An Aflac Accidental Injury Claim Form is one of the many claim forms that AFLAC has been offering for their policy holders. It is used when a consumer was involved in an accident and needs an assistance which Aflac can give and provide. This form consists of 2 pages and includes some instructions and information about the claim policy. Detailed information is also needed in the form supplied by the policy holder including personal and identification details, informations about the policy holder’s registration details, as well as some third party statements which is usually the attending physician of the consumer. There is also some contact informations in the form which can be used by the policy holder to check the status of their claims and for their concerns. Authorization such as signature is also required to be supplied in the form. A policy holder who applies for this type of claim must also prepare the entire necessary supporting document while filing.
Filing Aflac Accidental Injury Claim Form may be hastened up if the policy holder would provide all the needed information correctly. By doing so the claim would be granted immediately without the long wait. So 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.
Step2
Start by knowing 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.
Step3
Input the identity information of the policy holder in the boxes provided starting with the last name, suffix if any, first name, and middle initial. Each box must be only filled with one letter.
Step4
Next is to provide the date of birth of the policy holder followed by the contact information where the company may easily reach the policy holder and address of residency. Confirm if the given address is the holder’s permanent address by checking the box just below it.
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
After those information, next is more on giving details about the accident that happened regarding the patient. There is a space provided for each information that the policy holder would supply about the accidental injury checklist.
Step7
On second page of the form, supply the information asked again about the policy number of the claim and about the policy holder information for assured purposes of the form. Under the patient’s information, there are some questions that are needed to be answered by checking the box of the corresponding answer.
Step8
Just below the questions are two tables that is needed to be supplied with the dates of the injury treatment and who provided the treatment to the patient as well as his or her contact information. This is to determine the policy holder’s benefit. On the next table is about transporting and lodging details if the treatment needed so.
Step9
Finally sign the form on the space provided at the end of the claim form as well as including the date it was signed.
1
Write the needed informations correctly and accurately to avoid delays in the grant of the claim.
2
Follow the instructions carefully in the form as it may result to delay of processing the claim.
3
Provide all the necessary supporting documents as proof of all the information declared in the form.
4
If the one filing the form is not the policy holder, at the end of the form indicate it and sign the right provided space for the non policy holder applicant. Make sure to provide the relation to the policy holder. Presenting some documentation and attaching it would help.
Ask the Community
Still get confused or have more suggestions? Leave your thoughts to Community Center and we will reply within 24 hours.