Public Mediation

AFLAC Inc-Dispute-#1548150

K. S. vs. Aflac (American Family Life Assurance Co., Headquarters)
1932 Wynnton Rd, Columbus, Georgia, 31999-0001, United States
Amount Involved: $4,000.00
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Statement of Claim
Complaints Involved (3) - View
Claimant says:
"Back in Sept 2007 I purchased several policies from AFLAC. One of the was the top of the line hospitaliztion plan they offered. I thought I was doing a good thing for my family, since I was a single parent. Several years earlier I had been hospitalized and it caused a get deal of finanical stress on my family.

In March of 2012 I was hospitalized for chest pains at Altru Hospital in Grand Forks ND. I was admitted via the ER. I was assigned a room on a floor. I have trying to work with my AFLAC agent to get this issue resolved with no luck. The main headquarters in Atlanta GA. First they said I was not in the hospital long enough that it had to be 23 hrs. I had never received a copy of my policies until I started questioning things. The information I had been provide, did not say there was alloted time period that a person had to be admitted to the hospital before they would pay. My agent worked very hard to resolve the issues, however the main headquarters would not budge. They felt I was trying to commit fraud against them. If anyone was a victim of fraud here it would be me.

From the time I took out my policies with AFLAC I paid over $10,000 in premiums to cover myself and children. Now I am back in the position that I was trying to avoid when I took out the policies. It is causing me financial stress on me.

I had always heard that AFLAC was a good company and took care of their customers. I totally disagree with this. I realize that part of the problem is the current situation with health care in this country, but I do not feel like I'm asking the world of AFLAC to live up to what I had been promised, they would cover any amount of time that someone in my family was hospitalized.

Part of the problem is that Altru Hospital put me in the catagory of an "outpatient" even through I was admitted to their hospital. They are stating this due to defination of what observation is defind as by Medicare/Medicaid. I was a patient in that hospital on the cardic ward. I am not covered by Medicare/Medicaid. My health insurance is thru Blue Cross/Blue Shield of North Dakota.

I also plan on contacting the ND State Insurance Commisson Office on this situation."
...
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What Claimant Wants Hide
1. Payment due: Altru Hospital Bill Jul 16, 2012 $1,500.00
2. Refund: Partial refund of premiums that have been paid to AFLAC Jul 16, 2012 $2,500.00
3. Other – Pay for claim posting cost Jul 16, 2012 $7.95
Just make me happy!
Claimant invites AFLAC (American Family Life Assurance Co., Headquarters) to make a fair offer to resolve this complaint.
Cash total : $4,007.95
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Respondent's Counteroffer

There has been no response to this claim from AFLAC (American Family Life Assurance Co., Headquarters). This claim will remain posted until resolved
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