). This company stole my money and did not provide me with any services.
We have paid for our "Accident/Disability Policy" with Aflac since 2/08. Our "Type of policy" is described as "Named Insured/Spouse" as we pay additional to cover my wife. I was told by the Aflac representative that with the additional fee, my wife would be covered as I was. Along with that we have two additional riders described as "Off-the-job accident disability benefit rider and Sickness disability benefit rider."
We were lead to believe that we both had the same coverage and shared the same benefits of the policy. In reading the very "in depth" (we'll call it) policy, one finds that the policy is mostly written in the wording for an individual policy and it would be just that if not for additional riders and fees to cover more, such as that of an additional family member.
The section describing "Type of Coverage" reads "see your Policy Schedule to determine the Type of Coverage issued: Individual, Named Insured/Spouse Only, One-Parent Family, or Two-Parent Family." Under the description for "Named Insured/spouse" the definition reads "coverage for only you (the Insured) and your spouse."
The "Policy Schedule" shows "My Name" as the insured. I understood this to mean the "Main policy holder" and nothing more. I mean.. it's got to be under someone's name. Does it not?? The important part for me is that my wife is covered as well. It appears she is as described under "Type of coverage - Named insured/Spouse" to be found on the very next line.
With all these statements in the policy we had no reason to think my wife doesn't share in all the same benefits of the policy that I would. Especially since we pay additional to have her on the policy. Recently, my wife took ill and spent 9 days in the hospital at a cost of almost 250k to date, paid mostly by another insurer thank goodness. She had two weeks of recovery time at home and off of work. We filed a claim with Aflac under the "Sickness rider" and the claim was denied with the simple explanation that "my wife was not covered under the policy riders."
To look at and see these policy documents, there is no reason at all to think she would not be covered. Then you come to the Rider and their coverage. "This rider applies to the Insured only, as shown in the Policy Schedule." Yes... I saw this. Still I thought that with the additions on the policy that it included my wife as described in "type of coverage" and as described to me by the Aflac rep. I was wrong.
A layman and simple person has no chance against some insurance companies that are out there and we feel very deceived and flat out ripped off by Aflac. We can't and will no longer recommend Aflac as a reputable company and our hope is that others will see this deception before it's too late.
Obviously, due to the extremity of my wife's illness we are now financially devastated and will work the rest of our lives (shes 40, I'm 45) to pay this off. The failure of Aflac to come through for us and help offset at least a very small portion of the amount we now owe just leaves us that much more in debt and that much more of a struggle to pay the bills.