Report: Aflac
Category: Health Insurance
Aflac lies, deceit, failure to pay, dishonest, ripoff, didn't pay great job of ADVERTISING how they're there for you when you're 'hurt and unable to work,' but the reality is that they're a bunch of liars who will find every possible loophole to avoid paying valid claims Columbus Georgia
*REBUTTAL Employee ..Your boss is in on it, too.
Aflac
Fax:
Columbus, Georgia, 31999
U.S.A.
Submitted: 2/19/2007 12:18:14 AM
Modified: 2/2/2008 9:02:25 AM
G
Los Angeles, CaliforniaAflac does a great job of ADVERTISING how they're there for you when you're 'hurt and unable to work,' but the reality is that they're a bunch of liars who will find every possible loophole to avoid paying valid claims. I found out firsthand.
After being injured while at work, I discovered that my Aflac short-term disability policy wouldn't pay [ostensibly due to the injury being covered by workers' comp]. Okay, I could live with that--although no one ever TOLD me when they were signing me up that on-the-job injuries were exempt. But after I suffered a second injury--before returning to work after the first one--they PROMISED to pay, but never did.
I already have a very long, detailed account of my saga on my web site, but I don't know if hyperlinks are allowed and/or will show up here, so I won't bother attempting to post its link. However, you can easily find it by using Google to search for 'aflac complaints.' I'm usually the first result!
The bottom line is this: Aflac repeatedly told me and my family that after workers' comp had stopped for my first injury I'd be able to receive benefits from them on the second. And they kept telling us that for 1-1/2 years, right up until the time we actually filed the claim. Then, out of the blue, they came up with a 'continuation clause' that precluded payment due to the fact that I hadn't returned to work between the two injuries.
Just to reiterate: They KNEW I hadn't returned to work during the entire time they led us on, and it was only when we filed the claim that they suddenly decided they couldn't pay.
I've gone around and around in circles with Aflac over this, and I'm now done with them as far as trying to work things out strictly between us. I've consulted an attorney and I understand we have solid legal ground to stand on. I'm considering a class-action lawsuit instead of an individual lawsuit, because the response to my web site's 'Aflac complaint page' has shown that there are MANY other people who've been screwed by this unscrupulous company.
In my opinion, Aflac sucks and should be avoided like the plague.
G
Los Angeles, California
U.S.A.
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Updates & Rebuttals:
- READ YOUR POLICY Pete [2/27/2007 12:42:21 AM]
- If it was so clear... G [3/4/2007 12:43:50 PM]
- I still think you're being unfair. Pete [3/5/2007 8:21:06 PM]
- ...and I don't! G [3/5/2007 9:40:46 PM]
- Good Point... Pete [3/6/2007 10:07:00 PM]
- Read your policy Jaysonlee [11/26/2007 5:21:27 PM]
- Your boss is in on it, too. Defendtruth [2/2/2008 5:23:58 AM]
READ YOUR POLICY
'G' has written quite a bit about her experience with AFLAC, not only on this site, but on others, including her own lengthy webpage. I would have to assume for purposes of this rebuttal that 'G' fully explained her circumstances to the AFLAC representatives she spoke to, and didn't misunderstand the information she was given. Assuming this, it DOES seem that some of the information she received was in error.
Her tale of multiple injuries and financial difficulties is a sad one. My heart goes out to her. I certainly hope that she is able to recover in both areas. I'm also sorry that she feels misled. However, I believe that the ultimate responsibility for her dissatisfaction lies with her, not with some AFLAC rep in Georgia.
'G' invested in AFLAC's Short-Term Disability Plan, the terms of which are detailed in a simple four page document, which she probably had the opportunity to read before she signed the policy. In any case, she would have received it within seven days of signing. In the first paragraph on page one of this simple policy, in bold print and capital letters appears the following: READ YOUR POLICY CAREFULLY!
'G' doesn't say whether or not she's actually read this four page document, which is far shorter than her entry on her website. It is more than fair to say that had she taken five minutes to read it, she would have understood EXACTLY what she was entitled to, and saved herself countless hours of phone calls and blogging, and upcoming legal fees. I am a bit surprised that somebody of 'G's' obvious intelligence and diligence wouldn't, FIRST and FOREMOST, simply read the agreement she signed to determine what her rights were.
Because she is in litigation over the matter, I would dare offer my opinion on whether she deserves to be paid on her disability claim. I'm sure that she could post the text of her policy, were she so inclined. However, the fact that I'm writing a rebuttal should give you an idea of what my opinion is.
AFLAC's benefits save peoples lives. I know this because I see it every day. AFLAC is number one in the voluntary benefits marketplace, paying more money in claims than the next ten companies COMBINED. While I hate to see somebody in her situation, the words and language that 'G' uses are inaccurate and unfair. AFLAC insures more than 40 million people worldwide, and it's an unfortunate but understandable fact that a few of those people may be unhappy with some aspect of their service.
READ YOUR POLICY CAREFULLY!
If it was so clear...
Sorry, but if it was a simple matter of 'reading the policy,' why did it take my agent--who's been at this for many years--and the supervisor at the claims department he spoke to, several days to research the answer? They were both stumped. They both admitted NEVER having seen a case like mine and, therefore, having no idea what to tell me. When they did respond, they said that the fact I had not returned to work after the first accident had NO BEARING on my ability to collect benefits on the second accident. None. That's what they said, that's what NUMEROUS people at Aflac said over the next 1-1/2 years...so if it is so clear, why were all of those Aflac EMPLOYEES--who are presumably experts in this field--so wrong?!
As for your other contentions, you're wrong. For example, there is NOTHING inaccurate or unfair about the words I use to describe my experience with Aflac--believe me, I'm not about to set myself up for charges of libel. And regarding Aflac 'saving lives,' etc., all I can say is that my logs of how people arrived at my site's 'Aflac complaint page' make VERY clear that there are lots of unhappy people out there. Lots of them. And I'm taking screenshots to prove it.
I still think you're being unfair.
G:
When I wrote that your words regarding Aflac were inaccurate and unfair, I was referring to your claim that the people at Aflac were 'a bunch of liars who will find every possible loophole to avoid paying valid claims.'
First of all, please understand me. I really do hope you get paid. If you should win a lawsuit, good for you! Maybe Aflac will change their mind and pay you what you think they owe you.
I know firsthand what it's like when there is no money coming in. It's the scariest thing in the world.
You were clearly given the run around. Maybe your agent wasn't on his game, or the claims department misunderstood you, despite the number of times you explained your situation. I would imagine that he or she didn't mislead you intentionally. I can assure you that it is far better for everyone, top to bottom in the company, that you get paid LOTS of money for your claim.
The agent, as well as the claims department should have informed you immediately that YOU DID NOT HAVE A VALID CLAIM. That is clearly written, not only in your policy, but on the brief sales brochure that you should have received when the agent visited your place of business. The following appears in the sales brochure:
'The benefit period will be restored for separate periods of disability that are due to unrelated causes, provided that you have returned to work and performed the material and substantial duties of a full-time job for at least 14 days.'
My original point was that Aflac didn't lie. They didn't just 'come up' with some obscure clause or loophole. Why did numerous people in Aflac tell you that your failure to return to work had no bearing on your claim? I have no way of knowing. If your agent didn't know, then his District Coordinator should have. This is basic stuff.
G, my experience is that the rare policyholder who is unsatified with their Aflac product falls into two categories: a.) People who are upset that they pay every week for a policy that they haven't used. Usually, it's a Cancer Indemnity Plan that they haven't gotten the chance to collect on (I'm not kidding). b.) People don't fully understand their coverage because they haven't thoroughly read their policies. In your case, it was made worse because of misinformation.
Had I been your agent, I would have told you immediately when you first contacted me that you were unlikely to collect.
G, what Aflac offers is truly fantastic. I'm sorry for the treatment you received from your representative. As Aflac employees, we are proud of the company we work for. As I said before, the experience that you are having is rare, despite the fact that you're able to find others who are unsatisfied.
...and I don't!
Pete, I appreciate your taking the time to comment.
It's interesting to note that the verbiage of the denials I received contradicts this quote of yours: 'The benefit period will be restored for separate periods of disability that are due to unrelated causes, provided that you have returned to work and performed the material and substantial duties of a full-time job for at least 14 days.' According to the denials I received, had I returned to work 'even for one day' between the two accidents, the second one would have been covered. Now, don't you find it curious that you THOUGHT it was so clear-cut, yet your own research completely contradicts what I was told? (And I'm NOT being sarcastic here.)
What I'm getting at is that this WAS a complicated, unusual situation which, as previously mentioned, caught everyone at Aflac who we had contact with off-guard. None of them knew the 'correct' answer until they researched it. Unfortunately for me, they all told me the WRONG 'correct answer' until I actually filed the claim.
Keep in mind that my first injury was ineligible for Aflac benefits because it occurred at work and was covered by workers' compensation. Maybe that accounts for the '1 day' vs. '14 day' discrepancy...or not. I really don't know! But that's the whole point--I'm not SUPPOSED to know this stuff, but Aflac *is*. And when the situation is so unusual and so complex that multiple people (agents, reps, supervisors, etc.) have to research it before issuing a 'definitive' answer, how on earth am I, a non-insurance professional, supposed to figure it out? THEY'RE the ones representing the company and the policy...so I believe the onus is on them to provide the correct answer.
Good Point...
G:
I agree with you on every point. It SHOULD have been as simple as that one paragraph, and yet it wasn't. I'd be totally pissed also.
Best of luck to you, G.
Read your policy
I have the same policy you do at the same company. The very first line of your policy states 'This Off-the-Job Accident Disability Rider ....'
This seems pretty clear to me.
Your boss is in on it, too.
Good luck in that class action suit. Be sure to have Aflac's call logs and recordings supenoed. Oh wait, privacy laws. I've been to their claims call center, they dot every i and cross every t, with security guards and everything.
What's wrong with those 40 million policy owners and 400,000 payrolled accounts, are they blind or just stupid? There in on it, too. They allow Aflac agents into their companies worldwide.
Wall Street and 50 state insurance commissioners are so gullible. Thank GAWD for the internet. The mighty duck will fall!
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