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CONTINENTAL AMERICAN INSURANCE COMPANY Post Office Box 84075 * Columbus, GA. 31993 Phone (800)4333036 * Fax (8668492970) HOSPITAL INDEMNITY WELLNESS BENEFIT CLAIM FORM Failure to complete all section

How to fill out aflac hospital claim forms

How to fill out Aflac Hospital Indemnity Wellness Benefit Claim Form

1. Obtain the Aflac Hospital Indemnity Wellness Benefit Claim Form from the Aflac website or your employer.
2. Fill in your personal information including your name, address, and policy number at the top of the form.
3. Indicate the type of wellness benefit received, such as a health screening or preventive service.
4. Provide the date of the wellness procedure and the name of the healthcare provider.
5. Attach any necessary documentation or proof of the wellness service (receipts or invoices).
6. Review the completed form for accuracy and completeness.
7. Sign and date the claim form at the bottom.
8. Submit the form along with any attachments to the claims address provided by Aflac.

Who needs Aflac Hospital Indemnity Wellness Benefit Claim Form?

1. Individuals covered by an Aflac Hospital Indemnity policy who have undergone qualifying wellness procedures.
2. Policyholders who wish to claim benefits for health screenings or preventive care services.

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What is Aflac Hospital Indemnity Wellness Benefit Claim Form?

The Aflac Hospital Indemnity Wellness Benefit Claim Form is a document used by policyholders to claim benefits for hospital stays and wellness checks covered under their Aflac hospital indemnity insurance policy.

Who is required to file Aflac Hospital Indemnity Wellness Benefit Claim Form?

Policyholders who have received hospital services or wellness checks covered by their Aflac hospital indemnity plan are required to file this claim form to receive their benefits.

How to fill out Aflac Hospital Indemnity Wellness Benefit Claim Form?

To fill out the Aflac Hospital Indemnity Wellness Benefit Claim Form, policyholders should provide their personal information, details about the medical services received, the dates of service, and any other required information as specified on the form.

What is the purpose of Aflac Hospital Indemnity Wellness Benefit Claim Form?

The purpose of the Aflac Hospital Indemnity Wellness Benefit Claim Form is to facilitate the claims process for policyholders seeking reimbursement for eligible medical services and hospital stays covered by their policy.

What information must be reported on Aflac Hospital Indemnity Wellness Benefit Claim Form?

The information that must be reported on the Aflac Hospital Indemnity Wellness Benefit Claim Form includes the policyholder's name, policy number, details of services received, dates of treatment, and any other relevant medical information as requested.