How to file a claim
Find the form that fits your need below
Need your policy number? Just give us a call and we will be happy to help!
Gather the important documentation
Examples
Examples
- UB04
- Copy of Police Report
- Receipt for out of town travel
- Hotel invoice
- Itemized bill from physical therapy visits
Claim Forms
| Aflac traditional coverage |
|---|
| Accident Claim Form |
| Accident Wellness Benefit Claim Form |
| Cancer Claim Form |
| Cancer Wellness Benefit Claim Form |
| Hospital Claim Form |
| Physician's Benefit Claim Form |
| Aflac Short-term Disability Claim Form |
Send your claims to:Address:Aflac Worldwide Headquarters1932 Wynnton Road Columbus, GA 31999 Fax:1 877 442 3522Website:https://www.aflac.com/file-a-claim/default.aspxPhone:1-800-992-3522 |
| Aflac group coverage |
|---|
| Group Accident Claim Form |
| Group Accident Wellness Benefit Claim Form |
| Group Critical Illness Claim Form |
| Group Critical Illness Health Screening Form |
| Group Hospital Claim Form |
Send your claims to:Address:Aflac Group Claims DeptPO Box 84075 Columbus, GA 31993 Website:https://www.aflacgroupinsurance.com/Email:groupclaimfiling@aflac.com |
| Assurity coverage |
|---|
| Assurity Disability Claim Form |
| Assurity Accident Expense Form |
| Assurity Hospital Indemnity Form |
| Assurity Critical Illness Claim Form |
Send your claims to:Address:Post Office Box 82533Lincoln, NE 68501-2533 Website:https://www.assurity.com/customer-center#forms-libraryFax:1 800 869 0368 |
Dental Source
Website:
http://fcldental.com/homeAddress:
101 Parklane Boulevard,Suite 301
Sugar Land, TX, 77478
Phone:
1-877-493-6282or
281-313-7150