An Aflac Cancer Claim Form is a type of Aflac Claim’s form wherein the policy holder would prove and indicate information about him or her having a so-called illness: cancer. This is a 4 pages form wherein the claim applicant is going to provide all the necessary information about the illness detail by detail. A third party’s statement is also needed for a more liable type of proof given. This is to ensure that the policy holder is not lying under any circumstances. By using this form, any other claim forms may now be supported. It is like the main filing form for cancer patient policy holders.
An Aflac Cancer Claim Form is a quite long form which needs accurate information from the patient and/or policy holder and the attending physician. Here is a step by step procedure on how to fill the 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
Start by checking the box on the top most part of the form wherein the policy holder must indicate which type of claim may apply. As well as providing the information needed on the box below.
Step3
At the policy holder information section, input the identity information of the said party, including his or her address. A social security number is also needed on this part and a contact number.
Step4
Next is by writing down the patient information starting by full name and checking the box below which corresponds to the patient’s relationship with the policy holder.
Step5
The next pages are more on intended for the physician’s statement. All the information regarding the patient’s illness and medical records is needed to be written down here. The policy holder may take on writing the policy number, policy holder name and patient’s name on the topmost part of the physician’s page. The following statements must be provided by the attending physician generously and accurately. The same thing applies for the 3rd page of the form in which the physician should fill the tables provided in it.
Step6
The attending physician must be able to sign and date the form below the form. Including a tax ID number is needed.
Step7
The last page is the Claim Authorization to Obtain Information. There is a table which must be filled with all the needed information and details like again the policy holder name, policy number which is covered and under by the policy, policy holder’s address the patient name and an expiration date. The right part of the table is intended for an Aflac authorized person.
Step8
Lastly, sign and date the form for authorizing purposes.
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
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.
6
Use blank ink or blue when filling out the form and write legibly in a way that the processing unit would clearly understand.
7
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.
8
Do not forget to have the physician signed and dated the form for it is needed and is a must in the form.
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