• Report: #214632

Complaint Review: AFLAC

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  • Submitted: Sat, October 07, 2006
  • Updated: Sat, June 16, 2012

  • Reported By:Winchester Virginia
AFLAC
1932 Wynnton Road Columbus, Georgia U.S.A.

AFLAC ripoff, short term disability claim denial for invalid reasoning Columbus Georgia

*Consumer Suggestion: Pre-existing condition or loophole?

*Consumer Suggestion: AFLAC....Prevention is possible

*REBUTTAL Owner of company: Your Premiums Did Not Increase!

*UPDATE Employee: Interesting Aspects of Your Report

*Consumer Comment: WHY WOULD I VISIT THIS SITE

*UPDATE EX-employee responds: Aflac is not at fault

*General Comment: Aflac Comment

*Consumer Comment: Your treatment was before effective date

*Consumer Comment: Why i am on this site

*Consumer Comment: AFLAC is Great

*Consumer Comment: pre-existing decisions based on diagnosis

*Consumer Suggestion: Pre-Existing Condition, or not?

*Consumer Suggestion: A note on Pre-existing Conditions

*UPDATE Employee: Incorrect claim

*UPDATE Employee: Wrong...

*Consumer Comment: Both sides of the fence

*UPDATE Employee: AFLAC is a reputable company in business over 50 years!

*Consumer Comment: Read your policy

*UPDATE Employee: Aflac will make it right, will you?

*UPDATE Employee: Read your policy

*Consumer Comment: I am an AFLAC District Sales Coordinator - not and employee

*UPDATE Employee: FYI

*Consumer Comment: I am also interested in a career with AFLAC insurance

*Consumer Comment: Response to Kenneth

*Consumer Comment: Pre-Existing Condition = Not Covered

*Consumer Comment: Pre-Existing Condition = Not Covered

*Consumer Comment: Pre-Existing Condition = Not Covered

*Consumer Comment: Pre-Existing Condition = Not Covered

*Consumer Comment: What's Up With That?

*Consumer Suggestion: AFLAC is fantastic! never had a problem in 2 years with them.

*Consumer Comment: Darcey, take note...

*Consumer Comment: Prospective New AFLAC Agent

*Author of original report: Thanx for an intelligent response Aafes

*Consumer Comment: There is indeed a separate bureau

*Consumer Suggestion: Darcy, You're completely wrong.

*Author of original report: You didn't answer any of my questions Elane.

*Consumer Suggestion: Happy To Oblige, Darcy.

*Author of original report: I guess you must amaze yourself Elaine

*Author of original report: I guess you must amaze yourself Elaine

*Author of original report: I guess you must amaze yourself Elaine

*Author of original report: I guess you must amaze yourself Elaine

*Consumer Comment: Neither Love or Hate Aflac

*Consumer Comment: Why I Read ROR

*Author of original report: What part don't you understand?

*Consumer Comment: I don't understand your sarcasm...

*Consumer Comment: Thanx for the warning

*Author of original report: Thanx Jennifer

*Consumer Comment: E-Mails Not A Good Idea

*Author of original report: Thanx Brian

*UPDATE Employee: How Did Aflac Fail You?

*Author of original report: Thanks Dino

*Consumer Suggestion: Cancellation of AFLAC

*Consumer Comment: Dina is Right

*Consumer Comment: Dina is Right

*Consumer Comment: I undertsand your frustration

*Author of original report: A good reason to not contract with AFLAC

*Consumer Comment: Sounds like AFLAC is right to me

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I signed up for a short term disability from Aflac in November of 2005 with policy taking effect in January of 2006. At that time I did not have any reason to believe that I would be needing to utilize the service however it was open enrollment time and I knew I would not be able to sign up for the service for another year.
I began to experience pain in my neck and back and along with the numbness in my hand I feared that I was experiencing a stroke. I visited my primary care physician in December of 2005 who referred me to a neurologist in the same month.The neurologist ordered x-rays and an MRI which were not performed until the following month (January 2006). Since the neurologist was unable to diagnose the source of the ailment without the test results he prescribed a pain medication to me until the diagnosis could be made.After reviewing my test results in late January the neurologist diagnosed my problem as a ruptured disc.The doctor discussed several treatment options at this time to include physical therapy, steroid injections and as a last resort surgery. The physical therapy treatment began in February of 2006 and was unsuccessful. Next the steroid injections were started at the beginning of March 2006. After experiencing no relief from the malady I finally agreed to have the disc replaced surgically. The operation took place in August of 2006.

It is now October of 2006 and my claim has been denied after 8 weeks of a constant runaround. I have read each and every one of the complaints against Aflac and the common theme is to deny all claims and look for loopholes to avoid fulfilling the insurance contract. The customer service department has denied receiving faxes of which I have retained the journal that proves the fax was accepted sucessfully. The customer service rep has basically lied by saying it takes 4- 5 hours to receive a fax.

Anyone can plainly see from the dates I have provided that I am entitled to recover on my claim. Aflac (who apprently insulates itself from scrutiny by not allowing you to talk an auditor) has denied my claim based on my first Doctor visit in December stating that I received treatment. I was prescribed pain medication until I could be treated. Pain medication is not a cure. That's like saying that strep throat can be cured by tylenol. The tylenol is prescribed until the strep test is done by the lab and then the antibiotics are prescribed. The antibiotics are the treatment not the tylenol. Same scenario here except the actual diagnosis and treatment did not begin until February of 2006.

In short Aflac is just a huge rip-off and I now intend to contact the insurance commission as advised in a prior posting. Next I intend to file a claim with the better Business bureau and finally I intend to send an e-mail to everyone that works in the hospital that I work in outlining all of my experiences with Aflac. Hopefully I will be able to steer some people clear of the Aflac rip-off.

Darcey
Winchester, Virginia
U.S.A.

This report was posted on Ripoff Report on 10/07/2006 08:24 AM and is a permanent record located here: http://www.ripoffreport.com/r/AFLAC/Columbus-Georgia-31999/AFLAC-ripoff-short-term-disability-claim-denial-for-invalid-reasoning-Columbus-Georgia-214632. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year.

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REBUTTALS & REPLIES:
0Author 56Consumer 1Employee/Owner
Updates & Rebuttals

#1 Consumer Suggestion

Pre-existing condition or loophole?

AUTHOR: Brie - ()

 The view is always different looking into a home from the outside compared to living in the home and having the facts.

From consumer to consumer who have been denied claims by AFLAC i notice a common thread. The terminology pre-existing condition seems to be at the center of the sink hole. What is a pre-existing condition? Does the medical industry have a differrent operational definition than the insurance industry? and if so why?

It is black or white when a policy uses a unform definition that the public agrees upon because it is a "operational definition used by the same medical community to which insurance companies used medical reports information to determine if a claim is legitimate to receive approval or denial. Symptoms alone do not constitute a pre-existing condition. Many conditions share the same symptoms.

To consumers who may read this rebuttal and to AFLAC representatives, employees or former employees who may read this rebuttal i say ' If you are an ethical business who makes money by collecting premiums on insurance supplement that is designed to provide coverage for accidents, illness, cancer and whatever else, clarify your verbage used in these supplements, and if you are going to use medical reports and information to determine approval or denial of a claim, then use the same operational definitions that the medical industry use and accelpt when it relates to determining whether an individual has a pre-existing condition prior to the effective date or 30 days after a policy goes into effect.

yes there will always be upset consumers when there is a denial, and there will always be people looking for a loop hole, but when you use semantics and unclear language in policies to create a loop-hole for denials, you not only catch the bad guy, which is a wonderful thing, you hurt honest, innocent people who placed trust in your business, otherwise would not have purchased the product or service.

Clean it up AFLAC. you have a responsibility to not only your investors but your consumers. Outsiders looking in, please wait until you have an actual policy in front of you before you judge the comments made by policy holders. It's not the hurt feelings I defend but the language in these policies that i share with other consumers who have been denied.

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#2 Consumer Suggestion

AFLAC....Prevention is possible

AUTHOR: Brie - ()

 AFLAC is none the less a business, an insurance company who needs to make profits or why be in business.

As a consumer who was recently denied a claim you must understand the consumer who is faced with a sudden illness and unable to work, stress, mounting bills and a broken promises of security in the form of insurance supplements.

While your representatives have a job to obtain and maintain accounts, it is critical that you as an industry be upfront and honest with consumers. You basically are saying you don't want to cover anything unless a policy has been in effect for a year and the illness occurs after that year the policy went into effect.

If that is the case, then be honest with the consumer. Don't lead consumers to believe that they have coverage to protect them when they need it the most. Using semantics not to cover a condition is simply "wrong" and "unethical".

If a consumer went to the doctor complaining of a cold in January but the policy went in to effect in February and months later they determined the consumer had cancer of the lungs, are you going to say it was pre-existing? You can always find common complaints that may or may not be a part of symptoms to many diseases, but until someone is actually diagnosed with a "condition" it can't be pre-existing.

Here are two suggestions: If you don't want to pay these claims, then stop offering the insurance for disability short-term. Ju Make sure the consumer understands what you expect before you will pay a claim and avoid being the cause of someone becoming homeless with premiums to AFLAC up to date. Take accountability and stop using controversial phrases in your policies to not pay legitimate claims.

 

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#3 REBUTTAL Owner of company

Your Premiums Did Not Increase!

AUTHOR: Longtime Aflac Agent - (United States of America)

What must have happened is that you work for a company that is paid every other week (biweekly, not semimonthly). So, most months, you and your coworkers receive two checks. However, two months out of the year, you will receive three checks instead of two, as there are 26 annual paychecks in a biweekly payroll cycle.

Your employer gets a monthly bill. Two bills each year will include three payrolls, and the amounts you list as having "increased" easily prove this to be true. Thank you.
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#4 UPDATE Employee

Interesting Aspects of Your Report

AUTHOR: Longtime Aflac Agent - (United States of America)

As a longtime Aflac field agent, what I found most interesting about your report is the statement that (paraphrasing), you didn't have any health issues when you signed the application in November, and just started noticing symptoms in December, before the policy went into effect January 1st. You also say that you only signed up for the policy because you knew if you did not, you would have to wait one year until the next open enrollment.

Bear in mind, your MIB report (Medical Information Bureau) will show whether or not you knew, or should have known, that you might need to go out on disability at the time of the application, or during the initial 30 day waiting period for illnesses (i.e. any new disease that manifests 30 days after effective date will be paid under the Aflac disability policy; pre-existing conditions are payable only after the policy has been in effect over 12 months). Accidental injuries that result in inability to work are not subject to any waiting period. In fact, I once had someone sign up with an August 1st effective date who had a serious car accident on August 3rd. Before the first payroll deduction was made the middle of that month, Aflac had sent the person a check for about $2,200!

I have also experienced the following behaviors from employees at initial and open enrollments:

1) After I had been in business a couple of years, an employee said, "If I knew there were health questions, I would have signed up last year;" looking for "wiggle room;"  He had aggressively told me before, "I'm not interested!" From that, I learned to say, "I know you don't need it right now; just be sure to sign up for the policy(ies) that make the most sense before you do need the coverage. We have to ask health questions, and in most cases, having coverage at the time of the accident or illness is required. This is why Aflac premiums are extremely affordable, unlike group health insurance where everyone is covered." Perhaps the agent at your employer also practices this due diligence and this has enhanced your understanding.

2) A construction foreman told me he had Aflac in the past and let it drop instead of paying premiums direct to Aflac to keep his coverage when he changed jobs. He acted like he did not know which plan(s) were most interesting, and needed to talk to his wife. On my third follow-up phone call, he said they decided to go with Disability. When I asked him the health questions, he told me that he had been diagnosed with a neck condition very recently, but it was not problem since he is a supervisor. He seemed to hope that I was "hungry" enough for a sale to not disclose the condition on the application, however, I included this information. When Aflac reviewed the application, his MIB showed he had lied to me about needing a surgery in the very near future, and Aflac did not issue a policy. To this day, he tries to prevent others from signing up for Aflac, since we did not issue a policy so he could be paid for the pre-existing condition, or file a lawsuit if we did not pay him.

3) A very similar situation to 2) above recently occurred, and the employee had been with the company for years and was in a supervisory role. He always tried to thwart open enrollments, so I was leery when he called me to ask about Disability. I told him I would ask health questions in person, and he claimed over the phone not to have any health issues. When I met with him, he disclosed that he was a Georgia native, however, he denied ever having known anyone connected with Aflac. And it turned out, he did have a need for surgery that would make him unable to work for an extended period of time. Also, he mentioned that he would be reducing his hours, and possibly retiring, within the year! I was relieved that Aflac did not issue a policy in this instance, as well, as monthly benefit amount was higher on the scale due to his income.

The bottom line is, regardless of the monthly benefit amount, most people can purchase an Aflac disability policy at a cost at or around half an hour's pay per week. Of course, they need to qualify based on no current health problems, and some past health conditions may prevent one from every qualifying. If it makes sense, get it before you need it. My opinion, based on your posting, is that you already appreciated this at time of application, and were looking for "wiggle room."
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#5 Consumer Comment

WHY WOULD I VISIT THIS SITE

AUTHOR: melissamd - (United States of America)

To the author:  You seem so concerned as to why someone would visit this site...should it really matter?  I am looking at these posts because I have just signed on with AFLAC and wanted to see consumer reviews...I have read a number of posts from people with problems.  Some are valid, some are not.  As others have said--I agree that AFLAC is not doing anything deceptive or looking for loopholes.  

 It seems in today's world when something doesn't go our way we look at everything other than ourselves to blame.  No, you are not to blame--but neither is AFLAC.  They have a stated policy regarding pre-existing conditions, and unfortunatley you sought help for a condition prior to your policy starting.  

As I saw a representative reply it might be worth a shot to try to resolve the situation with your representative rather than call the company a scam.  As for AFLAC employees replying to these posts it would seem if I worked for a company I would want to keep track of what's going on with it--and if I saw a problem, if I am conscientious, I would want to address it and try to help if I could.  
If the company is such a scam, how did it get to be voted as one of the WORLD's most Ethical Companies?  Yes, there will be denials of claims, and yes, the ultimate goal for ANY company is to make money...no one offers a product to NOT make money---they offer a service--and are entitled to make an income from that service.  It is called INSURANCE, not a personal bank.  Saying that it is a scam because it didn't pay a claim is ludicrice..that's like calling your car's warranty a scam because something goes wrong with your car and it's not covered under the warranty so you have to pay for the repair.

I can understand your frustration, and even sympathize....insurance and pre-existing condiitions is very frustrating.  I have a back problem that I have to wait to fix due to pre-existing conditions caluses.''Good luck to you
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#6 UPDATE EX-employee responds

Aflac is not at fault

AUTHOR: adharper - (United States of America)

You said it yourself, the policy was not effective until Jan. 2006 and your problems started in Dec. 2005. Clearly not Aflac's problem. You did not have the policy in force at the time that your problems started. On a side note, the customer service rep did not lie to you when they told you it takes 4-5 hours to receive a fax. What you need to understand is that Aflac is such a big company that their one building in Georgia actually has its own zipcode. They have such much mail going in and out of there and so many faxes coming in and going out that one department may not receive your one fax for several hours. Aflac was voted in the top 10 ethical companies the last 3 years in a row. I can understand how annoying it must be for you that your body decided to start having problems BEFORE your policy was in force but no one at Aflac is to blame. We buy insurance in case things happen but it's all a gamble! You were gambling that nothing would happen for you to use the policy in the first place especially BEFORE it was actually in effect and you lost. Sorry.
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#7 General Comment

Aflac Comment

AUTHOR: shelly2733 - (United States of America)

I just wanted to comment to those who said that someone (even a satisfied Aflac customer) had to search this Rip-off site to find negative information about Aflac. 

I simply googled "should I buy Aflac" and was led to this site completely unaware of this utter mayhem.

So, no - you don't have to google Aflac rip-off to be led here - sometimes it just happens by accident.

And to the original poster - your comments are so rude and full of pure hatred for life that I really will not take anything you've said about Aflac into account.  If you can be so ignorant and nasty to people who haven't even said anything rude to you at all; then you have bigger problems than Aflac.  Geez Louise.  Touchy, touchy.

I think I'm gonna get some Aflac through my employer.

Thanks for all of the helpful posts and realistic expectations of an insurance carrier.  Helloooooooooo - pre-existing condition!

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#8 Consumer Comment

Your treatment was before effective date

AUTHOR: Reality Check - (U.S.A.)

Plain and simple, your treatment started before your effective date. Your eventual diagnosis may have been well after your policy came into effect but you sought treatment for that condition before your policy was in effect.
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#9 Consumer Comment

Why i am on this site

AUTHOR: Rskoropat - (U.S.A.)

Since this seems to be a prevailing question. i actually did a google search for claim aflac 49505 to see if there was a listing of how much was paid for a procedure code and saw that AFLAC was in the Ripoff Report and couldn't believe it. lol
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#10 Consumer Comment

AFLAC is Great

AUTHOR: Rskoropat - (U.S.A.)

I have been a customer of AFLAC for a little over a year now and have to say that i am VERY satisfied. In response to the filing a claim on something that was diagnosed before the policy is in effect, i had signed up for the AFLAC in much the same way, signed up in November to take effect in January. Filed a claim in December and after talking with the agent they went ahead and processed the claim. I too have been left speechless at times at what they cover... My daughter contracted Lyme disease and was told (after asking on a whim) that the disease and treatment weren't covered, but the tick bite was.... I seriously didn't expect any part of it to be covered since it wasn't an "accident"

Just my $.02
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#11 Consumer Comment

pre-existing decisions based on diagnosis

AUTHOR: Ju - (U.S.A.)

I signed up for AFLAC in May of 2008. At the time, and many times hence, my agent has assured me that the date of diagnosis determines whether or not a condition is pre-existing. She told me that regardless of when I experienced symptoms, or even when I sought medical attention, or even if my doctor "suspected" a specific diagnosis, that the actual date the condition is OFFICIALLY DIAGNOSED is the date AFLAC uses to determine when the condition officially "began" for insurance purposes.

The language in the policy is such that it appears to be able to be interpreted ambiguously. I am not a naive person when it comes to insurance, but my agent was so convincing that I signed up based on her statements.

Am I being fleeced? After reading these posts, I'm wondering if I should cancel my AFLAC coverage.
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#12 Consumer Suggestion

Pre-Existing Condition, or not?

AUTHOR: Davz - (U.S.A.)

According to HIPAA:

Under HIPAA, the only preexisting conditions that may be excluded under a preexisting condition exclusion are those for which medical advice, diagnosis, care or treatment was recommended or received within the 6-month period before your enrollment date. (Your enrollment date is your first day of coverage, or if there is a waiting period to get into the plan, the first day of the waiting period.)

If you had a medical condition in the past, but have not received any medical advise, diagnosis, care or treatment within the 6 months prior to your enrollment date in the plan, your old condition is not a preexisting condition to which an exclusion can be applied. Moreover, under HIPAA, preexisting condition exclusions cannot be applied to pregnancy, regardless of whether the woman had previous health coverage.

So, basically if you went to see the Dr. during your "waiting period" it is NOT a pre-existing condition, or if you had not received any advice, diagnosis, or care in the 6 months before your "enrollment date" it is aslo legally NOT a pre-existing condition.

I hope this information helps. It certainly contradicts what all the uninformed consumers/employees are saying. I found it on the Department of Labor's website (http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html)

Best wishes, and I hope you feel better!
-Dave
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#13 Consumer Suggestion

A note on Pre-existing Conditions

AUTHOR: Davz - (U.S.A.)

I would recommend reading up on the HIPAA (Health Insurance Portability and Accountability Act) of 1996 and seeing if Aflac is really allowed to limit your benefits based on pre-existing conditions. You may find information in there that will help.

I would also like to address the poster who stated AFLAC never raises it's rates. This month my rate jumped 50% without notification. From $69/month to over $104/month. The only reason I found out is because it is automatically deducted from my paycheck, and my employer caught the change, and discovered it happened to quite a few of our employees who have Aflac.

Not that it really matters _how_ I found this page, but I was doing a search to see if other people noticed an increase in their premiums as well, or if it's just an error. Back to my search...
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#14 UPDATE Employee

Incorrect claim

AUTHOR: Angrywoman - (U.S.A.)

M'am I forgot to add...

Claims you send to 877-442-3522 DO take up to 24hours to be scanned in. The customer service reps are standing by fax machines. We are a fortune 500 company with thousands of employees. There is a dedicated department whose job is to recieve a fax, sort it, and scan it in the system. Do you know how many faxes we get a day? THOUSANDS upon THOUSANDS.

Secondly, regardless of what your fax confirmation says, IT DOES NOT MEAN WE GOT IT. It can say successful a thousand times. We have a highly innovative fax search system that allows us to do detailed searches for faxes by searching the # you sent it from, to, the date, & time. If it's not there, it's not there! Refax it. The # is TOLL FREE.

Finally we do not allow you to talk to auditors because if we let you talk to them, we'd have to let everyone talk to them. They are NOT customer service reps. Their job is to PROCESS the claims. They spend all day sifting and reading through piles of paperwork to process claims. If they spent time on the phone arguing that means they are wasting time on the phones instead of procesing claims. Right now we have a 7 day turn around time for claims. If they answered phones all day, they would not be able to process them in 7 days. It'd be more like 20-30 days.

We have over 6000 customer service specialists who are trained to assist you. Each person takes on average 70-80 calls per day. What we don't need is people calling in yelling because they did not read the policy. I'm sorry to be blunt, but again, go ahead and take it to a commissioner, take it to a lawyer, you will be in for a rude awakening.
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#15 UPDATE Employee

Wrong...

AUTHOR: Angrywoman - (U.S.A.)

I have worked for Aflac for years and I can tell you that the reason it was denied was because you started suffering the problems BEFORE the policy took effect. Read the policy.

I am not saying this to be rude, but, (i will put this in non policy language) that whether or not you sought medical treatment before or after your effective date, you clearly knew you had an issue before the policy took effect.

So you can contact the insurance commissioner, and believe me, you don't want to do that...bc they will launch a full blown investigation. Including getting info from the MIB (Medical Information Buearu) and review your history. If they can find you sought treatment before the effective date (whther or not it was diagnosed after the eff dt is irrelevant) then you will NOT be paid. Plus they will be able to rpve what ever caused your ruptured disc HAD to happen before the eff date. Just because you weren't "diagnosed" doesn't mean it wasn't there. Something had to happen- that's comon sense.

The most you will get is a refund of your premiums paid and your policy cancelled.

And honestly, if you ran an insurance company and you knew someone saw a doctor BEFORE the effective date then again common sense tells you, this person was injured before this policy took effect. Would you still insure the person? In the business world that would be idiotic. It's like we're BUYING your claim.

Believe me, I know first hand aflac can have crappy customer service, slow process times, & long holds....but we ALWAYS pay VALID claims. ALWAYS.
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#16 Consumer Comment

Both sides of the fence

AUTHOR: Moca72 - (U.S.A.)

Darcey (and I know I spelled it right, do not even go there),
It is amazing that you would even take so much time on a site like this to espouse so much venom. However, I am not here to attack you or to even address you personally. I have been on both sides of the fence.

I recently, last year to be exact, had surgery for a total abdominal hysterectemy. I had visited a doctor a few months prior and was informed I had cystic fibroids. I had just signed my short term disability paperwork with an effective date of the next month. This coincidently was the same month I had my diagnosis. However, the month prior I had my routine female exam where I was also told I had fibroids, but it would not require surgery. So this was NOT a diagnosis of anything more than fibroids. Nothing major. However the insurance company, not Aflac at the time, denied the claim. Keep in mind that it was also only a matter of days. But imagine my frustration and anger when I was informed that my claim would be denied. However upset or ticked off I was about it, there was nothing I could do about it. I fought, cried, and yelled at the world, it did not change the outcome.

Now on the flip side of the fence, I am an insurance agent. However I do not sell for Aflac. In fact I work for an auto insurance company. I am not a claims agent, I only service existing policies. It seems that much of your entire tirade has been personal attacks on individuals on this site. There have been some instances where you were only responding to what can easily be perceived as personal attacks on you, so there I respect your right to defend your stance. However as someone who once sold insurance of all kinds and now services auto policies, I can also see the side of the insurance company.

A really good example would be the following: An insured called to make a payment on their insurance policy. The policy was cancelled. The insured made a payment on the policy and the policy was reinstated effective the next day. However they were "bound" for coverage as of the time of the phone call, which just essentially means that the insurance company as good faith would honor claims made from the time of the phone call forward. Now here is the catch. While the insured was making the payment, another driver on the policy was making a frantic 911 call to report an injury accident. The times of the calls were only minutes apart. However after research, it was determined that the call to report the accident occured BEFORE the call to make the payment. Guess what happened? You got it, the claim was denied. Was it fair, was it right, was it ethical? A person could argue the point until they're blue in the face, but it boiled down to a mere minutes.

I could give more examples of situations like this, rental reimbursement being added after the accident and the insured being upset that they are not covered for a rental vehicle. My personal favorite is the person who calls in after 30+ days and wants to report a stolen vehicle, that hasn't been added to the policy!!!!

Obviously these are situations where the insurance company will more than likely win, and the little man (the average consumer) is left without adequate protection. Darcey, the only piece of advice I would give you is to look at this from the other side.

In all my anger, frustration, and hurt that my own personal claim was denied, I took a step back and tried to see the other side. It does not mean I agree with the decision, far from it! But I was able to objectively look at things from a different perspective.

As an agent, I try my best to educate my insureds/clients. In every field there are unscrupulous people, sales/insurance/auto sales being the main ones. If agents would take time to educate insureds and stop counting the commissions first, there would be less Darceys out there and more people who truly understood the concept of insurance (which is nothing more than the transfer of risk to a shared pool). That is not a personal attack on you either Darcey, I just think more people need to educated about their policies and what it covers and does not cover.

Tammy
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#17 UPDATE Employee

AFLAC is a reputable company in business over 50 years!

AUTHOR: AFLAC Admirer - (U.S.A.)

I am happy to say I am employee of AFLAC.

I'm sorry to hear about your situation.
I understand why you would be upset and so to say feel ripped off.

True the policy went into effective January 1, 2006.
However, you seeked medical treatment regarding this condition in December, 2005 - prior to the effective date.

This is considered a pre-existing condition.
ALL DISABILITY PLANS OFFERED BY ANY INSURANCE COMPANY have pre-existing conditions.
AFLAC is one of the few companies that does pay its claims.

All AFLAC plans are voluntary.
AFLAC does not raise it's rates.

What insurance company does not raise its rates on an annual basis?

All AFLAC plans are portable at Group Rates.

There's a reason why AFLAC has over 50 million satisfied policyholders!
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#18 Consumer Comment

Read your policy

AUTHOR: Libralady - (U.S.A.)

your policy says no preexisting condition is covered in the 1st 12 mths you knew you had back & neck pain that is the reason you took the policy in the ist place. Your policy says if manifested or treated within first 30 day of being written you are not coverd. READ, READ, READ everyone is too lazy to read including myself.

I had a Disability Policy with another Company and I did'nt read it until I needed to file a claim I couldnt because my waiting period was 14 day instead of what I thought the lady said but guess what I got the policy and never read it. Its not the INS Company fault it say so in BLACK & WHITE Im looking at Aflac Disability Police right now and I wouldnt have paid you either you went to the doctor less than 1 mth after taking out the policy. Underwriters are trained for these things if you went to doctor before or if you buy overthe counter RX, your MIB report will show for those of you who dont know your Kroger, CVS, Publix card all report your over the counter buying habits.

Who am Im a Proud Independent Agent and Im not being paid to say this "Independent" I meet people everyday you love Aflac more than I do because it has save them from financial ruin. Moto to story READ READ READ then you wont feel Ripoff
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#19 UPDATE Employee

Aflac will make it right, will you?

AUTHOR: Defendtruth - (U.S.A.)

I'm a veteran Aflac agent in Texas. I won't waste this space about the millions of dollars in claims paid to MY policy owners alone (I wish I could post references here legally)... Aflac has changed people's destinys around here and I sleep very well at night.

Six reasons why a claim is RARELY declined:

1. Improper documentation. Forms not readable, information missing, wrong policy numbers, etc. Once resubmitted properly, then eligible benefits are paid. YOUR AGENT CAN RESUBMIT A DENIED CLAIM! Always ask your agent for an exception, Aflac is staffed by humans. Humans make mistakes. If you're eligible for benefits...THE POLICIES WILL DO WHAT THEY READ THEY WILL DO.

2. Elimination periods not met. 30 days after effective date on any sickness-related policies. Aflac has the right to check your MIB report on high end coverage to make sure there's no Adverse Selection (see next) both at the application process and before the approve a claim.

In your case, OFF JOB Short-term disability sickness has a minimum 7 day, up to 30 day elimination period depending on the coverage elected. Did you read your policy before seeking treatment? A good agent urges their policy owners to "call first" so there's no misunderstandings.

3. Adverse Selection. Applicant omitted or falsified information when health questions were asked knowing treatment was needed. Sickness related policies ask "would any prudent person seek treatment". In other words, should seek treatment because a prudent person would do so?

4. Filed on the wrong policy. You can't file a broken arm claim on your dental plan. You can't file an internal cancer strike on your accident plan. (except the annual wellness benefit after 12 months of paid premiums).

5. Fraud. Faked claims, faked doctor statements, faked reports. Now and then, some will squeak through and get paid. Aflac can afford it. Thank goodness auditors will flag random claims and investigate. Keeps our premiums cheap.

6. Unpaid premiums. And this is not always the case. If policy has lapsed less than six months and back premiums are paid, Aflac will reprocess the claim.. and if it's legit, PAY IT.

If you KNOW that none of the above is true in your case, then I urge you to contact your agent's REGIONAL SALES COORDINATOR. Type in your zip code at this url for your local office and set up a meeting to explain your situation. Ask to speak with the RSC directly, "Is Joe Agent in your region? I'm a policy owner and work for XXXX Hospital, may I meet with your about my denied claim? I would like to have it resubmitted because...." The RSC doesn't want to lose your trust or business and is bound to resolve your complaint locally the best he/she can (at least my RSC would). The RSC has resources your agent doesn't have.

http://aflac.com/us/en/find_sales_office.aspx

This is a fact: Your policy is a contract. You answer the health questions honestly, pay your premiums on time, Aflac will do their job and pay eligible benefits usually within 10 business days (depending on how far you are from Columbus, GA because of the US postal service).

If your short-term disability policy wasn't AFTER TAXED (you can cancel an after-taxed plan anytime with no penalties) then your agent did you a dis-service (unless your employer wanted all plans pre-taxed). Double check on that. Asking other employees what was said, what was offered and explained, helps your case with the REGIONAL SALES COORDINATOR, too. If Aflac is wrong, they'll bust their butts to make it right.

Be careful what you say about Aflac to your co-workers. If someone cancels their coverage based on what happened to you and your outspoken anger... think about how you would feel when they say "I cancelled my cancer plan because of what you said and look at Susie, she just got a check for $3500 for her breast cancer surgery... now I have to wait for re-enrollment to get it back and PRAY I DON'T GET CANCER IN THE MEANTIME!"

Thank you for your reconsideraton and reading this post.
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#20 UPDATE Employee

Read your policy

AUTHOR: Wildcat79 - (U.S.A.)

To whom it may concern:

You stated that you signed up for the disablity income protector in Nov. 2005 with the effective date starting in Jan. 2006. Aflac didn't rip you off, you failed to read your policy. You chose to consult a doctor before the effective date. It is one of those things that can happen, but if you look at your policy. It didn't start until Jan of 2006 and then you have a mandatory 30 wait period depending on your elimination period you chose. This is what makes insurance so high these days is people go years without health insurance, and the first thing they do when they think something is wrong is go get some kind of insurance to pay for it. That is why you should consider this before feeling pain and purchase these policies when you are healthy as a horse. Don't wait until stuff starts happening.

You have nobody to blame but yourself. Don't make my job any harder than it already is by posting these claims to people who don't know nothing about what we do. Thank God this website gives us a chance to tell our side of the story. Aflac is the best career move I ever made and I am proud of my company.
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#21 Consumer Comment

I am an AFLAC District Sales Coordinator - not and employee

AUTHOR: Jeff - (U.S.A.)

I am deeply sorry that anyone who thought they were covered by a policy, find they are not. I am more sorry to hear that an Aflac associate may have not provided superior customer service.

I am extremely happy to represent a company that pays the highest claims in the industry. Aflac is the most ethical company I have ever known.

Aflac has over 40 million policyholders, and there are 44 negative reports on this website. That is unheard of in ANY industry.

With that said - I am sorry if anyone has been hurt, or did not understand a policy, there are always misunderstandings, and in times of distress we all want to blame someone.

As with anything people should read their policies, that would avoid some misunderstandings. And yes there are people who take out a policy knowing they have a condition that should exclude them, that is unfortunate but any insurance company ahs to protect themselves against that, it is called "adverse selection"

Aflac is a great company! I am proud to represent it.

Here is a recent article about Aflac

COLUMBUS, Ga., May 16 /PRNewswire/ -- Citizenship, transparency, innovation and reputation are some of the attributes that make Aflac one of the globe's most upstanding companies according to Ethisphere magazine's July issue featuring the World's Most Ethical Companies list.

Jeff Sock
Aflac
District Sales Coordinator
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#22 UPDATE Employee

FYI

AUTHOR: Jack - (U.S.A.)

To start, please let me say that a) I am an independent Aflac agent, and b) would like to share some information to the previous remarks on this site. I found this site simply by Googling "Aflac" because I wanted to verify some facts I wished to share with a family member and prospective agent. The comments on here surprised me, frankly. While the insurance industry as a whole has quite a bad reputation for dishonesty, I find Aflac refreshing in that they are up front about what they will cover and what they won't - and they pay, roughly $6 billion annually, in claims from the US and Japan. Obviously, if you have a pre-existing condition, your claim will not be paid, nor should you expect it to be paid.

To those of you who had these policies, but no longer have them, please be aware of the following: the policies are portable - this means that if you go from one employer to another who does not offer these benefits, call your agent and have them deducted from your bank account or credit card on a monthly basis. These policies belong to you, not your employer! If you cannot locate an agent close to you via the telephone directory, please visit the website and they can locate one for you. These benefits are much too beneficial to be without.

For those of you interested in working as an Aflac agent, I can only say good things about the company. They have been a pleasure to work for and with - I highly encourage you each to consider it objectively. Yes, unfortunately, there are claims that get denied. That is the nature of insurance as a whole, not just Aflac or supplemental insurance. However, you don't get to be a Fortune 500 company on Standard and Poor's, Moody's, and A.M. Best with Superior ratings by consistently "ripping off" the consumer.

Wishing you all the best!
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#23 Consumer Comment

I am also interested in a career with AFLAC insurance

AUTHOR: Greg - (U.S.A.)

I am currently an insurance agent but have a propert and casualty licesne, basically i deal with home and auto insurance mostly. lets say this was an auto policy and you used your vehicle as a delivery vehicle, but you failed to disclose that to the agent writing the policy and had an accident. The insurance company would begin an investigation and more than likely find out that you were using your vehicle for "commercial" use. Your claim would be denied under concealment. You failed to notify the agent that you used your vehicle for delivery. They would have written you under a commercial policy. Anyways back to your dilema, You probably failed to notify the AFLAC agent of you pre-existing medical condition. I'm sure if you would have notified him/or her they would have told you the truth up front. Also maybe your agent was avoiding your calls because agents are not trained to handle you claim and are not authorized to answer any questions. They can help try to get an adjuster on the line but cant tell you if and how much we are going to pay. I hate it when people call expecting me to know these things. I always provide them with a claim number and inform them if they have a claim PLEASE contact their adjuster for any questions. Although i dont mind helping if the ADJUSTER is avoiding the client then i will call his or supervisor and let them know whats going on. I am just on here because as someone else posted I am interested in a career with AFLAC and dont want to go with a campany that doesnt do what they say they are going to do. I am an insurance agent licensed to help with the needs of people, and enjoy helping them out. Thanks..
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#24 Consumer Comment

Response to Kenneth

AUTHOR: A - (U.S.A.)

I don't know if you'll be coming back to see this or not, but I thought I would respond to you. I too am looking into employment with Aflac. I have been a sub-producer at an Allstate office for over two years now. I always like to read about both the good and bad about a company. The bad helps me to see customer issues in hopes that I can be prepared to address my customers for similar situations.

The thing you must understand is that people are going to feel ripped off when something happens. Allstate "rips people off". State Farm "rips people off". Aflac "rips people off". I've talked to people who feel the whole insurance business is a ripoff.

Unfortunately for the original poster, they got caught in an unfortunate situation. What is either forgotten or not known is that states set up the regulations and the company tailors their policies accordingly. This is why I wish it wasn't referred to as a "loophole", at least not with a negative connotation. It was just unfortunate timing of when the policy started and when the initial diagnosis occurred. And like a previous responder said, things have gotten this strict due to frivolous claims be people in the past.

Just remember Kenneth that virtually every company has "ripped someone off" because you can't please everyone so be prepared to take the bad with the good wherever you work.
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#25 Consumer Comment

Pre-Existing Condition = Not Covered

AUTHOR: Angela - (U.S.A.)

I do NOT work for AFLAC nor do I personally have an AFLAC policy. My company offers AFLAC but I have never been one to purchase "extra" insurance. just my choice, not due to any bad experiences with insurance.

You have mentioned several times that anyone that finds this site must have a PROBLEM with AFLAC or they wouldn't be looking at the "rip-off" site. I found this site using GOOGLE and the search words "AFLAC Temporary Disability Insurance". The reason I searched this is due to a fellow employee that DOES have this coverage and has to have back surgery and she asked me to find a form she needed to complete. I went to this RIPOFF site just to see the comments, not because she has had a problem with AFLAC.

Anyway, I understand your frustration but I have NEVER seen ANY INSURANCE company pay a claim for a pre-existing condition. That's why they have you fill out pages and pages of medical history forms and sometimes require physicals.
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#26 Consumer Comment

Pre-Existing Condition = Not Covered

AUTHOR: Angela - (U.S.A.)

I do NOT work for AFLAC nor do I personally have an AFLAC policy. My company offers AFLAC but I have never been one to purchase "extra" insurance. just my choice, not due to any bad experiences with insurance.

You have mentioned several times that anyone that finds this site must have a PROBLEM with AFLAC or they wouldn't be looking at the "rip-off" site. I found this site using GOOGLE and the search words "AFLAC Temporary Disability Insurance". The reason I searched this is due to a fellow employee that DOES have this coverage and has to have back surgery and she asked me to find a form she needed to complete. I went to this RIPOFF site just to see the comments, not because she has had a problem with AFLAC.

Anyway, I understand your frustration but I have NEVER seen ANY INSURANCE company pay a claim for a pre-existing condition. That's why they have you fill out pages and pages of medical history forms and sometimes require physicals.
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#27 Consumer Comment

Pre-Existing Condition = Not Covered

AUTHOR: Angela - (U.S.A.)

I do NOT work for AFLAC nor do I personally have an AFLAC policy. My company offers AFLAC but I have never been one to purchase "extra" insurance. just my choice, not due to any bad experiences with insurance.

You have mentioned several times that anyone that finds this site must have a PROBLEM with AFLAC or they wouldn't be looking at the "rip-off" site. I found this site using GOOGLE and the search words "AFLAC Temporary Disability Insurance". The reason I searched this is due to a fellow employee that DOES have this coverage and has to have back surgery and she asked me to find a form she needed to complete. I went to this RIPOFF site just to see the comments, not because she has had a problem with AFLAC.

Anyway, I understand your frustration but I have NEVER seen ANY INSURANCE company pay a claim for a pre-existing condition. That's why they have you fill out pages and pages of medical history forms and sometimes require physicals.
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#28 Consumer Comment

Pre-Existing Condition = Not Covered

AUTHOR: Angela - (U.S.A.)

I do NOT work for AFLAC nor do I personally have an AFLAC policy. My company offers AFLAC but I have never been one to purchase "extra" insurance. just my choice, not due to any bad experiences with insurance.

You have mentioned several times that anyone that finds this site must have a PROBLEM with AFLAC or they wouldn't be looking at the "rip-off" site. I found this site using GOOGLE and the search words "AFLAC Temporary Disability Insurance". The reason I searched this is due to a fellow employee that DOES have this coverage and has to have back surgery and she asked me to find a form she needed to complete. I went to this RIPOFF site just to see the comments, not because she has had a problem with AFLAC.

Anyway, I understand your frustration but I have NEVER seen ANY INSURANCE company pay a claim for a pre-existing condition. That's why they have you fill out pages and pages of medical history forms and sometimes require physicals.
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#29 Consumer Comment

What's Up With That?

AUTHOR: Cory - (U.S.A.)

Noticed this alot lately. If a person doesn't agree with a person's post, the OP comes back with; what are you doing on this site or you must work for that company or don't you have anything better to do then rebut a post. The gal wanted to know how I could sit around and post all day. Hey, that's the advantage to owning your own company, you're your own boss, you can do whatever you want to, all day long. I enjoy reading these posts. I'm never too old to learn from other's mistakes. I learn to watch out for certain ripoff companies and it's great to find out they're some people who are dumber then I. This site has allowed me to not make mistakes others have made so I find it an invaluable learning tool. If you're gonna post here, be prepared for the consequences.
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#30 Consumer Suggestion

AFLAC is fantastic! never had a problem in 2 years with them.

AUTHOR: Steve [Not A Lawyer] - (U.S.A.)

This is a classic case of someone not reading and/or not understanding a simple contract.

At the time I was an AFLAC customer, it was clearly spelled out regarding PRE EXISTING conditions. NOT COVERED. Very simple language in the contract.

AFLAC used to send me unsolicited checks! Each year I got a "wellness check" for like $60 for whatever.

In my experience, AFLAC paid without a problem. And, no, I am in no way affiliated with AFLAC.

Just a satisfied prior customer. I left them when I changed jobs where it was not offered.
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#31 Consumer Comment

Darcey, take note...

AUTHOR: Ju - (U.S.A.)

Darcey,

I empathize with your customer service complaint. I have been down that road before, and I agree that poor CS can indeed infuriate all but the most saintly of individuals. If that had been your primary gripe initially, I would have been far more sympathetic to your situation. I don't doubt that this could happen--I have myself been frustrated when unable to get a human being on the phone when calling a company with a concern (see comment at bottom about Nationwide).

It's clear that you feel you were treated poorly by CS, which I'm sure added insult to what you saw was the original injury (being short of approved coverage by AFLAC by only a few days).

Before I go any further, though, I want to point out that I got to this website purely by chance, as a result of googling some questions I had about AFLAC and a couple of other insurance providers. The fact that I am on here, and got hooked into these particular postings, has nothing at all to do with whether or not I'm a satisfied or dissatisfied customer of AFLAC. Nor am I a "shill".

To make these assumptions about people who have responded to you reflects an overly paranoid and suspicious nature, as does your contention that ALL insurance companies are a ripoff. (I am a mental health professional and this is solely my personal interpretation of your postings).

Insurance companies are the way they are nowadays, due to the multi-billion dollar insurance fraud "business". Things were not always such in the insurance world, but sadly society has driven them down this path via fraud and excessive litigation. And, before you make one of your blanket ASSumptions that I work for an insurance company, the answer is no. I am no happier about how insurance companies do business than you are, but I do have the insight to understand (at least a little) why they do what they do. That doesn't mean I like it or feel that they are justified. It's just the way things are.

Re: the status of the decision by AFLAC--if you went to the doctor when the pain started, the pain (and therefore the condition) EXISTED at that time. A condition does not begin to exist at that point in time when a doctor eventually recognizes it. And prescribing pain medication is a treatment. So, you had the condition, and you were treated, before your insurance kicked in.

Aside from all this, you really should review the provisions for using this website, which state that solid, productive criticism, as opposed to trivial comments, are the objective for postings. It is clear that you are only using it to vent your rage in a cynical, sarcastic, and small-minded manner, not only at AFLAC but apparently at anyone who opposes your opinion.

You claimed recently that your main point of contention all along has been poor customer service rather than the original issue of coverage. However, your initial posting was NOT primarily relating to poor customer service, but rather to your position that you were in the right, and AFLAC was in the wrong to deny your claim.

I imagine it is clear to all who have read your tirades, that you are changing your tune since the majority of responses from people indicated that AFLAC was correct in establishing a pre-existing status for your condition. It is apparent that you are now stating that your primary concern was customer service, in an obvious attempt to save face after being "wrong" about AFLAC's decision.

Darcey, quit your whining, drop your overwhelming need to be "right", chalk it up to experience, don't waste any more valuable time on interoffice email threats or the like, knock that immense, disempowering chip off your shoulder, and just move on.

I was drawn to respond (who knows why?) but will not use my precious time again, not even to see if you respond to this, as I don't think any response you make will be any more insightful than your previous postings. I'm sure it will only amount to sarcastic rantings in which you intentionally misspell my name as a childish means of retaliation.

(By the way, I had a heck of a time once getting a Nationwide person on the phone when I had them for my auto/home policy. You just never know).

Jules
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#32 Consumer Comment

Prospective New AFLAC Agent

AUTHOR: Kenenth - (U.S.A.)

I am considering a career with AFLAC. I am searching this site because I was asked by my potential future employeer to find something negative about AFLAC. Hopefully, that explains why I am searching this site. From my understanding on the information that I read about the policies that AFLAC services, pre-existing conditions are not covered and there is a time frame for when those pre-existing conditions started. Where you told by an agent that this would be covered? Did you inform the agent that you were going to seek coverage/benefits for this injury? Again, I am just doing research to find out "bad things" about this company. I don't want to work for a company that is "ripping people off". I will add one more thing though. Answer this question, if you were in an auto accident and you had damage to your car and then went to open a new policy, would you claim the accident on your new policy?
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#33 Author of original report

Thanx for an intelligent response Aafes

AUTHOR: Darcey - (U.S.A.)

You are 100% correct. That's exactly the loophole Aflac is using. As I stated previously I have accepted the ruling but felt it necessary to point out the poor service offered by Aflac. I was a little upset at first since I felt and still feel the decision should be based on when the diagnosis is made. I would probably have abandoned this website by now if not for the ramblings of a few folks that just happened to come to the "rip-off report.com" by accident. These same folks also just happened to strongly support the insurance companies... But I digress.

As far as the "bureau" serving insurance companies I was told yesterday they are there to track people who abuse insurance claims and do not apply in my case. I have never had any other claim of this type. The "bureau" is in place to track people who take out insurance policies for the sole purpose of making a fraudulent claim and skipping before an investigation is complete (they usually use identity theft to operate) or they track people that constantly injure themselves (usually while shopping in a large retail chain store) and file a bogus claim with the hopes that a counter offer will be made to avoid the hassle. These are nuisance claims/lawsuits. These are the examples given to me yesterday. Again this does not apply in my case according to my new homeowner's agent. I maintain that the "bureau" referred to by Elane deals with fraud and not with some "big brother is watching you" data base that will "black ball" me when I go to change insurance companies. This bureau could care less what I say about Aflac or any other insurance company as implied by Elane. This particular bureau would only collect the data of a claim being filed and whether or not it was paid and then spit it back out when requested.


Elane, Elane, Elane your ability to totally misconstrue, misinterpret and misunderstand is to use your own word "Amazing". I guess you're not done amazing yourself yet. What does hurricane Katrina have to do with anything in this post? Are you just trying to cast out as much gibberish as possible to take attention away from your obvious inability to focus on the actual complaint?

I don't know why you can't understand that I came here to vent my frustration with "Aflac's extremely poor customer service". I don't agree with their decision on my claim but I understand the reasoning. You... for some unknown reason have muddied the issue with some mystic and cryptic reference to a "bureau" that is in place primarily to track insurance fraud. How does my claim, which has been denied, have anything to do with that entity? Are you implying that I committed some type of fraud by filing my claim? Are you implying that by my complaining about my shabby treatment by Aflac customer service that I will somehow be blackballed by every insurance company in the nation? Do realize how ridiculous your statements really are?

In answer to your statement about trying to get anyone to insure me I just switched homeowner's insurance yesterday for a better rate and no mystical "black flag" was raised. I asked the agent (through Nationwide, which is a nationally recognized company and much more credible than. ahem...Elane)) about the "bureau" referred to by you and Aafes and that is how I now know the Insurance Bureaus purpose. I thought he would enjoy reading this forum so I showed him the statements made by Elane. The agent said there would be no reason for him to consider the claim that may or not have been reported to the "bureau" you refer to so why would I care if they kept a record of claims filed?. I think it's a great idea after hearing how the "bureau helps prevent fraud and keeps my insurance rates down. In fact my lack of claims filed and my stellar credit rating saved me a great deal of money by switching companies. I do this every so often to make sure I am getting the best rates.

I am not loyal to one company but I am loyal to a company that gives good personal service, with a human face, that I can go to with any concerns or complaints that I might have. Aflac does not offer that service and for some reason you keep trying to cloud the main issue (really poor customer service by Aflac), with your wild references to pointless and unrelated side issues. I will not let your babble detract from my complaint.

I did not contract with Aflac for the sole purpose of collecting anything. It just turned out that I came within a matter of a few days of having a claim. If I contracted for the sole purpose of collecting money wouldn't I have just waited the extra month so there would not be an argument? If I were dishonest I could easily have worked around the loophole. But as usual I paid the price for being honest.

The decision by Aflac to deny my claim is all well and good and I have accepted that decision Elane. I will not however accept the poor service Elane. I will cancel my policy when open enrollment comes up in November Elane and I will also tell whoever will listen .about my experience with "Aflac's poor service" Elane. That is my right as both a consumer and an American Elane. Then everyone can read your silly prose Elane and decide for themselves who the "rube" is Elane. I doubt very seriously if Aflac wants any more help from you Elane.

So Elane you have served neither Aflac nor me with your inane and ridiculous responses. You have still not told us why you came here initially? I have stated on several occasions that I came here to vent my frustrations relating to dealing with an insurance company. Can't you just state your reason for your first visit here? On second thought .dont bother. It would probably make about as much sense as the post I had to correct for you.

So why don't you just let people like Brian and Aafes make intelligent and most importantly to the point posts Elane since you can't seem to focus. You don't understand much of anything judging from your illiterate responses Elane. It is not worth anyone's time or effort to decipher your responses Elane. I already spent a few minutes the other morning deciphering one of your postings for you Elane, I won't bother again.

In response to the insurance you currently have at your work. If Aflac is so much better why didn't you just decline the obviously inferior insurance that you now have in favor of the much superior Aflac? There, problem solved. I'm just sorry you were unable or incapable of figuring that out on your own. You could have had your favorite insurance and maintained your feelings of superiority at the same time.

So thanks again Elane for entertaining me for a few minutes. Please keep replying so the people I send here to read about my complaint against "Aflac's very poor service"...... will be entertained by you as well.
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#34 Consumer Comment

There is indeed a separate bureau

AUTHOR: Aafes - (U.S.A.)

There is, indeed, a separate bureau used by insurance companies to decide on underwriting health/life/disability insurance coverage. It is called the MIB Group (Medical Information Bureau) and has over 500 U.S. insurance companies contributing information to this database. An excerpt from their website:

"Organized in 1902, MIB's core fraud protection services protect insurers, policyholders and applicants from attempts to conceal or omit information material to the sound and equitable underwriting of life, health, disability, and long term care insurance."

The company, like credit reporting agencies, also allows a consumer to request a copy of their individual record once annually, without charge.

As for the pre-existing condition debate in this thread most insurance companies define a pre-existing condition as "a medical condition that existed before an insurance policy was effective. Depending on the policy, a preexisting condition may be defined based on when it originated, when symptoms first appeared, or when treatment was first sought.

The loophole they are using in the OP's case is that the symptoms first appeared prior to the policy being in effect and the actual diagnosis.
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#35 Consumer Suggestion

Darcy, You're completely wrong.

AUTHOR: Elaine - (U.S.A.)

You are completely and totally wrong about the insurance company data reporting centers. They are like - and I repeat - LIKE - credit bureaus. They keep data on all people who have insurance. Insurance companies DO check credit reports to see if you're statistically more likely to file claims. That's one of the ways they determine your rates and coverage.

What I'm talking about is a clearing house that maintains records on all your insurance claims. Let's say you have diabetes and have been treated as having such. You apply for life insurance through an insurance agency and deny ever having diabetes on their application. They'll find out that you've been lying, Darcy! Let's also say that you are a "slipper and faller" at grocery stores and have filed numerous claims with the stores in your area and other states as well. They keep track of that as well. And auto accidents. They are keeping track of your insurability, Darcy.

If you don't believe me, which I'm sure you won't...ask any insurance company. Go ahead. Get out the yellow pages and call some. Ask. The insurance company data collection agency could care less if you express your unhappiness with any company. That's not what they're in business for. Oh, by the way, just like with the credit bureaus, you are entitled to receive a copy of what they have on you. Go ahead and ask. Find out if you're insurable.

OK, now for the rest:

They are in business to make money. They need to maintain investments and pay off investors so they will invest more money because people do have claims. Do you think that Hurricane Katrina claims will not affect your homeowners/auto insurance rates because you don't live in the Gulf Coast south? How else will they pay for it? Go bankrupt and not pay anyone???

Insurance is not a game. You should not buy insurance with the sole purpose of collecting more than what you pay in. That's potential fraud. If that's your intent, the Virginia Department of Insurance would like to know more about you and your intentions.

As for addressing the issues: I did. Go back and read my first response. You just do not understand insurance. I understand that. Many people don't. But rules and regulations are there for a reason. Because you don't think their fair doesn't make them wrong or discriminatory. Sometimes they do make mistakes. They have rules and regulations for that too. It's called an appeal process. You can read about that in the insurance company's handbook.

I do know what I'm talking about. And I'm sure AFLAC would like to have me back. I have another company covering our short term disability at the company I work for now. Why pay for 2 insurances when one will do?

Elaine
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#36 Author of original report

You didn't answer any of my questions Elane.

AUTHOR: Darcey - (U.S.A.)

I'm disappointed Elane (yeah I know it was written just above this post but it didn't seem to help you did it?) by your short reply and most importantly by your failure to address the actual issue. I take it from your reply that you were only here to create an issue and not help people decide whether or not to contract with Aflac. That is the purpose of this forum after all.

I asked you some valid questions and you did not reply to any of them. You chose instead to make up some phantom "insurance credit reporting bureaus".

I'm not sure if you're trying to scare people that come to this site or what your motivation really is. I know that insurance companies occasionally send out a "soft hit" to an individuals credit report however the inquiry does not affect the score like an application for a loan would.

There is no separate bureau solely used by insurance companies to decide whether or not to offer coverage. Even if they did, my expressing displeasure for one paricular company would be the least of their concerns. All insurance companies care about is taking in money with the least amount of risk possible.

They are in business to take in money and keep it by any means possible. That is why they have clauses and restrictions. Why else would they exist? Do you really believe insurance companies primary purpose is to help their clients? The reality of the situation is that insurance companies exist to make money for their investors. If you invest in a company and they give your money away without a fight you would drop that company like a rock.

It's kind of like a game. We as clients try to make a claim and get some of our money back while the insurance company tries to keep the money for their investors.

I don't have a problem playing the game but I do have a problem with poor service which is what Aflac is becoming infamous for in this forum. Just read the 2 pages of complaints on this company and you will see the pattern.

If they (Aflac) don't wake up and put a human face on thier bureaucracy then people are going to stop contracting with them. When that happens the investors start bailing out due to lowered profits. Then the whole house of cards comes down and a lot of people are out of work.

I don't know what your motivation is for visiting this website and at this point I don't really care. You tried to snipe me for some reason and then couldn't back up your play. You'd have been much better off trying to address the issue... which is that you don't agree with me.

Just look back at Brian's post. He stated his case clearly and concisely and even offered a valid solution to my problem. He didn't agree with me but he didn't try to make me look like a rube either. He is probably very successful with Aflac and they need more people like him.

Bottom line if you don't know what you are talking about it's better to just be quiet. I'm sure at this point the folks at Aflac would just as soon have you....not go away mad.....just go way. Your kind of help they don't need.
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#37 Consumer Suggestion

Happy To Oblige, Darcy.

AUTHOR: Elaine - (U.S.A.)

I'm glad I made your day, Darcy. I wish you all the best in getting ANYONE to insure you. BTW, are you aware of the insurance credit reporting bureaus? I'd find out what was on that before you apply for any other insurance. Best wishes and better health. And congratulations for finding my spelling error. I'm amazed that I made one...and you're correct! I did misspell that. I'm amazed you found it! Good call, though!
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#38 Author of original report

I guess you must amaze yourself Elaine

AUTHOR: Darcey - (U.S.A.)

Well Elaine in your well thought out and grammatically correct response to my posting you forgot to do one critical thing....proof-read your own posting. This probably is not a critical step in most postings since no one is graded for their spelling or proper word usage here. However if you are going to make a statement referring specifically to spelling and grammar you might want to make sure you are, at the very least, using the correct word in a given situation.

Just in case you can't figure out what I am talking about the word you were searching for is "throw" not """through""". If you don't believe me look it up. I have even copied and pasted your response below so you don't have to go back and read your own posting. I used the triple quotations to highlight the pertinent portion of your post. For your information you spelled the word correctly you just didn't use it in the correct context.

"I also find - and this just blows my mind - that it is incredible the amount of people here that will """"through"""" good money after bad to 'trust' people who say they will lend money."

No, I do not go looking for certain companies because without fail, this website is always
"""to""" busy and boots me off when I search for a specific company.


"""I also am amazed at the amount of people here who couldn't write a properly worded and spelled sentence if their lives depended on it."""""

There, that should entertain you for a while.

Maybe you could go back """"through"""(this is the proper usage of the word)all of my posts and make corrections for me if you aren't """too""" (another example of proper word usage)busy. I know I must have made some mistakes.....but then again I never made a statement like you did about being amazed at people being "unable to write a properly worded and spelled sentence". But don't feel too bad as most people agree that spelling and grammar errors do not necessarily make a person "out of the ordinary stupid"(ahem).

Since you were a "human resources manager" you should know that you could have taken your wonderful Aflac policy with you anywhere. In my policy it clearly states that the plan is "Fully portable and you may choose to keep your policy regardless of job changes by continuing to pay premiums". You could have taken your precious Aflac with you to your new job and reaped all of the benefits. I'm sure they would have gladly accepted your money.

You are correct about this site being a good place to research businesses and that is why I keep replying to these posts. I intend to send as many people here as I possibly can to read the 2 pages of complaints relating to this company. But you never said what brought you to this site in the first place. Did you perceive that you were "ripped off" at some time?

Having health problems before contracting with Aflac is not the issue here. lots of people have had one problem or another and still contracted for insurance. The issue is the interpretation of the pre-existing condition clause. I maintain that the "diagnosis" of my condition "after" the policy took effect should stand. Aflac maintains the day I went to the primary care physician is the date that is pertinent to my policy. It is merely a matter of interpretation. The insurance company sees it their way obviously because they don't have to pay and I see it my way because I want to collect.

It's really rather simple when you look at it that way and I don't argue that point. However the "we didn't get" a fax 3 times in a row when I am holding the fax journal indicating successful completion in my hand.... and constant delays in making a decision (8 months).... along with the fact that no one person (auditor) is responsible for my claim.

Aflac makes it so they have no human face except for the agent that you buy the policy from. He/she can only do so much and then the final decisions are left up to some untouchable faceless person behind a screen of operators on a telephone line..... refusing to transfer you to a supervisor(leaving you on hold for 10 minutes at a time and then finally telling you that no supervisor is avilable and that they don't know when one will be back)...... or even give you a name of someone who is handling your claim. I don't think that is too much to ask.

Claims are denied all the time for one loophole or another as a matter of business. I can live with the fact that my claim was denied but I can't live with the poor service and not having a person to talk to about the dates in question. I might never agree with the person but I could accept the facts after having plead my case to them and being denied. I just want to get the word out there for all to see before they make a decision to contract with Aflac.

Anyway, thank you dear for writing and entertaining me this morning. I envy you a great deal since you have the rare ability to "AMAZE" yourself.
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#39 Author of original report

I guess you must amaze yourself Elaine

AUTHOR: Darcey - (U.S.A.)

Well Elaine in your well thought out and grammatically correct response to my posting you forgot to do one critical thing....proof-read your own posting. This probably is not a critical step in most postings since no one is graded for their spelling or proper word usage here. However if you are going to make a statement referring specifically to spelling and grammar you might want to make sure you are, at the very least, using the correct word in a given situation.

Just in case you can't figure out what I am talking about the word you were searching for is "throw" not """through""". If you don't believe me look it up. I have even copied and pasted your response below so you don't have to go back and read your own posting. I used the triple quotations to highlight the pertinent portion of your post. For your information you spelled the word correctly you just didn't use it in the correct context.

"I also find - and this just blows my mind - that it is incredible the amount of people here that will """"through"""" good money after bad to 'trust' people who say they will lend money."

No, I do not go looking for certain companies because without fail, this website is always
"""to""" busy and boots me off when I search for a specific company.


"""I also am amazed at the amount of people here who couldn't write a properly worded and spelled sentence if their lives depended on it."""""

There, that should entertain you for a while.

Maybe you could go back """"through"""(this is the proper usage of the word)all of my posts and make corrections for me if you aren't """too""" (another example of proper word usage)busy. I know I must have made some mistakes.....but then again I never made a statement like you did about being amazed at people being "unable to write a properly worded and spelled sentence". But don't feel too bad as most people agree that spelling and grammar errors do not necessarily make a person "out of the ordinary stupid"(ahem).

Since you were a "human resources manager" you should know that you could have taken your wonderful Aflac policy with you anywhere. In my policy it clearly states that the plan is "Fully portable and you may choose to keep your policy regardless of job changes by continuing to pay premiums". You could have taken your precious Aflac with you to your new job and reaped all of the benefits. I'm sure they would have gladly accepted your money.

You are correct about this site being a good place to research businesses and that is why I keep replying to these posts. I intend to send as many people here as I possibly can to read the 2 pages of complaints relating to this company. But you never said what brought you to this site in the first place. Did you perceive that you were "ripped off" at some time?

Having health problems before contracting with Aflac is not the issue here. lots of people have had one problem or another and still contracted for insurance. The issue is the interpretation of the pre-existing condition clause. I maintain that the "diagnosis" of my condition "after" the policy took effect should stand. Aflac maintains the day I went to the primary care physician is the date that is pertinent to my policy. It is merely a matter of interpretation. The insurance company sees it their way obviously because they don't have to pay and I see it my way because I want to collect.

It's really rather simple when you look at it that way and I don't argue that point. However the "we didn't get" a fax 3 times in a row when I am holding the fax journal indicating successful completion in my hand.... and constant delays in making a decision (8 months).... along with the fact that no one person (auditor) is responsible for my claim.

Aflac makes it so they have no human face except for the agent that you buy the policy from. He/she can only do so much and then the final decisions are left up to some untouchable faceless person behind a screen of operators on a telephone line..... refusing to transfer you to a supervisor(leaving you on hold for 10 minutes at a time and then finally telling you that no supervisor is avilable and that they don't know when one will be back)...... or even give you a name of someone who is handling your claim. I don't think that is too much to ask.

Claims are denied all the time for one loophole or another as a matter of business. I can live with the fact that my claim was denied but I can't live with the poor service and not having a person to talk to about the dates in question. I might never agree with the person but I could accept the facts after having plead my case to them and being denied. I just want to get the word out there for all to see before they make a decision to contract with Aflac.

Anyway, thank you dear for writing and entertaining me this morning. I envy you a great deal since you have the rare ability to "AMAZE" yourself.
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#40 Author of original report

I guess you must amaze yourself Elaine

AUTHOR: Darcey - (U.S.A.)

Well Elaine in your well thought out and grammatically correct response to my posting you forgot to do one critical thing....proof-read your own posting. This probably is not a critical step in most postings since no one is graded for their spelling or proper word usage here. However if you are going to make a statement referring specifically to spelling and grammar you might want to make sure you are, at the very least, using the correct word in a given situation.

Just in case you can't figure out what I am talking about the word you were searching for is "throw" not """through""". If you don't believe me look it up. I have even copied and pasted your response below so you don't have to go back and read your own posting. I used the triple quotations to highlight the pertinent portion of your post. For your information you spelled the word correctly you just didn't use it in the correct context.

"I also find - and this just blows my mind - that it is incredible the amount of people here that will """"through"""" good money after bad to 'trust' people who say they will lend money."

No, I do not go looking for certain companies because without fail, this website is always
"""to""" busy and boots me off when I search for a specific company.


"""I also am amazed at the amount of people here who couldn't write a properly worded and spelled sentence if their lives depended on it."""""

There, that should entertain you for a while.

Maybe you could go back """"through"""(this is the proper usage of the word)all of my posts and make corrections for me if you aren't """too""" (another example of proper word usage)busy. I know I must have made some mistakes.....but then again I never made a statement like you did about being amazed at people being "unable to write a properly worded and spelled sentence". But don't feel too bad as most people agree that spelling and grammar errors do not necessarily make a person "out of the ordinary stupid"(ahem).

Since you were a "human resources manager" you should know that you could have taken your wonderful Aflac policy with you anywhere. In my policy it clearly states that the plan is "Fully portable and you may choose to keep your policy regardless of job changes by continuing to pay premiums". You could have taken your precious Aflac with you to your new job and reaped all of the benefits. I'm sure they would have gladly accepted your money.

You are correct about this site being a good place to research businesses and that is why I keep replying to these posts. I intend to send as many people here as I possibly can to read the 2 pages of complaints relating to this company. But you never said what brought you to this site in the first place. Did you perceive that you were "ripped off" at some time?

Having health problems before contracting with Aflac is not the issue here. lots of people have had one problem or another and still contracted for insurance. The issue is the interpretation of the pre-existing condition clause. I maintain that the "diagnosis" of my condition "after" the policy took effect should stand. Aflac maintains the day I went to the primary care physician is the date that is pertinent to my policy. It is merely a matter of interpretation. The insurance company sees it their way obviously because they don't have to pay and I see it my way because I want to collect.

It's really rather simple when you look at it that way and I don't argue that point. However the "we didn't get" a fax 3 times in a row when I am holding the fax journal indicating successful completion in my hand.... and constant delays in making a decision (8 months).... along with the fact that no one person (auditor) is responsible for my claim.

Aflac makes it so they have no human face except for the agent that you buy the policy from. He/she can only do so much and then the final decisions are left up to some untouchable faceless person behind a screen of operators on a telephone line..... refusing to transfer you to a supervisor(leaving you on hold for 10 minutes at a time and then finally telling you that no supervisor is avilable and that they don't know when one will be back)...... or even give you a name of someone who is handling your claim. I don't think that is too much to ask.

Claims are denied all the time for one loophole or another as a matter of business. I can live with the fact that my claim was denied but I can't live with the poor service and not having a person to talk to about the dates in question. I might never agree with the person but I could accept the facts after having plead my case to them and being denied. I just want to get the word out there for all to see before they make a decision to contract with Aflac.

Anyway, thank you dear for writing and entertaining me this morning. I envy you a great deal since you have the rare ability to "AMAZE" yourself.
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#41 Author of original report

I guess you must amaze yourself Elaine

AUTHOR: Darcey - (U.S.A.)

Well Elaine in your well thought out and grammatically correct response to my posting you forgot to do one critical thing....proof-read your own posting. This probably is not a critical step in most postings since no one is graded for their spelling or proper word usage here. However if you are going to make a statement referring specifically to spelling and grammar you might want to make sure you are, at the very least, using the correct word in a given situation.

Just in case you can't figure out what I am talking about the word you were searching for is "throw" not """through""". If you don't believe me look it up. I have even copied and pasted your response below so you don't have to go back and read your own posting. I used the triple quotations to highlight the pertinent portion of your post. For your information you spelled the word correctly you just didn't use it in the correct context.

"I also find - and this just blows my mind - that it is incredible the amount of people here that will """"through"""" good money after bad to 'trust' people who say they will lend money."

No, I do not go looking for certain companies because without fail, this website is always
"""to""" busy and boots me off when I search for a specific company.


"""I also am amazed at the amount of people here who couldn't write a properly worded and spelled sentence if their lives depended on it."""""

There, that should entertain you for a while.

Maybe you could go back """"through"""(this is the proper usage of the word)all of my posts and make corrections for me if you aren't """too""" (another example of proper word usage)busy. I know I must have made some mistakes.....but then again I never made a statement like you did about being amazed at people being "unable to write a properly worded and spelled sentence". But don't feel too bad as most people agree that spelling and grammar errors do not necessarily make a person "out of the ordinary stupid"(ahem).

Since you were a "human resources manager" you should know that you could have taken your wonderful Aflac policy with you anywhere. In my policy it clearly states that the plan is "Fully portable and you may choose to keep your policy regardless of job changes by continuing to pay premiums". You could have taken your precious Aflac with you to your new job and reaped all of the benefits. I'm sure they would have gladly accepted your money.

You are correct about this site being a good place to research businesses and that is why I keep replying to these posts. I intend to send as many people here as I possibly can to read the 2 pages of complaints relating to this company. But you never said what brought you to this site in the first place. Did you perceive that you were "ripped off" at some time?

Having health problems before contracting with Aflac is not the issue here. lots of people have had one problem or another and still contracted for insurance. The issue is the interpretation of the pre-existing condition clause. I maintain that the "diagnosis" of my condition "after" the policy took effect should stand. Aflac maintains the day I went to the primary care physician is the date that is pertinent to my policy. It is merely a matter of interpretation. The insurance company sees it their way obviously because they don't have to pay and I see it my way because I want to collect.

It's really rather simple when you look at it that way and I don't argue that point. However the "we didn't get" a fax 3 times in a row when I am holding the fax journal indicating successful completion in my hand.... and constant delays in making a decision (8 months).... along with the fact that no one person (auditor) is responsible for my claim.

Aflac makes it so they have no human face except for the agent that you buy the policy from. He/she can only do so much and then the final decisions are left up to some untouchable faceless person behind a screen of operators on a telephone line..... refusing to transfer you to a supervisor(leaving you on hold for 10 minutes at a time and then finally telling you that no supervisor is avilable and that they don't know when one will be back)...... or even give you a name of someone who is handling your claim. I don't think that is too much to ask.

Claims are denied all the time for one loophole or another as a matter of business. I can live with the fact that my claim was denied but I can't live with the poor service and not having a person to talk to about the dates in question. I might never agree with the person but I could accept the facts after having plead my case to them and being denied. I just want to get the word out there for all to see before they make a decision to contract with Aflac.

Anyway, thank you dear for writing and entertaining me this morning. I envy you a great deal since you have the rare ability to "AMAZE" yourself.
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#42 Consumer Comment

Neither Love or Hate Aflac

AUTHOR: Jennifer - (U.S.A.)

Darcey I neither love or hate AFLAC. I've never done business with them at all. You don't have to hate a firm in order to make a comment on Rip Off Report.

Many people found this site while researching their own Rip Off and then stayed on it to comment, whether pro or con, on other reports. You can see when you make a rebuttal that some of the choices are Consumer Suggestion, Consumer Comment, Ex-Employee, Employee and so on.
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#43 Consumer Comment

Why I Read ROR

AUTHOR: Elaine - (U.S.A.)

I log in almost every day to ROR. I click on the link to list ALL the current reports. I go through and read the reports that either interest me (a company I may do business with), impact me (companies I have done business with) or something is so out of the ordinary stupid (either the company or the reporter. Ahem.) that I read it.

No, I do not go looking for certain companies because without fail, this website is always to busy and boots me off when I search for a specific company. I find this an interesting tool in researching businesses to deal with. I also find - and this just blows my mind - that it is incredible the amount of people here that will through good money after bad to 'trust' people who say they will lend money.

I also am amazed at the amount of people here who couldn't write a properly worded and spelled sentence if their lives depended on it. And I am amazed at the amount of paranoia on here by the posters who think that anyone posting against them MUST work for the company or has some 'in' which makes their response suspect.

As for your comments about being compared to a car, you started it, dear. You indicated you had health problems BEFORE you signed on to AFLAC. That makes you no better than the dented car analogy. As for health problems that come up after you're covered, THOSE would be covered, but that isn't the case here.

As for how I know AFLAC is good, I had them at one time, at a different employer. I never had to use them, but as the HR manager I saw some of my employees hurt and AFLAC helped them out tremendously.

Thanks for writing and entertaining me. Good luck!
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#44 Author of original report

What part don't you understand?

AUTHOR: Darcey - (U.S.A.)

First and foremost why are you here? How did you find this website? Were you on the web and decided to see who was badmouthing your favorite insurance company? I am seriously interested in your answer.

2nd your analogies are way off base. Are you seriously comparing a human being to a car? Are you seriously comparing a house to a human being? These are inanimate objects and easily inspected and diagnosed with pre-existing damage. A human being has internal systems that have been studied for hundreds of years and some are still not fully understood. I strongly resent being compared to a car or a house.

I will not reduce myself to questioning your "sense" as you have just done to me. I have not insulted anyone's "sense" during this whole affair and was actually under the impression that it was not allowed on this forum. I have pointed out peoples motivation for posting on this site but have not called anyone names or questioned their "sense". I do however feel as if I have now been insulted by you and hope that the moderators of this forum will take note.

My dents as you like to refer to my illness were not diagnosed until after the policy was in effect. I did not purchase insurance after a hurricane I purchased it during open enrollment which if you knew anything about such things (as you claim you don't) is only for a very short period during the year,one month. My ailment did not happen in the past it was not diagnosed or treated until after the policy took effect.If I had waited until February or March to seek treatment would Aflac have honored the contract if I admitted that my pain started in December? I think not.

How do you know how great a company Aflac is if you do not have their coverage? If your company does not offer this coverage why are you here?

I only hope that your employer offers this program to you as soon as possible. They need more money from folks like you.

In response to the last comment I can only hope that this company, that you have no affiliation with...... and are defending to the point that you are insulting me...... even though you do not have specific information relating to this case, doesn't stay in business long.

Lastly from me I sincerely would like to hear from you as to how you came to read this posting in the first place. I think all of us who have posted here would like to know how folks like you found this forum. If you are not affiliated with this company how did you end up here? As I stated before I came here as a disgruntled customer looking for an outlet to tell my story. I fully realize I will not benefit from venting here but it is therapeutic for me. I came here looking for others that had a bad experience with this company. What's your story?

If nothing had come back in the search for "Aflac rip-off I wouldn't even be here....how'd you end up here"?

I haven't insulted you so I expect the same courtesy in your reply.
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#45 Consumer Comment

I don't understand your sarcasm...

AUTHOR: Elaine - (U.S.A.)

If you had a beat up clunker car and got insurance on it, would you expect the insurance to fix all the dents that occurred prior to the implementation of the insurance plan?

That would be like trying to get homeowners insurance after Hurricane Katrina so the insurance company would be responsible to fix the damage. Come on, have some sense!

Besides sick leave, which is the cheapest and best disability insurance, AFLAC is a great company in case you are out of work and disabled for a period of time (determined by those who negotiated the plan with your human resources folks.) No, I don't work for them, and No, I don't have it. My company doesn't offer it, but if they did, I'd take it up. Insurance is protection for what happens in the future, not for what has happened in the past. If this and other companies covered "pre-existing conditions", they wouldn't be in business long.
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#46 Consumer Comment

Thanx for the warning

AUTHOR: Cyn - (U.S.A.)

Now I will be sure not to bother signing up for AFLAC. By the above definition, virtually anything could be considered "preexisting".
No need for a diagnosis or any real connection to the ultimate loss! If I saw a doctor for headaches a year ago, and then I am later diagnosed with something I need to stay out of work for, it's preexisting! What a joke.
Insurance companies are evil and will try to get out of paying any claim they can.
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#47 Author of original report

Thanx Jennifer

AUTHOR: Darcey - (U.S.A.)

For your heartfelt concern however our hospital system does not have any such IT policy at this time.There are certain prohibitions but none that will affect my intentions. I think after discussing this with the human resources director she is glad to have the information and has no problem with the disclosure of my experience to my fellow employees.

I have done my homework and even consulted an attorney in reference to what I can and can not say about my claim. As long as I am 100% truthful in my description of my experience and only include the facts of the case I am in no danger from Aflac.I considered an ad in the local paper but I've wasted enough money already. I can't afford cute little duck commercials.

Again I appreciate a satisfied customer coming to this "rip-off" website to look out for my best interests. I'm certainly glad you had the time to get on your computer and go randomly looking for a website called "rip-off report.com" and......... lo and behold............. you found a bad review of your favorite insurance company. How satisfied you must feel that you have had the opportunity to set this poor misguided sole straight. You must feel very lucky indeed.
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#48 Consumer Comment

E-Mails Not A Good Idea

AUTHOR: Jennifer - (U.S.A.)

Even though I was not going to rebut this again since you seem to think I'm an AFLAC shill I decided to give you a friendly piece of advice.

I realize that you think you were wronged by AFLAC and nothing is going to change your mind, however, you might want to reconsider sending an e-mail to 3000 of your fellow employees. You could just be opening the door to a bunch of diciplinary actions by your employer. Many firms have IT policies that forbid sending personal e-mails via the company e-mail system. Sending 3000 of them, telling your fellow employees of your "personal" opinion may violate this and they may consider each e-mail 1 offense and hit you with 3000 offenses. Not to mention what legal action AFLAC might be able to take. (I'm not sure if any)

Just some friendly advice from someone who has been a part of the process in creating IT policies.
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#49 Author of original report

Thanx Brian

AUTHOR: Darcey - (U.S.A.)

I appreciate your response and even the helpful suggestion. I do have to ask though....Does Aflac pay extra for damage control? I mean really, does this site have that much effect on sales that agents have to monitor and rebutt all of the complaints that people have towards this company?

Again I say nobody just happens upon this site to include Aflac agents. Happy people and representatives of honest companies don't need to go looking for a website that allows people to vent their bad experiences.

Anyway I just wanted to say that throughout this entire fiasco I have been totally up-front and honest with Aflac. I filled out the questionaire at cafeteria open enrollment with complete honesty. I had a previous surgery in 2003 for c5&c6, and when I informed my independant agent I was assured that the time restraints imposed by Aflac's pre-existing condition clause would not be a factor in November of 2005, when I filled out my application for short term disability.Aflac even went as far as to request my medical records from my primary care physician to confirm the fact that there was no treatment provided to me in the previous 12 months. I guess it was my mistake or misfortune depending on how you look at it to accept an appointment with a neurologist in late December due to a cancellation (I was initially set for late January).I went ahead and took the earlier appointment assuming it was related to the 2003 surgery which was well outside the pre-existing condition clause (loophole).In any event the diagnosis was made in Late January and it turned out to be totally unrelated to the 2003 surgery and if I had waited until the late January appointment the policy would have been in effect and I wouldn't be here typing this story(Or maybe I would just with a different complaint). I find it appalling that Aflac is denying my claim by looking back a matter of days. To me that is sneaky lawyer type practices.

I read the policy and my understanding of pre-existing within the last 12 months would be covered in my scenario since no diagnosois was made and no treatment was given. I have talked with my neurologist and the symptoms I displayed at the time, which are the main reason I sought medical treatment, may have been totally unrelated and the results of the MRI may have just been timely. Much like the person who goes to the ER for a broken arm and finds out through routine testing that they have cancer. But that is neither here nor there at this point since it would be one persons opinion (my Doctor) against anothers (Aflac who decides whether or not I get my money). So who's opinion do you think would win?

But I'm beating a dead horse here. We all know the result of this little battle of words and loopholes. I give-up Aflac, and all you fine people who come to rip-off websites to talk about how pleased you are with a company.

I will be returning to work in approximately one month. Coincidentally that is open enrollment and I can cancel my policy. Also I have prepared a document with this entire incident included and saved it to my thumb drive. I will take the document to work with me and attach it to an e-mail along with a link to this rip-off site (Nobody is going to find it without first being ripped-off). I then intend to send the e-mail to every person at the hospital (3,000 employees) so that they can decide for themselves if they want to enter into a contract with Aflac. I can't get my money but I can get some satisfaction and peace of mind knowing I saved somebody else from making the same mistake that I did.

To the people reading this trying to decide if you should contract with Aflac you can disregard every syllable that I have written but you can not disregard the 2 pages of complaints by cutomers and rebuttals by Aflac agents and representatives. So please choose wisely.

Lastly I want to thank Brian again since he actually represented himself as a company person and furthermore gave usable advice.
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#50 UPDATE Employee

How Did Aflac Fail You?

AUTHOR: Brian - (U.S.A.)

Hello! I am an independent agent with Aflac and if I understand the facts correctly, I don't see how Aflac did anything wrong here. Again, if you read your policy brochure it clearly states that pre-existing conditions are not covered for the first 12 months (it may be a different length of time in your state). Since your symptoms happened before the policy was in effect, it is called a pre-exisitng condition. That is the definition of a pre-existing condition. Also, Aflac has nothing to do with setting your open enrollemnt requirements. Those are set by the IRS for all Section 125 Cafeteria Plans. It short, this is what the IRS regulations state about open enrollment and Cafeteria Plan restrictions:

"What restrictions are placed on employees who participate in the Cafeteria Plan?
1. The medical insurance deduction taken on the cafeteria plan cannot be itemized on you personal
income tax return.

2. You must stay in the plan for the full plan year; this means you cannot cancel any covered insurance during the plan year except for a qualifying event, such as death, birth, marriage or divorce.

3. You must include all allowable insurance premiums in effect as deductions to calculate your tax savings."

So, I hope that helps you understand your situation a little bit better. I know you are frustrated with your situation, as anyone would be if they had something happen before their insurance coverage was in force. Just, please know that Aflac is only following the effective date of the policy and the IRS requirements on open enrollment.

One thing you might want to try is to have your agent write a letter to Aflac Headquarters on your behalf. If you signed for your policy in November, and didn't have the symptoms until December, you may have a persuasive point that you didn't have the problems when you signed the policy. That may persuade Aflac to decide in your favor, even though they have no legal obligation to pay your claim. I know it has happened before. Anyway, I think the only way you could get your claim paid is to get your agent working on your side and see what he/she can do. Please feel free to contact me if you have any questions. I hope this helps a little and that you get to feeling better.
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#51 Author of original report

Thanks Dino

AUTHOR: Darcey - (U.S.A.)

Thanks again for your observations Dino (I hope I got that right). Oh by the way you did not get my name correct. It is plainly printed at the end of my post...just as yours is.

Anyway, I will have to raise the BS flag on you on this one. Peope who are totally satisfied with service don't go surfing on a "rip-off" site. I would never even have found this site if I weren't disgruntled. Anyone with a grain of common sense will figure this one out. I didn't put "Aflac is great" in the search engine. I put in "Aflac ripoff" and got 2 pages of complaints on this company.

People reading this, just ask yourself, "Would I be here if I was a satisfied customer?"

I just wish I had done a little research before this experience. I would never have contracted with this company. This narrative is simply to discourage others from making the same mistake that I did. Aflac is a bad company plain and simple and anyone that contracts with them is in for some serious problems.

I'm just pointing out obvious facts and allowing honest folks to read and learn. I have nothing to gain at this point.

In reference to "easy cancellation" you are one of the following:
1. Seriously misinformed (you believed what Aflac representatives told you).
2. Guessing (since you have already had such a wonderful experience and would not know anything about cancellations because you would never consider doing so).
3. Being deceptive (which would confirm your affiliation with the company).
Open enrollment is the only opportunity you have to change insurance options. You can state otherwise since you do not represent yourself as a company spokesperson but you would be wrong.
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#52 Consumer Suggestion

Cancellation of AFLAC

AUTHOR: Dina - (U.S.A.)

FYI: Instructions on cancelling AFLAC are
1. Dont pay the next bill

That's how I cancelled, you are under no contract, sounds like maybe you had a problem with your payroll department at work!!
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#53 Consumer Comment

Dina is Right

AUTHOR: Jennifer - (U.S.A.)

If your symptoms started in December 2005 and your policy did not take effect until January 2006 it is considered a pre-existing condition and not covered. If you read your contract, I'm sure it's written there. They are not taking advantage of a loophole, they are enforcing the policy to the letter.

You might say, well it's only a month but where should they draw the line, a month, 6 months, a year?

And no, I don't work for Aflac or any insurance company, I just understand the simple concept of pre-existing conditions.
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#54 Consumer Comment

Dina is Right

AUTHOR: Jennifer - (U.S.A.)

If your symptoms started in December 2005 and your policy did not take effect until January 2006 it is considered a pre-existing condition and not covered. If you read your contract, I'm sure it's written there. They are not taking advantage of a loophole, they are enforcing the policy to the letter.

You might say, well it's only a month but where should they draw the line, a month, 6 months, a year?

And no, I don't work for Aflac or any insurance company, I just understand the simple concept of pre-existing conditions.
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#55 Consumer Comment

I undertsand your frustration

AUTHOR: Dina - (U.S.A.)

Darcy, (Hope I got that right)
No, I am not an employee, just an average family of four. I have never worked for any type of insurance agency and am not very skilled in understanding much of the policies. I agree that ALL insurance is a bit of a scam, I just wanted to get my point across that I was a happy AFLAC customer, and was surprised and amused by the results that WE achieved while under their policy. I feel passionate that they were what they presented themselves to be in my case!

One thing I noticed on this website is that commonly rebuttals are accused of being employees, I found that to be a common response, and I would have used the 'employee rebuttal' if that was the case- just accept that I did not have a bad expierience and that is the point I wanted to convey.

Yes, average citizens, read what you sign and be aware that insurance does not pay for prexisting conditions, not a loophole if it states it plainly in the policy. Sorry, that is just my opinion..
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#56 Author of original report

A good reason to not contract with AFLAC

AUTHOR: Darcey - (U.S.A.)

Thank you for solidifying my point.
Most honest people don't expect the insurance rip-off artists to use every loophole in the book to avoid payment.. I think this applies to the average citizen. That is why I posted this rip-off so that average citizens ( the majority of people in the country) won't get ripped-off by AFLAC. I realize AFLAC has used a loophole to avoid paying out money while greedily taking in an honest consumers money on the other end.

It is obvious that you are a shill of the AFLAC company doing damage control. You are probably employed by them solely for this purpose.

Otherwise honest folks, just trying to decide whether or not to enter into a contract with these charletains, might become discouraged.

The main point that honest hard working citizens need to get from this post is.. "Do I want to deal with a money grubbing, loophole seeking company like this, or do I want to just save my money myself and decide for myself whether or not I need my money after a medical emergency".

The runaround alone is enogh to discourage most honest folk.

Bottom line, I am out of luck. I just wanted other people with common sense to see exactly what happened to me and hopefully decide against AFLAC.

Insurance is plainly a scam and AFLAC is no different. They will gladly remove your money from your paycheck without any remorse or any loopholes(just try and cancel outside "open enrollment"), but when the time comes to pay any of your money back to you they will scrutinize every syllable of every report.

Insurance companies (AFLAC)are in business for one reason and one reason only, to take money into it's coffers. They are not in business to give any money back...without a fight.

So I say again...I am out of luck, but everyone please read my story and make an infrmed decision... and most definitely do not enter into any kind of contract with AFLAC.

I have nothing to gain from giving this advice but AFLAC and the shills they have employed to respond to these complaints have everything to gain....your money.
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#57 Consumer Comment

Sounds like AFLAC is right to me

AUTHOR: Dina - (U.S.A.)

Sorry to hear about the health problems you have been expieriencing. I know with most insurance policies, if you begin to be seen for a symptom that later turns into a condition before the coverage of the policy began, any insurance to my knoweledge would deny such a claim. That is a prexisting condition even if undiagnosed- that's just the way insurance works.It sounds quite legitimate to me. I am just writing this because I WAS a sattisfied customer and almost laugh at the things they did pay me and my family for on our accident policy, I recieved 2 checks the first year, then the 5 the next (and we're talking a stitch or two, a second time a previousl injured dislocated knee, etc.) we no longer have AFLAC because it is not carried at my husbands new employer but i must say I was a very satisfied customer, felt they were extremely helpful and willing to pay all of my claims, however minor they were(and some were VERY minor)..sorry, but it does'nt sound like they did anything wrong to you, in my opinion.
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