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not covering on accident

Complaint Rating:  100 % with 2 votes
100% 2
Contact information:
United States
So I get the run around which is the big piss off. I go to sleep one night wake up not knowing what was going on have spots in my arm which got infected swelled and I had to have surgery to get rid of the infection I was hospitalized. Get down to it first claim they say skin disorders are not covered. Talk to rep riley hicks she says well try spider bite in which I say I do not know what caused it she says well they may cover it so I go and have the doctors put possible spider bite deny again they do not cover spider bites or insects bees ect. So they review it deny again So I contact aflac phylis on here one of there claim reps calls me. And get this when I bought it I get a story of how poisin ivy is covered which is an alergy and skin condition which I got denied for. So this claim rep calls and tells me my doctor says it was a sickness well no it was not never had a fever or any signs of the flu my arm was effed up I am a collision tech/painter deal with solvents and dust. She tells me insects, aracnids, dust allergys, spring time allergies and so on are not covered they are a sickness. And I say well so is poisin ivy it is an allergic reaction to the oil on the leaf it is a skin condition and she tried to tell me that was different And when I said my doctor had no idea what the cause was as neither did I she hung up on me very effing professional. Sorry aflac poisin ivy is a allergic reaction which I for one am allergic to you said you cover any accident when I bought this policy and when I got hurt which I do not give a dam how it happened because I am not a needle junking or drug addict and never go to the doctor my doc even sent me a form seeing if I still wanted him to see me because I had not seen him in several years if that tells you how much I go this policy sounded good to me to cover the unexpected well it did not and now I am stuck with 1200 in deductables and out of pocket expenses merry christmas from aflac but hey they covered my disability on it a whopping 220 dollar check for 8 days off of work you do the math suppose to be 70 percent of my pay 11.50X 64X .70= yah not 220 actually 515.12 so they short me 295 plus 120 first doc visit 30 follow up 30 follow up 30 follw up and 3000 for hospitilization. Glad I had such great coverage thanks for having me under your wing instead of aflac you should be called ahfuk cause your coverage blows. Well it wasn't deemed an accident o.k. so I inflicted they damage and wanted to be off work for almost two weeks thats not what we said well yes you just did . Crock of crap check out these pics does this look like a illness.


Complaint comments Comments (3) Complaint country United States Complaint category Other


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A  8th of Sep, 2012 by    -1 Votes
And they open and close it again nice I canceled my policy the beginning of august and they charged me through september for a service that was not worth a ### and you have to get a lawyer to get them to pay out. I suggest anyone you gets a policy with them to give second thoughts. There is a guy at work been off since june cause of a motorcycle accident and low and behold he is having issues with these quacks. Read all the red lines and dont be convinced bye there heavinly grace circus act of how they will be there for you because in the long run you will spend more time and money running there paperwork around than you will receive. Go to hell aflac
N  14th of Nov, 2012 by    -1 Votes
I'm not saying that it is but that kind of looks like something my husband had a couple of years ago. MRSA, I viral type of staff infection. We thought it was a spider bite to begin with. He was admitted into the hospital almost two weeks for IV antibiotics and pain meds. Nothing the Drs gave him worked. He had so much infection he almost lost his left arm and had to have surgery. He was an electrician and plumber and had to crawl in and under tight, nasty places all the time. We were told by the Dr that he more than likely contracted the infection from his job. About 5 months before this he was laid off from a job he had worked at for over 15 years. Although he kept his accidental policy with Alflac and we decided to keep his short term disability policy he had but no way could we afford over $800.00 per month for cobra ins so needless to say he didn't have any medical coverage. We were told by the doctors that even though he had to have surgery he still needed to take an antibiotics to make sure it wouldn't come back. The cost of the meds he needed was a whopping $2, 800.00 for a 7 day supply!!! Thank goodness he had a great doctor that filled out the necessary paperwork and the pharmaceutical company gave him a voucher and he was able to get the medication. We filed a claim with Alflac and was turned down. They said it wasn't an accident. We then filed a disability claim and was turned down. We never gave up. Between all the paperwork the doctor had to fill out and after going back and forth with the insurance company, after 7 months they finally started to pay the claim. They had to give him 12 months of back pay and send a check for $2, 000 each month. If the policy states they will pay you 70% of your lost wages, they only paid you 20%. Unless you have a clause in your policy like most do that you must me out of work for 5 to 7 days and then that's when your 70% kicks in. If you make $11.50 per hour and you were out of work 8 days to equal 64 hours, $11.50 X 64 = $736.00. $736.00 X 70% = $515.20 but they only paid you $220.00 ($736.00 - $515.20 = $220.80) seems that they only paid you 30%. Sounds to me like they still owe you 40% more. Don't give up! That's what they are counting on. They will do anything to try to keep from paying your claim. You paid your premium each month and they owe you exactly what the policy states they pay!!!
A  1st of Feb, 2013 by    0 Votes
I agree but yah i gave up cause I was about to choke them through the phone and spent more time and yes I am a atuo body tech/auto painter. All I can say is aflac blows and if yah think about all the stupid ### they pay for in there dog and pony show they put on another guy at work went through the same load of ###. Anyway as long as people are stupid and pay for them these in case ### happens companys will carry on.

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