Aflac Insurance Complaint

Aflac Fraud - Cancer Insurance

47
Helpful Votes
Posted By: BOOTER on 5/23/2008

Location: Portland , OR

I am 66 yrs of age,, and never before felt compelled to enter any type of complaint.

That cute little duck represents the largest ripoff company known to man. My deceased wife purchased a cancer policy two years prior to her diagnosis of colon cancer.

Everyone 'thinks' they have good insurance--until they have a claim.

If you are contemplating buying an Aflac policy (God forbid) before buying, pretend you have a claim--and call the so called 'claim hotline'. You will get a recording (eventually)--and they will send you a form to submit--During my wifes illness--we submitted 54 claims--NONE repeat None were honored in a routine manner.

Typically you will receive a form 'requesting more information'.Then they will request an explanation from your doctor. To further 'discourage' the policy holder--they break down the claims--(less than $200)--EACH separate claim--must of course be reviewed by your physician. Just what a harried doctor wishes to do--file 8 pages (average)--SO understandably--these forms tend to get buried in the 'IN FILE'.

AFLAC IS WELL AWARE OF THIS--and will go to any length--stall--more information required--anything but honor claim.

I REPEAT we filed 54 claims--not ONE was handled routinely. MY wife had many chemo treatments. These typically cost about 3-5 thousand each. If you take the time to read the 'very small print--you will see that several chemicals are excluded from your policy. The bottom line,, when you file for your claim--you will discover that your 'insurance' is good for an average of $250 on each treatment--in the meantime, the insured--and their loved ones are becoming 'stressed out'--Aflac is obviously aware of this--and the more paper work--the better.

Finally, I WENT TO OUR STATE INSURANCE COMMISSIONER--and we did eventually receive about $4,000 dollars.


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    Ghost of Doc J (05/23/2008)      
    First, my sincere condolences. The last thing cancer patients need is added worry whether their care is going to be covered by insurance they were 'told' would pay. The poster is 100% correct as to the fate of multi-page claim substantiation forms...they get (appropriately) shoved aside until time permits the Doc to fill out everything that was filled out on the HCFA-1500 (claim form). The insurance companies know this, and thereby slow up paying claims. Why? Because the longer a claim is unpaid, the longer the funds are held (earning interest) by the insurance company. Thank you, Art, for telling your story. Again, my deepest sympathy for yo ... more >>

    furnitureman (05/23/2008)      
    Sorry to hear that. I have Aflac and my 3 year old had a brain tumor. They paid within in a week on each claim I sent in. I never had any problems. Sorry to hear for your loss.

    Ghost of Doc J (05/24/2008)      
    Thank you, Art, (BOOTER) for visiting my page at my3cents. I welcome you to our little online community. My role here is identical to other folks here. We simply interact (and frequently disagree) about consumer issues. My 'mission'? I deplore health insurance companies and government administrated health programs. It is far past time that we allow patients and physicians to interact one-on-one, without having government or a money-grubbing insurance company in the exam room with us. I am deeply (truly!) saddened by stories like yours. From first-hand experience, I know that your wife's doctors were equally devastated by her death. The injury ... more >>

    gladgrad (06/18/2008)      
    I too am very sorry for your loss.
    Aflac is not primary health insurance, so if you were expecting 3-5 thousand dollars per chemo treatment, from Aflac.. that is not what Aflac does. That is the job of your primary medical insurance which you must have in order to even get an Aflac policy. What Aflac does is pay you cash so you can meet out of pocket expenses; i.e. co-pays and deductables, buy groceries, pay the PG&E or put it toward your rent or mortgage payments, however you see fit. If your agent couldn't help streamline the claim process for you, making it as easy as possible, I apologize... Did you ask your agent for assistance? You co ... more >>

    gladgrad (06/18/2008)      
    To Ghost of doc J

    My mother got lung cancer and was killed by the chemotherapy. Her doctor insisted she was strong enough, I disagreed. 10 days after her first round of chemo she died. Not from the cancer, but from the Chemo treatment. When my sister and I tried to contact him, our many phone calls went unanswered... we never did speak with him, that was 4 years ago. I don't think he was all that broken up by her death.. You cannot lump all doctors into the caring compassionate box nor can you lump all insurance companies in the catagory of money grubbing crimminals. If you sent a blood sample to the lab and it is mismarked...will you reci ... more >>

    Principissa (06/18/2008)      
    I am so sorry for your loss. I have lost my grandmother to breast cancer and my aunt Mary to lung cancer.
    We have Aflac through my husbands job. The two times we have had to use it due to work related injuries we've not had a problem. If you had the coverage as stated in your policy then they should have paid. You are absolutely right, it should not have taken as long as it did. The last thing that you and especially your wife needed was to be worrying about a claim that should be getting paid while receiving/dealing with a loved one undergoing chemotherapy. Stories like your wifes really break my heart. It shows me that the only thing the ... more >>

    spitfire123 (07/09/2008)      
    I am sorry you had this experience. Aflac is not intended to pay for your wife's chemo treatments....that is what health insurance is for. Rather it is supplemental insurance, to help you with bill, and other out of pocket expenses. You had an agent who originally signed you up; why didn't you contact that person and let them handle the claim? I have been an Aflac rep for 12 hears and I alway file all Cancer Claims myself. You could have also called the Regions or State Coordinator where you live (Aflac has many offices in all fifty states.) and they would have been glad to help you out. Aflac is a good company and I have many clients ... more >>

    Oklahoma5 (11/03/2008)      
    Sorry for your loss. The claims should not have been so difficult to do, that is why you have an agent.

    AFLAC WORKS!!!



    Grtcvg4u (12/02/2008)      
    My Father-in-Law, was diagnosed with Stage 4 Renal Cell Carcinoma in 2006. Although treated in a military hospital which normally no charge is incurred by the patient, he paid a $9.00 co-pay and with minimal documentation (pathology report, and 2 page claim form) he received his first check for nearly $10,000.00 for removal of his cancerous kidney and 2 day stay in ICU within a week of filing the claim. His cancer spread to his bones and eroded his hip socket causing the need for a hip replacement with a specialist out of town. Aflac paid for the ambulance ride, my Mother-in-Laws mileage, benefit for hotel stay and the surgery itself. He ... more >>

    abbie6 (02/15/2009)      
    YOU SHOULD GO DIRECTLY THROUGH YOUR AGENT TO FILE A CLAIM. THIS CLAIM WOULD HAVE BEEN PAID RIGHT AWAY AND YOU WOULD NOT HAVE HAD THE ISSUES YOU HAD. AN AGENT MAKES ALL THE DIFFERENCE. IF THEY DIDN'T PROMPTLY RETURN YOUR CALL OR HELP YOU YOU SHOULD HAVE CALLED YOUR STATE AFLAC OFFICE AND FILED A COMPLAINT AND SOMEONE WOULD HAVE GOTTEN BACK WITH YOU RIGHT AWAY AND ADDRESSSED THE PROBLEM!!!!!! AFLAC IS GREAT AND PAYS THOUSANDS TO CANCER PATIENTS-BUT JUST LIKE ANY INSURANCE COMPANY, IF YOU DONT' HAVE A GOOD AGENT IT CAN MAKE YOUR EXPERIENCE BAD.

    timjdd (06/15/2009)      
    Actually, Aflac does not coordinate benefits with other insurance companies, and a claimant does not have to wait until the primary insurance has paid anything (that very often takes several weeks if not months!) to the care provider. Aflac pays directly to the claimant, regardless of other insurance. A reputable agent will not sell supplemental policies to employees who have no primary insurance without fully explaining the concept of "supplemental" and giving the employee a reasonable expectation of potential costs of treatments compared to what benefits Aflac will likely pay. As a reputable agent myself, a potential client will have to ... more >>


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