Aflac Continuing Disability Claim Form Physician s Statement

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Accidental death - Certified death certificate & beneficiary statement claim form. Police report - Required for MVA and any other occurrence investigated by the police. Physician's office notes. Emergency room - ER or urgent care report.

Proof of Loss: Written proof that is required to be furnished to the insurer about a loss to help determine the extent of insurer liability. Provider: A facility, licensed as such, that provides health services for an individual.

Please print a separate form for each additional family member or call 1-800-99-AFLAC (1-800-992-3522) to request additional forms. Claims for all other benefits covered under this policy must be filed separately using the claim forms available at aflac.com or by calling 1-800-99-AFLAC (1-800-992-3522).

Please print a separate form for each additional family member or call 1-800-99-AFLAC (1-800-992-3522) to request additional forms. Claims for all other benefits covered under this policy must be filed separately using the claim forms available at aflac.com or by calling 1-800-99-AFLAC (1-800-992-3522).

Aflac Aflac cannot process claims until they have the employee's statement, physician's statement, employer statement and the authorization page. Claims approval process takes 5 days to process and pay out claims.

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Policy number. Policyholder's name. ... Policyholder's address. Date of injury or when symptoms first occurred. ... Definitions & acronyms. ER visit. Surgery. Operative report - Must include the type of procedure or procedure code. ... My Claims.

To file a claim, simply select the appropriate claim form for your specific product and mail or fax it to us at the address on the form. Download the form. Fill it out. Send it in to: PO Box 60676, Worcester, MA 01606.

How long do I have to file a claim? A. There is a one-year timely filing provision in your certificate. Please review the provision and call us with any questions.

Simply log in to your account at aflac.com/MyAflac or download the MyAflac app to your mobile device. Step 3: Go to \u201cFile a Claim\u201d, select \u201cPhysician visits, routine or preventative services\u201d and follow the steps.

Policy number. Policyholder's name. ... Policyholder's address. Date of injury or when symptoms first occurred. ... Definitions & acronyms. ER visit. Surgery. Operative report - Must include the type of procedure or procedure code. ... My Claims.

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