Report: #733717

Complaint Review: Aflac

  • Submitted: Thu, May 26, 2011
  • Updated: Fri, June 17, 2011
  • Reported By: mbcube — alta loma California United States of America
  • Aflac
    1932 Wynnton rd. Columbus, GA 31999
    Columbus, Georgia
    United States of America

Aflac Denies accident claim - took nearly 5 months! Columbus, Georgia

*Consumer Comment: Pffffuch Affflaaac

*Consumer Comment: Spot on, Linda.

*Consumer Comment: What is an Accident?

Show customers why they should trust your business over your competitors...

First - the accident:
After working a he**ish/stressful 13 hr day, I ran to catch the last train home and my defibrillator fired in the station  - 4 times. It was trying (and did) save my life. This was in Downtown LA. The hospital the paramedics took me to would not have been my first choice, but since my EKG was looking bad, they took me to the closest. I spent 3 days there, they reset my device (this was the first time it ever fired), and send me on my merry way.

The claim -
It wasn't until a few weeks later that I realized I should make an accident claim. After all, my policy say nothing about having an AICD (and should I have died, they'd likely have a much bigger claim!). Their denial letter states " according to the information received, the condition referenced above was not caused by an injury, therefore, benefits are not payable for this particular claim."

My policy says NOTHING about what CAUSES the accident. [continued below]....
..... They only list exclusion (like skydiving etc.).

On a side note - I should state that I'm so disgusted with Aflac and this incident. I had the hospital send the reports required 4 times (2 to Seattle, 2 to Georgia) Finally -  had them send it registered mail to Georgia. Aside from the last traceable time, they kept "not receiving" it. The hospital kept assuring me that they did send it. Now, considering what I know about Aflac and its treatment of policy holders, I know they just round filed it. And sadly the denial letter took them less than day after getting the paperwork. Head warning folks - if your dumb enough to deal with Aflac, be smart enough to document EVERYTHING. You & your lawyers will need it! 
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#1 Consumer Comment

Pffffuch Affflaaac

AUTHOR: mr rik - (USA)

70 Reports today...
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#2 Consumer Comment

Spot on, Linda.


It's amazing how people read between the lines, make their own "Professional" determination of the coverage and then go ballistic when they try to play attorney and claim "accident" for a medical condition.

Your analogy to "accidental pregnancy" is hilarious. :)  :)

If this incident is an "accident"  what is a Medical Emergency?  :(
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#3 Consumer Comment

What is an Accident?

AUTHOR: Linda - (United States of America)

OMG! You can't be serious.  An accident is anything from external that causes you harm. Anything from internal is an illness. I suppose your appendix bursting you would consider an accident or maybe  even an "accidental" pregnancy should be covered by an Accident policy?  Just because your heart malfunctions, doesn't mean your brain needs to.

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