File A Claim.
File a claim.
AFLAC (Tier One).
Register your account myaccount.aflac.com to access and manage your coverage, submit and track claims, enroll in direct deposit for fast claim payment and more.
Click Here >> to download claim instructions for AFLAC accident & injury policy.
If you have an accident or injury and you have AFLAC Insurance policy you can go any licensed physician or facility to get care. You do not need to get them a copy of your policy, you will file a claim later on.
After your service get a copy of your medical bills and the summary of services that you received. For example a copy of the emergency room discharge paperwork and medical records from that visit. Preferred paperwork are forms = “CMS 1500”, or medical discharge form “UB04”.
Once you have that required claims information you can submit the claims through the AFLAC portal.
File a claim.
Independence American Insurance Company.
If you have an accident or injury and you have a Independence American Insurance policy you can go any licensed physician or facility to get care. You do not need to get them a copy of your policy, you will file a claim later on.
After your service get a copy of your medical bills and the summary of services that you received. For example a copy of the emergency room discharge paperwork and medical records from that visit. Preferred paperwork are forms = “CMS 1500”, or medical discharge form “UB04”.
Once you have that required claims information you will send a copy of it to the insurance company with the proper claim form.
Below is the claim form you can download. Don’t wait too long to submit this for reimbursement due to insurance company rules we usually suggest sending in the claim within 30 days of your injury or accident.
File a claim.
Washington National Insurance Company.
Click Here >> to download a claim form for the Washington National accident & injury program.
If you have an accident or injury and you have a Washington National Insurance policy you can go any licensed physician or facility to get care. You do not need to get them a copy of your policy, you will file a claim later on.
After your service get a copy of your medical bills and the summary of services that you received. For example a copy of the emergency room discharge paperwork and medical records from that visit. Preferred paperwork are forms = “CMS 1500”, or medical discharge form “UB04”.
Once you have that required claims information you will send a copy of it to the insurance company with the proper claim form.
Below is the claim form you can download. Don’t wait too long to submit this for reimbursement due to insurance company rules we usually suggest sending in the claim within 30 days of your injury or accident.
If you need have a Washington National Insurance policy and need to make changes to your address, billing information, or you need to change your beneficiary then you can use the below from to make those changes. Click Here >> to download a policy change form form Washington National Insurance.
If you need to change your banking information then you ca use this form: Click Here >> to download banking account change form. You can just fill out the attached form and send to health.customerservice@cnoinc.com (you don’t need to send in the voided check). Alternatively, you can send it to the fax listed on the document as well.
The general policy holder services number for Washington National is 800-541-2254.
File a claim.
National General Insurance (An Allstate Insurance Company).
Click Here >> to download a claim form for a National General Insurance accident & injury policy.
If you have an accident or injury and you have a National General Insurance policy you can go any licensed physician or facility to get care. You do not need to get them a copy of your policy, you will file a claim later on.
If you have a policy that also covers sickness (not just accidents) with National General then you can use this claim form Click Here >> to download National General - sickness claim form.
After your service get a copy of your medical bills and the summary of services that you received. For example a copy of the emergency room discharge paperwork and medical records from that visit. Preferred paperwork are forms = “CMS 1500”, or medical discharge form “UB04”.
Once you have that required claims information you will send a copy of it to the insurance company with the proper claim form.
File a claim.
Combined Insurance (A Chubb Company).
Click Here >> to download a claim form for Combined Insurance accident & injury policy.
If you have an accident or injury and you have Combined Insurance policy you can go any licensed physician or facility to get care. You do not need to get them a copy of your policy, you will file a claim later on.
After your service get a copy of your medical bills and the summary of services that you received. For example a copy of the emergency room discharge paperwork and medical records from that visit. Preferred paperwork are forms = “CMS 1500”, or medical discharge form “UB04”.
Once you have that required claims information you will send a copy of it to the insurance company with the proper claim form.
If your Combined Insurance policy includes the wellness benefit then you can get your $50 wellness credit by sending in the wellness claim form. Click here to download the wellness claim form to get the $50 rebate.
COMBINED INSURANCE CONTACT INFORMATION FOR POLICY HOLDERS:
Clients can call our Customer Service team toll free at 1-800-544-9382 with any questions regarding their policies
Clients can now view their account online and print forms such as claim forms and beneficiary change forms by logging in to the self-serve portal at www.combinedinsurance.com
Clients can now file a claim through our new TELE-CLAIM system by also calling our Customer Service toll free at 1-800-544-9382 and to simply follow the prompts given.