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Report: #1321628

Complaint Review: Aflac - Nationwide

  • Submitted:
  • Updated:
  • Reported By: pg2381 — Murfreesboro Tennessee USA
  • Author Not Confirmed What's this?
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  • Aflac Nationwide USA

Aflac Aflac Insurance Hospital Indemnity Insurance Columbas Nationwide

*Author of original report: Resolved

*UPDATE Employee: Aflac Response

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BUYER BEWARE!!  Aflac insurance is a complete rip off.  I signed up in December 2015 for the Accident and Hospital Indemnity policies, Accident for obvious reasons, but hospital because my boyfriend and I were planning on marrying, and he has health issues.  Just a little background on me so you can understand my complaint better.  In June 2014 I started have the worst pain in my life.  It was like a migraine but 10x's worse.  I went to Vanderbilt Hospital and after CT scans, MRI's and an angiogram, I was diagnosed with RCVS.  Ever since my diagnosis for this disease, and prescribed proper medication, I've been fine.  Fast forward to March 2016.  I started having tenderness on the right side of my forehead and what felt like stabbing in my brain.  I go to my primary dr and tell her.  She refers me to a neurologist.  The neurologist sends me for a CT scan, the results come back abnormal.  He sends me for an MRI.  MRI results come back I have a skull based tumor.  The neurologist refers me to a neurosurgeon.  The neurosurgeon recommends removing the tumor asap because of how rapidly it's growing, and he knows this because he is based at Vanderbilt.  He looked up my imaging from 2014 and saw there were no signs of a tumor then.  May 2016 I have a craniectomy done.  The tumor is sent to the Pathologist for a biopsy.  

July 2016, I'm diagnosed with Langheran's Cell Hystiocytosis.  I file a claim on my hospital indemnity policy for being hospitalized for 4 days.  First I'm told Aflac has to have a copy of the UB04 form.  This form is the form the hospital sends to your actual medical insurance company for billing.  Nevermind that everything on the UB04 form is the same exact information that the hospital statement you get has.  That's their first stall tactic.  So I finally get those and send them in.  Then Aflac tells me I have to send them a copy of my medical records from Dec. 2014 till Dec. 2015.  The second stall tactic.  I get that paperwork and send that in.  I actually sent them till April of 2016, so they could see where I first complained to my dr in March about the stabbing pain and tenderness, and her referring me to a neurologist.  So after chasing all this paperwork around, they come back and say my claim is denied because it's a pre existing condition.  

Seriously??!!  So I call to speak to a rep, that tells me the same thing and I ask her who makes these decisions and she responds the "claim auditors".  My response is, what kind of education do the "auditors" have?  Do they have PHD's?  How many years did they study neurology and oncology?   They are trying to tell me I have walked around for 2 years with a tumor between my brain and skull.  Really?!  Nevermind the information I sent of my imaging from 2014, where no tumors were found.  Because I was diagnosed with RCVS in 2014, which caused me headaches, and complained of tenderness and head pain in March 2016, that we found out to be a tumor and a whole completely different disease, and neither of these diseases are remotely related, they are trying to say my surgery was due to a pre existing condition.  I'm not done fighting with them, but ultimately I feel like it's going to be a big fight, like probably getting a lawyer involved.  This insurance is a joke and the company is nothing but a rip off.  I will never recommend Aflac to anyone and will seek out anyone I can to warn them before wasting hard earned money on garbage.

This report was posted on Ripoff Report on 08/09/2016 04:44 PM and is a permanent record located here: https://www.ripoffreport.com/reports/aflac/nationwide/aflac-aflac-insurance-hospital-indemnity-insurance-columbas-nationwide-1321628. 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. Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content

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REBUTTALS & REPLIES:
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#2 Author of original report

Resolved

AUTHOR: - ()

POSTED: Thursday, August 18, 2016

Thank you Phyllis for your help.  Aflac has since contacted me and paid my claim out.

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#1 UPDATE Employee

Aflac Response

AUTHOR: AflacPhyllis - ()

POSTED: Wednesday, August 10, 2016

Hi pg2381,
I'm Aflac Phyllis, an Aflac worldwide headquarters employee here to help. Aflac's J. D. Power 2015 Certified Contact Center to look into this for you. Please email them at aflacservice@aflac.com so they can assist you. When you email them, please include the following in the subject line of your email: ripoffreport.com message from pg2381. Please copy the contents of your post from this website into the body of the email. 
Also, Aflac has established corporate privacy procedures in an effort to protect your identity and policy/claim information. Therefore, if your father is an Aflac policyholder, when you email us, please provide his full name and AT LEAST TWO of the following criteria: Policy number, Claim number, Claim Check number, Date of Birth, or Name of his employer. 
Thank you, 
Aflac Phyllis

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