• Report: #908204

Complaint Review: AFLAC

  • Submitted: Sat, July 07, 2012
  • Updated: Tue, September 18, 2012

  • Reported By: Laney — Hubert North Carolina United States of America
AFLAC
1932 Wynnton Road Atlanta, Georgia United States of America

AFLAC AFLAC does not pay for injury claims as they advertise on tv! Atlanta, Georgia

*General Comment: Accident Claim

*Consumer Comment: Read your policy!

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As a current customer of AFLAC for almost 10 years I continue to be frustrated that they find every loop hole to not pay the admission benefit and the confinement benefit for a hospital stay due to an injury.  Three years ago, I had a hysterectomy which resulted in an injury to my intestine during surgery.  This injury was well documented on all of my records as well has causing me to be hospitalized for several weeks.  Since this injury occured during an "illness" procedure, they refused to pay.  If my intestine became injured from a stabbing from a "bad person", then they would have paid.  The injury and recovery would have been compared to a stabbing, but since it occured in a different setting, then I was declined receiving my benefits. Isn't if awful to think that if I was assualted then AFLAC would have paid.  For shame on AFLAC. 

 Well now AFLAC is once again giving me the run around for another injury claim.  I was injured from my lawn mower and was admitted to the hospital.  The CT scan showed an enlargement of my spleen.  Also, the CT scan happened to show inflammation in my colon.  Since this information is also being reported, now AFLAC says "no" to any additional benefits on my Accident Policy.  They only paid $120.00 for my Emergency Room visit.  I have given them every documentation available, to include CT scan report, Doctor's reports, detailed hospital bill (listing date of admission/discharge).  For as much as I have paid in premiums for the last 10 years for the Accident and Hospital Indemnity Policies, I think they could pay the $1,300.00 admission benefit and for two days of confinement. 

Once again, I am being penalized because AFLAC wants to find a way not to pay.  Lucky for them my CT scan reported something else that I was not aware of or would have gone to the Emergency Room for.

This report was posted on Ripoff Report on 07/07/2012 04:13 PM and is a permanent record located here: http://www.ripoffreport.com/r/AFLAC/Atlanta-Georgia-/AFLAC-AFLAC-does-not-pay-for-injury-claims-as-they-advertise-on-tv-Atlanta-Georgia-908204. 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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#1 General Comment

Accident Claim

AUTHOR: Momo - ()

The policy you have is an accident policy that pays for injuries due to an accident.  Aflac paid the claim correctly as the policy states, $120 for the emergency room visit.  It is unfortunate that you had other health issues, however these were illnesses and therefore Aflac cannot per the policy pay.  Your hospitalization was due to an illness.  I am very familiar with this policy and it pays you exactly as it promises.  Please read your policy and understand how to use it.  Don't blame Aflac for following the policy guidelines.  If you want coverage for hospitalization for any reason, then take a look at some of their Hospital policies.  

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#2 Consumer Comment

Read your policy!

AUTHOR: NoSoap - (USA)

I have the plan you are referring to.  It states, in 14 point font, that a visit to an ER after an injury pays $120.  Period.   Why are you mad because the company is sticking to the letter of the policy?

Also, this is an Accidental Injury plan.   The problems with your intestines are unfortunate, but they aren't related to the Injury you suffered.

There is a plan that would have paid for your confinement, no matter what.  It's called "Hospital Confinement" or something like that.  I know that it pays hundreds of dollars for ever night you spend in the hospital.

I don't think you were ripped off.I think instead, you found out that you had other medical issues when you got a CT scan for an injury.   And those "other medical issues" had nothing to do with the policy you put a claim in for.  Like I said, it is unfortunate, but NOT a ripoff. 

When you buy a policy, it is up to YOU to read it, carefully, and word-for-word.   Don't get mad at the company because you had some bad luck. 

Peace,

NOSoap.

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