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Aflac

Aflac review: not paying / incompetence 14

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Author of the review
12:27 pm EDT
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I have had a heart attack and severe stroke. I have tried to collect on my aflac insurance policy for almost 2 months. All i keep getting is the run around. Like they need additional information all the time and keep putting this claim off. Even the hospital said there is not anymore medical records to be sent. They have sent aflac everything they possibly could. The stress from having to deal with aflac i believe the stress from dealing with aflac is gonna throw me into another possible heart attack or stroke. The whole reasoning behind me getting aflac was for exactly this reason that i should be covered. Now they are not wanting to pay out and i am endanger of loosing my home and vehicle that i have worked for my entire life which is very stressful to me. It is simply they do not want to pay!

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14 comments
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sean royer
, US
Jul 08, 2022 5:13 pm EDT

I had a partial nephrectomy due to a mass they found on my kidney and I filed a claim but they said since it wasn't found to be a spreading cancer tumor they don't cover that. I got aflac to cover situations like this. I got the accident and also critical illness and they wouldn't pay anything to me. I was hospitalized and had surgery to get it removed and was also out of work for 6 weeks to recover. I am very VERY disappointed in aflac. They make billions of dollars and won't pay out on a claim because it ended up being a very rare carcinoma that isn't one that spreads cancer.

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MaxFA
, US
Jun 16, 2021 12:08 pm EDT

Aflac is a horrible company... average wait time on the phone is around 1.5 hours. We couldn't reach them by phone last week and were forced to set an appointment time for a call back. That was Thursday and our first option was today, Wednesday the following week. They gave us the option of Tuesday on the recording (right, you never speak with real people), but when we asked for Tuesday they set it for Wednesday at 10:15 AM. It's currently 11:03 and still no call. I tried calling again, and once again it's over an hour wait time. My mom passed several months ago and we have been trying to stop the drafts, but it's virtually impossible to reach anyone with that company. Read all the reviews on all of the sites, not just this one.. they are consistently rated poor by customers AND people who work for them! A consistent poor record... and as I read the responses from their reps in the threads above, even these people are shooting back and arguing, and placing all the blame on the clients! Read the responses, sounds like they are trained to constantly respond to nothing but complaints, they sound extremely defensive! LOL... horrendous company!

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wlovejoy
st. martinville, US
Oct 17, 2014 6:45 pm EDT

First off my frustration with AFLAC started many years ago. My wife and I pay them alomost 2k a year. A few years back I had a Heat Stroke / Heat Exhaustion which nearly killed me. They though I had brain damage and a blood clot in my lungs as well. Took me over three months to recover and get back to work. We called them and they said it was not covered because they "viewed heat stroke as a diliberate act". Boy was I pissed. Fast forward to now. I got hurt and require surgery and will be out of work for up to a month. Call them back to submit claim. I was told I will get a $125.00 payout. That's a joke.

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C Steedley
Pittsburgh, US
Jul 29, 2013 9:43 pm EDT
Verified customer This comment was posted by a verified customer. Learn more

I have short term disability with Aflac and just have surgery in July I have been calling customer service every day since the 16th of July in regards to my claim. After ten days and three faxes from my doctors office they stated my claim was good and going to an auditor today I call and was informed that I am now waiting for my agent to give them info on my claim. The person I spoke to today said that since I went to my doctor last June in regards to having this surgery it is per existing but needless to say I have been paying for short term for two years now. I'm sure that your duck is being taken care of during his rehab my bills need payed and I'm not getting anything from your company I just my have to rethink my enrollment next year Cjs

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StopComplaining99
Cleveland, US
Mar 05, 2011 5:50 am EST

Meggs, I'm sorry for what you and your fiance is going through. I am not trying to sound rude but you are trashing the company but you are not giving any specific details. Alot of factors can affect a claim and policy. When did the policy go into effect? Initial disability claim forms has only one page for the employer and two pages for the physician. If there are further information needed other than date then they have to make sure there were no pre-existing conditions. The first thing you should do is read the policy very well. When a person signs up for a policy there are questions on the policy application that must be answered. The answers to these questions determine whether or not a person can be issued a policy. These questions and requirements on policy eligibility can differ from policy to policy and state to state. For example if the policy application asks if the person to be covered has been treated for diabetes in the last 12 months and the answer selected is no and then a policy is issued based on the information provided. Then when a claim is filed and the information indicates that the person was treated for diabetes then they have to request further information to make sure the policy was completed correctly. Once they get all the information needed they will pay if it is a valid claim. However, if medical records indicate the application was completed incorrectly, and if the questions had been answered correctly, it would not have been issued in the first place. If this happens then usually the policy will be canceled as if it was never issued and a full refund is given to the policyholder for all premiums paid minus any claims that were paid if any. How is this Aflac's fault because the policyholder did not answer the application correctly. When you sign up for a policy you should always listen carefully and make sure you understand the questions when you answer. Once a policy is issued and you get your copy you should READ YOUR POLICY! and it also usually has a copy of your application and you should read it carefully to make sure that it was answered correctly and that the agent marked the correct answers you told them. If you get a lawyer make sure you have a copy of your policy. If you go in front of a judge and the judge sees a copy of the policy, the policy application and the medical records he or she will want to know why you are wasting his or her time.

I'm not trying to be rude but I've noticed in several different business that most customer complaints are unwarranted! This includes myself. That is why anytime I have a complaint with any business, I always remain calm and polite. When you show people respect they are more willing to help with what they have the power to help with.

I've noticed with many businesses, most customers with legitimate complaints are usually more polite, understand and respectful. While most customers with invalid complaints are normally the loudest and rudest people ever. It is difficult to help people like that.

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Meggs
, US
Nov 12, 2010 2:32 am EST

my fiance was diagnose with a dibilitating disease and has an aflac poilcy he filed his claim in june '10, here we are in november '10 and still no decision on his disabilty claim. He has now been out of work for over 6 months. Aflac kept asking for more and more medical records, they all have been provided by ALL of his doctors. Now they just keep saying the poilcy is in review, and he should have an answer within a few days, they have been saying that since sept '10. Oh and i failed to mention that they are still with drawing over $100 out of his account each month, but if he cancels the policy then they will deny his claim! Aflac is awful, i will never recommend them to anyone! bills are going unpaid, credit is ruined, and savings is gone! next step is for us to get a lawyer!

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Shanna33
Houma, US
Feb 23, 2010 10:08 pm EST

WJE,
First I am very sorr for our loss and frustration. I have been with AFLAC for 11 years, if you would like I would be more that happy to help you. Typically one of the first things that AFLAC will need is the death certificate. Also, was there a will? My email address is canell_shanna@yahoo.com. I have no problem giving you a phone number to contact me, but I do not want to give it in this setting. I will need some more information in order to look into this for you. I help people everyday and I love what I do and I love AFLAC. I understand your frustration with this matter as I have gotten frustrated myself with situations involving a policyholder passing away, but ALFAC does have guidlines to follow and they have to follow certain laws. Now that being said it usually is easier for an agent to get things done, all of my clients know that I handle all of their claims myself, I do not want them to have to deal with headquarters, not because of problems, but when I sell a policy I sell a promise and my promise is to be here when they need me and to live up to what I told them. Servicing to me is what I get paid to do.

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Big EM
Ford City, US
Feb 17, 2010 5:28 pm EST

Aflac is the worst company I have ever dealt with because they will give you no other phone number than their customer service number. My brother-in-law passed away in October. A claim was filed with Aflac and it was paid promptly but, I believe, in error. I have read the policy multiple times and dispute the payment amount. I am the power of attorney for my sister, the widow, who is in a nursing home. There is no executor because the estate was too small to probate. The widow inherited everything. Aflac customer service reps will not discuss the claim with me at all because they don't understand what to do when there is no estate executor. I sent all of the information they requested, multiple times, and the customer service department sent it on to their legal department. It has been over two months. I call regularly. They will not give me a phone number for the legal department. They will not let me speak to the customer service supervisor. They will not respond to my letters. One morning my wife called and a customer service rep. told her he would speak to me but not her. That afternoon, when I called, I was told they couldn't discuss the policy with me because the legal department had not yet reviewed my POA.
(This is a very old policy and I can't locate the agent who may have passed.) If anyone has a name and phone number that I can call to get to a person who will check into my situation, I would appreciate getting it. WJE

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ppldisap20
, US
Feb 11, 2010 9:35 pm EST

I have been a purchaser of many products and services and know that the presentations give by sales reps sounds good but its up to the people the purchaser to read what they are signing and have knowledge of things before they purchase. Aflac pays claims everyday. They save houses and keep families afloat. There are so many great stories about Aflac but there are also some that did not understand the entirety of their policies in the beginning and therefore are having problems. There is no delay processing with claims if there are problems like stated above additional documentation is needed for the claim; there is a app that is to be completed with any insurance policy issuance. There is a section in policies that indicate everything and every issue that anyone above is having that will give you answers to your questions. If you were expecting disability and don't have a disability policy you won't be paid for disability, someone at Aflac can help you whether its getting the additional information needed for your claim or explaining your policy to you you just have to be willing to listen and understand that your complaint is probably not valid after reading the policy verbiage. I am living proof Aflac pays you just have to get the correct policies that apply for you and read and learn about that policy. And for the denied torn muscle the $145 is payment for your incident but you should read your policy and you will see and understand why you received the payment that you did. Your complaint was not justified. Aflac pays valid claims and per the policy language.

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spitfire1234
, US
Dec 08, 2009 7:18 am EST

Sorry, but there is more to your claim than you are letting on. If you truly had an injury, they would pay for the first visit and any other follow up visits up to a stated maximum number. If you want to be paid specifically for a torn muscle, I refer you to your policy language. It does NOT state that torn muscles qualify for a lump sum injury benefit. Also, you state you have been out of work for 2 weeks. The Accident policy is NOT a Disability policy; it doesn't pay you for days out of work; only for doctors visits, surgery and hospitalization. I'm sorry that you didn't read your policy after you bought it, but there is no scam here. Just someone who didn't bother to read what he had bought.

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GooderC
Portland, US
Mar 11, 2009 12:09 am EDT

I just for denied for the 2nd time from aflac.. I have Accidental insurance through my work with Aflac and I tore my calf muscle playing basket ball.. I was denied for anything other than the hospital visit and my follow up DR visit for a total of $145! they told me that they will not cover torn muscles unless they require surgery! Are you kidding me! I've been outta work for now 2 weeks and am going to lose my house if I don't get some sort of help, the help that I THOUGHT I was paying for!

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Jeff
,
Sep 18, 2008 2:47 pm EDT

I filed a claim with Aflac due to heart problems (fainting and dizzy spells). Dr has had me off work since July '08 and I have not received a penny from Aflac. When I call they tell me I'm only covered if I'm in the hospital. This is not what I was told when signed up for this crap that cost me $112 per month.

This is for Jason I had American Heritage and they covered and paid claims right away. In my eyes American Heritage is the better of the 2 that I've had. I wish I still had them, then I would not be stressed about losing my house and cars that I've worked so hard for. The reason Aflac is so big is that they spend all the money they should be paying to their insured on football trivia questions and advertising. Good companies let there reputasion speak for itself!

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Chad Marsh
,
Jul 13, 2008 4:36 pm EDT

AFLAC is not a reputable business in my opinion. At the beginning of 2008, I signed on with their daycare flex plan. They deduct $199 from each paycheck while I'm paying the daycare the same amount every two weeks. It takes AFLAC 10... that's TEN business days to reimburse that money. In the mean time, other bills go unpaid because of their slow reimbursement period. I know it doesn't take 10 business days to process a check. The only logical explanation is that they hold on to that money as long as they can to collect interest on what is surely a massive amount of money. In the meantime, my bills go unpaid. I am cancelling all of my AFLAC coverage as soon as possible. They are not a reputable business.

Chad Marsh

Little Rock, AR

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Jason
,
Jul 10, 2008 8:20 pm EDT

I am sorry to hear of your medical issues. Aflac is the number one supplemental insurance company in the world. They pay over 1 billion (that is billion ... with a "b") dollars in claims each year. They pay claims in a timely manner (usually 3-5 business days ... name another company that does that). Their claim forms are clearly marked as to what information is needed to review the claim. Additionally, most of the time that Aflac needs additional information is because of the time you are filing the claim. You failed to mention how long you had the policy. If you suffered a heart attack within the first year of the policy, Aflac (along with any other insurance company) is going to research your medical records to determine if a policy should have been issued in the first place. Lastly, if there are no more medical records to be gotten, all your physician or hospital needs to do is advise Aflac of this.