File a Claim
Aflac Group makes it easy to file a claim.

What type of coverage are you filing a claim?

We're here to help you. Each of our representatives is prepared to answer your questions about your plans, and we're proud to offer interpretation services for more than 50 languages.

If the information you need isn't addressed below, give us a call. We look forward to helping you.

Claims

For the most efficient service, please follow these instructions and provide as much information as possible. All claims require a signed and dated Authorization for Disclosure of Health Information (HIPAA form). Claims can be mailed to:

Aflac Group
Attn: Claims
PO Box 427
Columbia, SC 29202

or faxed toll-free to: 1.866.849.2970

Group Disability Insurance Claims

For disability claims, we will need information from you, from your employer, and from your attending physician. Please provide all the information requested in Part A of the initial claim form. Your employer is responsible for providing the information in Part B, and your attending physician is responsible for providing the information in Part C.

In addition, please read and then sign the Authorization for Disclosure of Health Information (HIPAA form) included in Part A, as well as the separate Authorization for Disclosure of Health Information (HIPAA form).

Please date and sign all required forms where indicated.

Disability Claim Form

Group Hospital Indemnity Insurance Claims

A hospital indemnity claim requires supporting documentation for review of benefits, itemized bills showing medical treatment dates and diagnosed conditions, hospital admission and discharge papers for inpatient hospital admission and confinement benefits, pharmacy receipts for prescription drug reimbursement, and a signed and dated Authorization for Disclosure of Health Information (HIPAA form). Also, if you are filing during the first year of your coverage effective date, we'll need you to provide the information requested on the Pre-Existing Investigation Statement.

Please date and sign all required forms where indicated.

Hospital Indemnity Claim Form

Group Accident Insurance Claims

Please provide a date and complete description of your accident. You can provide this information in the designated space on the 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 attached to the completed claim form.

If you were first treated in an emergency room, a copy of the hospital discharge papers is required to verify the first date of treatment, diagnosis, and procedure.

Please include all dates of treatment and charges incurred due to the accident.

Please date and sign all required forms where indicated.

Accident Claim Form

Group Critical Illness Insurance Claims

For critical illness claims, we need information from you and your attending physician. Please provide all information requested on the Insured's Statement portion of the claim form. The Attending Physician’s statement portion of the critical illness claim form is to be completed by the physician who first diagnosed your condition. Please submit required medical documentation for the specific covered critical illness, the claimant's birth certificate, a list of the names of all doctors and hospitals in the appropriate section, as well as a signed and dated Authorization for Disclosure of Health Information (HIPAA form). Also, if you are filing during the first year of your coverage effective date, we'll need you to provide the information requested on the Pre-Existing Investigation Statement.

 Critical Illness Claim Form

Group Cancer Insurance Claims

Please submit the pathology report used in the diagnosis of a malignant cancer, the claimant's birth certificate, and any itemized medical bills with the diagnosis and procedure codes, as well as a signed and dated Authorization for Disclosure of Health Information (HIPAA form). Also, if you are filing during the first year of your coverage effective date, we'll need you to provide the information requested on the Pre-Existing Investigation Statement.

Please date and sign all required forms where indicated.

Cancer Claim Form

Group Dental Insurance Claims

Please complete the Patient section, Boxes 8–18, as well as the Policyholder/Employee section (excluding Boxes 31–38 and 40.) Your dentist should complete the Billing Dentist section, Boxes 42–66 (excluding Box 53).

Please date and sign all required forms where indicated.

Dental Claim Form

Health Screening Benefit or Wellness Benefit Claims

Please fully complete the claim form for the Accident Wellness Benefit, the Critical Illness Health Screening Benefit or the Group Hospital Indemnity Wellness Benefit.

Please date and sign all required forms where indicated.

Accident Wellness Claim Form

Hospital Indemnity Wellness Claim Form

 Critical Illness Health Screening Form

Group Life Insurance or Accidental-Death and Dismemberment Insurance Rider Claims

Please provide a certified copy of the deceased person's birth certificate and death certificate. If the cause of death is an injury or accident, include a copy of any related police report and/or newspaper articles.

Please date and sign all required forms where indicated.

Beneficiary's Statement for Death Claim Form