Aflac - Denied Accident Claim
I injured my shoulder somehow, not exactly sure of accident date.But I started having problems with it in October 2016 and went to see an Orthopedic doctor in November (well within the 60 days for treatment rule by AFLAC).
The orthopedic doctor ordered an MRI which revealed a torn labrum which required surgery. I had the surgery with follow up physical therapy. I submitted the Accident Claim form via e-mail (along with the several other reports they require). For some reason they don't feel the need to correspond and say they received it.
I called in about 12 days after I submitted it and they told me the claim was denied because I did not have an exact date or pinpoint accident even though this happened and I started having trouble and received treatment within AFLAC's required time frame. When I spoke to the awful customer service rep, she told me I needed to file additional documentation (doctor's original consultation chart notes!!!!) which is not part of the required documentation for the claim to see if that helped them give the claim further consideration. She told me if that didn't work I could write an appeal letter which I plan to do if it continues to get denied. I've had this supplemental insurance since 2012 and have only filed 3 claims.
If this gets denied I will definitely terminate my policy through them.They should be ashamed of themselves for not only the way their customer service deals with the policy holder but additionally list ALL of the proper documentation required and for God sake's communicate with your policy holders because without their premium payments they would not have employment.
Reason of review: Poor customer service.
Monetary Loss: $2000.
Preferred solution: Let the company propose a solution.
I didn't like: No communication with policy holder about claim status.