As an Aflac Policy Holder, they are entitled to use each policy generously as needed and as what the policy are offered. These policies include the Aflac Accident Wellness Benefit Claim Form. This is a 2 pages form that covers lots of treatment and wellness actions that may benefited from like an annual physical, ultrasound, PSA which is a blood test for prostate cancer, pap smear, eye exam, dental, exam and so on as may be seen on the form. When this form is completed, it must state accurate information about the policy holder and the treatment that was done with the dates that it happened. The attending physician of the patient must also state informations needed in the form. It must signed and authorize before submitted for the processing.
An Aflac Accident Wellness Benefit Claim Form is briefer than any other Aflac forms of claim, even though the information needed to be in it must be sufficient enough to be processed. There are appropriate instructions on the form to be followed by the policy holder to obtain a complete form. Here is a step by step procedure on how to fill this form out:
Step1
Obtain the form by downloading in Aflac’s official sites or even by asking it at Aflac’s Claim Administration directly. It is better to have the original form itself to avoid nullity of the claim which rarely happens.
Step2
Input the identity information of the policy holder in the boxes provided starting with the first name, middle initial and last name, and. Each box must be only filled with one letter.
Step3
Next is to provide the date of birth of the policy holder followed by the zip code for mailing purposes. Input each detail one by one on each box provided for answers.
Step4
After that in the right corner of Patient’s information table, proceed to inputting the policy number of the claim. Know which policy number applies under the type of claim that is going to be filed. Supply the policy number individually on the box provided at the topmost of the form. Policy numbers can be asked into one of Aflac’s assistance officer or personnel.
Step5
Next section is the personal information of the patient applying for the claim policy. Including name, birth date, gender, and the relationship of the patient into the policy holder.
Step6
On the wellness information section, start by providing the date of treatment which must be provided strictly.
Step7
Next, there are several boxes just below, check in the box which may state the form on what type of treatment is done. If a Pap smear, write the date as well as if mammogram.
Step8
The last section is intended for the attending Physician of the patient. He or she must provide identification such as full name, as well as a contact information. Address is also needed so have the physician write it down.
Step9
Sign the form at the end of the second page on the space provided and the date of filling out the form.
Step10
Mail the form in the correct address which can be seen in the form itself.
1
Read the instruction on the first page carefully for if not, it may cause failure to meet the need of the form.
2
Write the needed informations correctly and accurately to avoid delays in the grant of the claim.
3
Follow the instructions carefully in the form for every section may insist one, if not may result to delay of processing the claim.
4
Provide all the necessary supporting documents as proof of all the information declared in the form.
5
Only mark the treatment/s that has been done and performed.
6
Each policy holder has the right to decide on which policies are they going to take. So before filling this form out, make sure that as a policy holder, the treatments enlisted in the form is covered by his or her subscription.
7
Use blank ink or blue when filling out the form and write legibly in a way that the processing unit would clearly understand.
8
When submitting the form, make sure that the policy holder has their own copy of some supporting documentation and the completed form for further use and as a reference.
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