Aflac New York Group

Use our Service Request Form to request any of the following:

  • Beneficiary change
  • Name change
  • Address change
  • Ownership transfer
  • A copy of your certificate

To ensure that your service request is handled quickly and accurately, please print the form and then do the following:

  • Complete the top portion of the first page, including your certificate number, name, and contact information.
  • Place a check mark in the section(s) you wish to amend, and provide the required information.
  • Sign and date the bottom portion of the second page.

For your convenience, you can scan the signed and completed form and email it to or fax it to: 1.866.849.2974 .

You are also welcome to mail it to:

Continental American Insurance Company
Post Office Box 84075
Columbus, GA 31993

Need help? Call our Customer Service Center toll-free at 1.866.849.2964 .