Here is the claim form that you need to fill out for your accident:  https://api.aflac.com/docs/claimforms/S_00198.pdf  Accident Claim

 

You will need your Policy # ___________________________

 

Please follow these steps:

1. Fill out Page 1 of 2 with your information and a description of the accident
2. Complete the questions on Page 2 of 2
3. Attach any applicable documents from the lists below
4. Fill out this form to authorize Aflac to have access to your medical records: https://api.aflac.com/docs/claimforms/S-00216.pdf
5. Send the above documents completed to Omnia Benefits if you would like our assistance -or- you may upload the documents yourself online via your SmartClaim account

Fax: 443-740-9214

Email: claims@OmniaBenefits.com

SmartClaim: https://phs.aflac.com/aflac.phs.app/account/login

 

If any of the following apply to your accident, please submit the corresponding document:

• MRI or CT Scan bill
• Ambulance bill
• Police Report for auto accident stating details of the accident in their entirety

 

If you went to the emergency room, please submit:

• ER Report (may be obtained from the medical records)
• Itemized Bill from the Hospital
• Discharge Summary

 

For any follow-up visits, please submit:

• Summary of Service for your visit
• Physical Therapy (PT) itemized bill for up to 10 visits