An Aflac Initial Disability Claim form is used by those Aflac Policy Holders for their initial needs when they are disabled due to an injury or sickness. It is the kind of form that helps the policy holder to achieve such claim. Initial Disability Claim Form consists of 3 pages which may need some personal information to help with the identity of the policy holder as well as third party statements such as an employer and an attending physician. It is widely known for a company that covers its employee’s physical health wellness while at work. Using this form requires the policy holder to present some supporting documents if applicable and legitimacy of being an Aflac Policy Holder.
Aflac Initial Disability Claim Form needs detailed information which should be supplied generously by the policy holder, he or she must be able to state in the form the true condition of disability and authorize it properly with a help of some required person. 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 address given 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 initial disability checklist regarding the patient claiming the policy. There is a space provided for each information that the policy holder would supply which would include answering what caused the disability. Each answer would lead into something that the policy holder should provide, like a documentation
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. The first and second line of boxes is intended for the policy holder to fill in while the following boxes are mainly for the Employer of the patient. Including identification details, account number, contact information, and address of residency. After that is some questions that the employer may answer by checking boxes and giving statements. Some instructions are written to answer accordingly for the last questions below this page.
Step8
The last page is intended for the attending Physician of the patient right after supplying the policy holder’s information. Same as the employer’s section, the physician should do the same.
Step9
Sign and authorize the form.
1
For each page of the form, there are provided space for the designated person who is supposed to sign it. Do not forget to have them signed below.
2
Incomplete form may result to delay of processing so make sure to complete each and every section.
3
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.
4
Follow the instructions carefully in the form as it may result to delay of processing the claim.
5
Provide all the necessary supporting documents as proof of all the information declared in the form.
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