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AFLAC - Rejected my claim!? What did I do wrong?

I have AFLAC policies, which I bought through a spa I was working for at the time, one of them being short-term disability. I recently had to put in a claim when I couldn't work for two weeks due to an injury. I just got a letter back today stating that they had rejected my claim due to the fact that I don't work 30 hours per week and am therefore not eligible for benefits. No massage therapist in their right mind works 30 hours a week - nor do some of my (former) coworkers, whom I know have made claims in the past and received their benefits.

What did I do wrong that mine got rejected? Was I not supposed to count straight hours of massage, even though that's how I was paid? There must be something that includes massage therapists, otherwise ABMP wouldn't advertise them. Or should I be as angry at my agent as I feel right now, for knowingly selling me a policy I can't actually use?

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Permalink Reply by Daniel Cohen on February 1, 2011 at 7:51am

Were you an employee or an independent contractor? You should have included all your prep time, travel time, required ceu class rime etc to accurately show the time you are paid for. Unless you are an employee on hourly pay.

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Permalink Reply by Kara Royall on February 2, 2011 at 12:51pm

Shirley Miscevich, District Coordinator for AFLAC, has contacted me and we are working to resolve this.

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Permalink Reply by Mary Heinz on February 3, 2011 at 12:45pm

Kara, I am the Member Benefits Mgr with ABMP/ASCP. Our AFLAC representative asked me to post this for her....

THank you,

Mary Heinz, RMT

Kara, I'd like to introduce myself. I am a District Coordinator for Aflac and work with ABMP/ASCP to provide AFLAC to members at discounted rates. I was contacted by ABMP this morning advising that you had had a claim denied due to hourly requirement. Please email me 1) where you work 2) you agent's name if you have it, and contact number as well.

I want to investigate your policy, claim, etc. to see if I can help you. I also want to speak with your agent to find out about the policy that was written for you.

I work with MANY ABMP members who have been VERY satisfied with AFLAC, and we have paid many large claims on members as well. I certainly want you to be satisfied with your decision to trust in Aflac. Thank you and I look forward to hearing from you.

Shirley Miscevich

District Sales Coordinator

Representative for ABMP/ASCP

10800 Farley, Suite 306

Overland Park, KS 66210

Cell: 913-375-0701

email: shirley_miscevich@us.aflac.com

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Permalink Reply by Relax & Rejuvenate on February 5, 2011 at 12:17pm

Looks like your mistake was listing the hours of massage as your work hours.

You can only qualify for AFLAC if you are an employee, since their policies can only be offered by employers and being an IC means you are not eligible for any benefits whatsoever.

Employers are required to keep time sheets for all hours an employee spends at their place of employment -- massaging or not -- so as to make sure they comply with the Wage/Hour requirements.