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Pays up to an additional 25% of the benefits payable for covered injuries that occur while participating in an organized sport.
May not be available in all states
Wellness Benefit paid for routine medical exams to encourage early detection and prevention.
May not be available in all states
We do everything possible to pay your claim fast, because expenses don’t wait and neither should you.
While playing in the state hockey playoffs, your child was injured and was taken into the ER by ambulance.
His leg is broken and surgery is performed.
Policyholder submits via Aflac SmartClaim® by 3pm and receives benefits in just a day.
Payable to: You
$5,570
weekly coverage as low as a box of adhesive bandages.8
Don’t wait until it’s too late. Help cover yourself and your family with coverage from Aflac.
† One Day PaySM is available for certain individual claims submitted online through the Aflac SmartClaim® process. Claims may be eligible for One Day Pay processing if submitted online through Aflac SmartClaim®, including all required documentation, by 3 p.m. ET. Documentation requirements vary by type of claim; please review requirements for your claim(s) carefully. Aflac SmartClaim® is available for claims on most individual Accident, Cancer, Hospital, Specified Health, and Intensive Care policies. Processing time is based on business days after all required documentation needed to render a decision is received and no further validation and/or research is required. Individual Company Statistic, 2019.
1Injury Facts, 2017 Edition, National Safety Council. Accessed October 4, 2017. http://www.nsc.org/learn/safety-knowledge/Pages/injury-facts.aspx.
2The above example is based on a scenario for the Aflac Accident Advantage – Option 3 that includes the following benefit conditions: Ambulance Benefit of $200 (ground ambulance transportation); Accident Treatment Benefit of $200 (hospital emergency room treatment with X-rays); Accident Specific- Sum Injuries Benefit of $1,750 (fractured leg {femur}–open reduction under anesthesia); Initial Accident Hospitalization Benefit of $1,000; Accident Hospital Confinement Benefit of $250 (hospitalized for 1 day); Major Diagnostic and Imaging Exams Benefit of $200 (CT scan); Appliances Benefit of $300 (wheelchair); Therapy Benefit of $315 (9 physical therapy treatments); Accident Follow-Up Treatment Benefit of $210 (6 follow-up treatments); Family Support Benefit of $20 (hospitalized for 1 day); Family Lodging Benefit of $125 (hospital and motel/hotel more than 50 miles from residence); and Organized Sporting Activity Benefit of $1,000.
ACCIDENT – A36000 series
In Arkansas, Policies A36100AR–A36400AR, & A363OFAR. In Idaho, Policies A36100ID–A36400ID, & A363OFID. In Oklahoma, Policies A36100OK– A36400OK, & A363OFOK. In Oregon, Policies A36100OR–A36400OR, & A363OFOR. In Pennsylvania, Policies A36100PA-A36400PA. In Texas, Policies A36100TX–A36400TX, & A363OFTX. This is a brief product overview only. Coverage may not be available in all states including but not limited to Virginia. Benefits/premium rates may vary based on plan selected. Optional riders are available at an additional cost. The policy has limitations and exclusions that may affect benefits payable. Refer to the policy for complete details, limitations, and exclusions. For costs and complete details of the coverage, please contact your local Aflac agent.
Limitations and Exclusions for residents of Arizona:
Aflac will not pay benefits for services rendered by you or a member of the Immediate Family of a Covered Person. For any benefit to be payable, the Injury, treatment, or loss must occur on or after the Effective Date of coverage and while coverage is in force.
Aflac will not pay benefits for treatment or loss due to Sickness including:
Aflac will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void. Aflac will not pay benefits whenever fraud is committed in making a claim under the coverage or any prior claim under any other Aflac coverage for which benefits were received that were not lawfully due and that fraudulently induced payment.
Aflac will not pay benefits for an Injury, treatment, or loss that is caused by or occurs as a result of a Covered Person's:
Limitations and Exclusions for residents of Idaho:
Aflac will not pay benefits for services rendered by you or a member of the Immediate Family of a Covered Person. For any benefit to be payable, the Injury, treatment, or loss must occur on or after the Effective Date of coverage and while coverage is in force.
Aflac will not pay benefits for an Injury, treatment, or loss that is caused by or occurs as a result of a Covered Person's:
Limitations and Exclusions for residents of New Jersey:
Aflac will not pay benefits for services rendered by you or a member of the Immediate Family of a Covered Person. For any benefit to be payable, the Injury, treatment, or loss must occur on or after the Effective Date of coverage and while coverage is in force. Aflac will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void. Aflac will not pay benefits whenever fraud is committed in making a claim under the coverage or any prior claim under any other Aflac coverage for which benefits were received that were not lawfully due and that fraudulently induced payment.
Aflac will not pay benefits for an Injury, treatment, or loss that is caused by or occurs as a result of a Covered Person's:
3 Treatment & Diagnosis: Broken leg diagnosis & Treatment: Treatment of pathological fractures of the long bones. Julie J. Willeumier, Yvette M. van der Linden, Michiel A.J. van de Sande,et al, 2016.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367617/.
Costs of diagnosis and treatment(s) are based on:
Transport - Ambulance Ride (1): $800.00
Source: http://health.costhelper.com/emergency-room.html.
ER - ER Visit (1): $1,575.00
Source: http://health.costhelper.com/emergency-room.html.
Diagnostic - X-Ray (1): $360.00
Source: http://health.costhelper.com/x-rays.html.
Treatment - Open reduction surgery (1): $4,389.00
Source: https://healthcarebluebook.com/page_ProcedureDetails.aspx?cftId=747&g=Lower+Leg+Fracture+Treatment.
Post-Treatment - Walking cast (1): $549.00
Source: https://healthcarebluebook.com/page_ProcedureDetails.aspx?cftId=345&g=Leg+(Walking+Cast).
Post-Treatment - Crutches (1 set): $227.50
Source: http://health.costhelper.com/crutches.html.
Wellness Maintenance - Physical Therapy (7 visits): $200.00
Source: http://health.costhelper.com/physical-therapist.html.
Total Cost: $9,300.00
4 The information provided in the Benefits Estimator is illustrative only. Plans may not be available in all states, and benefits may vary by state, coverage, and plan level selected. Policies have limitations and exclusions that may affect benefits payable. The Aflac payout values do not guarantee an amount to be paid for the listed conditions. Benefits paid by Aflac (if any) will depend on the severity of the accident or illness, the physician diagnosis, and the treatment received. The “Aflac Pays You” data is an average of historical payments made to Aflac policyholders/certificateholders who qualified for benefits under their specific plans and does not reflect instances when benefits were not paid for a particular claim. Whether benefits are payable will be determined when a claim is processed. You must be 18 or older to apply for Aflac insurance. Availability varies by product; see your local Aflac agent for details. The out-of-pocket expenses displayed are estimated at 40% of the total medical cost, assuming that average major medical plans cover approximately 60% of the expense. Your major medical coverage may be more or less, and if an individual or family incurs expenses for non-covered benefits, these out-of-pocket expenses may increase potential unexpected costs. You will also need to pay for any limits or exclusions on your benefits which may include the number of refills for certain drugs, visits to certain specialists, or days covered for certain benefits. View Data Sources to see our underlying sources.
5 Latest Smartphone costs are based on latest smartphone release, 10/17. This is how much the new iPhone will cost, Megan Rose Dickey, TechCrunch.com, September 12, 2017. https://techcrunch.com/2017/09/12/this-is-how-much-the-new-iphones-will-cost/.
6 Average Cost of a Coachella General Admission ticket. What it Really Costs to Attend Coachella 2017, Megan Leonhardt. April 6, 2017. http://time.com/money/4724712/cost-coachella-2017/.
7 Average Cost of a Cell Phone Bill. How to Cut the Average Cell Phone Bill by More than 80%. Howlifeworks.com, Updated September 22, 2017. http://www.howlifeworks.com/technology/cell_phone_savings.
8Assumes the average cost of a package of adhesive bandages is $5*. Comparison is based on the average weekly premium for Nebraska Payroll Premium rates for industry Class B, Accident Indemnity Advantage 24-hour accident essentials - Series A-35B24; Individual Age 18-70. Premiums may vary by coverage type, account, state of issue, and the election of additional/optional benefits.
*Source: cvs.com, 2017.
