To avoid delays in processing of your claim form, complete each section, attaching documentation below when it applies. Primary medical insurance EOBs alone do not contain the required information to …

Aflac promised to be here when you need us most – and a big part of that promise is making the claims process easy. We built our online claims process to save you time and to help give you peace of mind.

I understand that I may revoke this authorization at any time, except to the extent that (1) Aflac has taken action in reliance on this authorization, or (2) other law provides Aflac with the right to contest a …

ARIZONA: For your protection Arizona law requires the following statement to appear on this form. Any person who knowingly presents a false or fraudulent claim for payment of a loss is subject to criminal …

ACCIDENTAL INJURY CLAIM FORM Thank you for trusting Aflac with your Accidental Injury needs. â To file your claim online, upload documentation on an existing claim, check claim status or get paid …

You can also submit your claim via fax or mail. To get started, select your state and download a claim form.

Please sign the attached HIPAA Form and return it with the completed claim form.

If the accident resulted from the use of a motor vehicle (s), a copy of the police or accident report is required. If your injury occurred on the job, a first report of injury filed with your employer must be …

If you are filing for disability, please complete the Initial Disability Claim Form (S00224). Forms are available on our web site at aflac.com. All bills should include the diagnosis, services rendered, and …

File a Claim Checklist for our policyholders. Learn which items are required to use Aflac's SmartClaim system to file a claim.