Aflac Cancer Policy rep mis represented me on cancer effective date ripoff Columbus, Georgia
I was sold a cancer policy on May 14, 2006 for my husband and my self. My rep said that the policy comes in effect June 1st, and what ever we did, not to get dignose with any type cancer before June 1. June 10th my husband was admitted to the hospital (his first ever hospital admission) with fluid around his right lung. June 13th a catscan was done on the lower lung and part of his kindey was seen. the doctors seem something and did test that showed a tumor in the urithin tube blocking his right kidney and it was cancer.
I contacted my rep, who informed me that the policy had only been in effect 13 days and that there was a 30 grace period (which I was not told and had not received my booklets yet) once the policy came in effect.
I filled a claim Sept 28 2006 and they sent my husband a check for the wellness part of the policy. So we assumed they would pay on the cancer policy. Once my husband was released from the dr treating his lung problem we started going to the doctor for the tumor in Oct 06. Him being out of work for 4 months and with no health insurance made it hard to pay our bills with just my income.
Long story short- I have fought with Aflac for 8 months, contacted my state insurance commissioners office, called aflac constantly on my claim, my husband was refused a catscan at emory clinic due to not have $3,000.00 to pay for it,the tumor spreaded up the urithin tube and he just got out of the hospital Feb 16th from having to have his right kidney removed.
The day before my husband got out of the hospital a letter came from Aflac stating they denied the claim, I am filing an appeal and seeking legal actions for unfair claim practices and bad faith claims. They misrepresented me and there company, they misled me when I called for the status of the claim, was told several times that the policy would be paid once it was completed. they gave us false hopes and information.
Kathy
LaGrange, Georgia
U.S.A.
5 Updates & Rebuttals
Read-your-policy-then-sign
Phenix City,Alabama,
U.S.A.
Cancer Policy- Limitations & Exclusions
#6Consumer Suggestion
Thu, January 15, 2009
Firstly let me offer my condolences for the diagnosis and related complications which have impacted your family on both a monetary and emotional scale. Genuine compassion and the desire to help policy holders in their time of need exists and is embodied at Aflac.
An agent should never misle anyone for the sake of their own gain. Operating with integrity is the way to treat someone, whether or not they turn out to be a customer. I do hope that action is taken against the agents that mislead others regarding a product that is truly great. An elimination period (also called waiting period) of 30 days from the active date on the policy is clearly stated. Do keep in mind the date you sign up is not the active date for the policy.
If you had an appointment with your doctor on the 31st day of your policy being active and on that date a pathology test is conducted which is positive then the initial diagnosis will be paid. The exceptions are listed in "Part 2- Limitations and Exclusions" and include premalignant conditions just as an example. This is not including all of the specifics, however helps to give a generalized idea, of course sickness which is not related to cancer is not covered under such a policy. It does however offer the right to a refund of premium in this case.
Please, please, please always read the documents requiring your signature and then ask questions if you have any. When dealing with anything of magnitude and money be clear on the terms prior to signing. Hopefully this can be of assistance to someone.
Read-your-policy-then-sign
Phenix City,Alabama,
U.S.A.
Cancer Policy- Limitations & Exclusions
#6Consumer Suggestion
Thu, January 15, 2009
Firstly let me offer my condolences for the diagnosis and related complications which have impacted your family on both a monetary and emotional scale. Genuine compassion and the desire to help policy holders in their time of need exists and is embodied at Aflac.
An agent should never misle anyone for the sake of their own gain. Operating with integrity is the way to treat someone, whether or not they turn out to be a customer. I do hope that action is taken against the agents that mislead others regarding a product that is truly great. An elimination period (also called waiting period) of 30 days from the active date on the policy is clearly stated. Do keep in mind the date you sign up is not the active date for the policy.
If you had an appointment with your doctor on the 31st day of your policy being active and on that date a pathology test is conducted which is positive then the initial diagnosis will be paid. The exceptions are listed in "Part 2- Limitations and Exclusions" and include premalignant conditions just as an example. This is not including all of the specifics, however helps to give a generalized idea, of course sickness which is not related to cancer is not covered under such a policy. It does however offer the right to a refund of premium in this case.
Please, please, please always read the documents requiring your signature and then ask questions if you have any. When dealing with anything of magnitude and money be clear on the terms prior to signing. Hopefully this can be of assistance to someone.
Read-your-policy-then-sign
Phenix City,Alabama,
U.S.A.
Cancer Policy- Limitations & Exclusions
#6Consumer Suggestion
Thu, January 15, 2009
Firstly let me offer my condolences for the diagnosis and related complications which have impacted your family on both a monetary and emotional scale. Genuine compassion and the desire to help policy holders in their time of need exists and is embodied at Aflac.
An agent should never misle anyone for the sake of their own gain. Operating with integrity is the way to treat someone, whether or not they turn out to be a customer. I do hope that action is taken against the agents that mislead others regarding a product that is truly great. An elimination period (also called waiting period) of 30 days from the active date on the policy is clearly stated. Do keep in mind the date you sign up is not the active date for the policy.
If you had an appointment with your doctor on the 31st day of your policy being active and on that date a pathology test is conducted which is positive then the initial diagnosis will be paid. The exceptions are listed in "Part 2- Limitations and Exclusions" and include premalignant conditions just as an example. This is not including all of the specifics, however helps to give a generalized idea, of course sickness which is not related to cancer is not covered under such a policy. It does however offer the right to a refund of premium in this case.
Please, please, please always read the documents requiring your signature and then ask questions if you have any. When dealing with anything of magnitude and money be clear on the terms prior to signing. Hopefully this can be of assistance to someone.
Read-your-policy-then-sign
Phenix City,Alabama,
U.S.A.
Cancer Policy- Limitations & Exclusions
#6Consumer Suggestion
Thu, January 15, 2009
Firstly let me offer my condolences for the diagnosis and related complications which have impacted your family on both a monetary and emotional scale. Genuine compassion and the desire to help policy holders in their time of need exists and is embodied at Aflac.
An agent should never misle anyone for the sake of their own gain. Operating with integrity is the way to treat someone, whether or not they turn out to be a customer. I do hope that action is taken against the agents that mislead others regarding a product that is truly great. An elimination period (also called waiting period) of 30 days from the active date on the policy is clearly stated. Do keep in mind the date you sign up is not the active date for the policy.
If you had an appointment with your doctor on the 31st day of your policy being active and on that date a pathology test is conducted which is positive then the initial diagnosis will be paid. The exceptions are listed in "Part 2- Limitations and Exclusions" and include premalignant conditions just as an example. This is not including all of the specifics, however helps to give a generalized idea, of course sickness which is not related to cancer is not covered under such a policy. It does however offer the right to a refund of premium in this case.
Please, please, please always read the documents requiring your signature and then ask questions if you have any. When dealing with anything of magnitude and money be clear on the terms prior to signing. Hopefully this can be of assistance to someone.
Gary
Vancouver,Washington,
U.S.A.
Sales Associate
#6UPDATE Employee
Sat, April 21, 2007
I am sorry that you have had a bad experience with AFLAC. As a sales associate with AFLAC I hate to see this. My many years of experience shows that there are many good, honest and knowledgeable agents. Some of those honest agents are not very knowledgeable. A very few agents are actually dishonest.
That being said, if the agent told you to not get diagnosed before the effective date of your policy then he was wrong. Well, partly wrong. No policy with any company will pay before the effective date of a policy. The agent should have told you to wait 30 days AFTER the effective date. This 30 day period is used to avoid adverse risk, people who buy a policy today fearing they have something wrong with them. They go to the doctor tomorrow and their fear is confirmed. If there checkup comes back clean then they cancel the policy. Without this 30 day waiting period there would be higher rates for all insureds as there are many people who would take advantage of the system. Sad but true. I know from the details of your case, fluid around the lungs, that you do not fall into this category though.
To the specifics of your case, the 6 page Cancer brochure which you should have been shown AND given a copy of clearly states that "THis policy contains a 30 day waiting period.If a covered person has cancer diagnosed before coverage has been in place 30 days...... the benefits for treatment of that cancer will only ap[ply to treatment occurring after two years from the effective date of the policy."
The policy also states that if you are diagnosed in the first 30 days you can ask for your money back since benefits will not be paid for 2 years on that cancer. It is not much but at least you can be put back whole to the place you were had you never purchased an AFLAC policy. I am not sure if it is too late for this but you could try. If you plan on keeping the policy for future cancer problems, or for two years to cover future treatments of this cancer, then do not ask for a refund.
This information is not in the "small print" but is clearly defined.
Again, that being said, if you feel like you have a case of misrepresentation against an agent, after having given the agent, his managers, his manager's managers and the company a chance to satisfy you, you could always file a clain directly against the agent's Error's and Omissions policy. I doubt you would win because you have an obligation to read what is clearly detailed in what you buy. However, if you can PROVE you were given false promises by the agent, go ahead and try.
A long time friend of mine is going through cancer treatment now. She has AFLAC and swears by it. I am sorry that you are in the situation you are in, both physically and financially.
My prayers are with you and your husband for good health in the future.