Claims

Not Sure How To File a Claim?

We can help! Call us at (888) 339-3593.

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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 (UB04, Copy of Police Report, Receipt for out-of-town travel, Hotel invoice. Itemized bills from physical therapy visits).

Here is a Claims Checklist to help!

Claims 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 Headquarters
1932 Wynnton Road,
Columbus, GA 31999

Fax:
(877) 442-3522

Website:
https://www.aflac.com/file-a-claim/default.aspx

Phone:
(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 Dept
PO Box 84075
Columbus, GA 31993

Website:
https://www.aflacgroupinsurance.com/

Email:
[email protected]

Phone:
1-800-433-3036

Assurity Coverage

Assurity Disability Claim Form
Assurity Accident Expense Form
Assurity Hospital Indemnity Form
Assurity Critical Illness Claim Form
Assurity Health Screening Claim Form

Send your claims to:

Address:
Post Office Box 82533
Lincoln, NE 68501-2533

Website:
https://www.assurity.com/customer-center#forms-library

Phone:
1-800-869-0355 ext 4484

Fax:
(800) 869-0368

Dental Source

Website:
http://fcldental.com/home

Address:
101 Parklane Boulevard, Suite 301
Sugar Land, TX 77478

Phone:
(877) 493-6282 or (281) 313-7150