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Dani
Life is about choices.
Member since 5/05 6532 total posts
Name:
Dani
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im so frustrated, upset, annoyed.. AFLAC
i was just denied my claim for disability while im out for maternity.
basically, my policy kicked in jan 1. you cannot be pregnant before that and qualify for the claim.
because my last menstrual period is listed as dec 29, they denied me.
i was NOT pregnant then! i am so upset. i was counting on that money.
my husband has put it into perspective for me. but im really annoyed and wonder if it's worth appealing. i dont even know who i could appeal it to with that argument.
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Posted 12/4/15 8:22 AM  |
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Long Island Weddings
Long Island's Largest Bridal Resource |
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Re: im so frustrated, upset, annoyed.. AFLAC
Appeal. Why wouldn't you? You have to fight for these things!
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| Posted 12/4/15 8:28 AM |
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StaceyWill
It's a girl!!!
Member since 6/10 21539 total posts
Name:
Stacey
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Re: im so frustrated, upset, annoyed.. AFLAC
Posted by Straightarrow
Appeal. Why wouldn't you? You have to fight for these things!
ITA
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| Posted 12/4/15 8:31 AM |
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Dani
Life is about choices.
Member since 5/05 6532 total posts
Name:
Dani
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Re: im so frustrated, upset, annoyed.. AFLAC
you're right!
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| Posted 12/4/15 8:38 AM |
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GoldenRod
10 years on LIF!
Member since 11/06 26792 total posts
Name:
Shawn
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Re: im so frustrated, upset, annoyed.. AFLAC
Argue that it's humanly impossible to ovulate two days after AF, and then start explaining how pregnancy works. 
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| Posted 12/4/15 8:53 AM |
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clotheshorse
LIF Adult
Member since 5/12 1294 total posts
Name:
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Re: im so frustrated, upset, annoyed.. AFLAC
Having your last period on 12/29 means you weren't pregnant yet. How could they deny your claim on a policy active as of 1/1?
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| Posted 12/4/15 8:54 AM |
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Dani
Life is about choices.
Member since 5/05 6532 total posts
Name:
Dani
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Re: im so frustrated, upset, annoyed.. AFLAC
they stand by the fact that it's calculated by your last menstrual period.. and that you can't have a due date less than 40 weeks after the start of your claim.
so i was due oct 5. oct 7 was the earliest i could be due to receive disabilitity.
but honestly, im going to fight it stating that i was indeed NOT pregnant and that i didn't even file the claim for it until AFTER the 40 weeks as well. i started disability in november.
and then im cancelling with them if they still deny it because that is horse$hit.
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| Posted 12/4/15 9:14 AM |
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clotheshorse
LIF Adult
Member since 5/12 1294 total posts
Name:
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Re: im so frustrated, upset, annoyed.. AFLAC
Posted by Dani
they stand by the fact that it's calculated by your last menstrual period.. and that you can't have a due date less than 40 weeks after the start of your claim.
so i was due oct 5. oct 7 was the earliest i could be due to receive disabilitity.
but honestly, im going to fight it stating that i was indeed NOT pregnant and that i didn't even file the claim for it until AFTER the 40 weeks as well. i started disability in november.
and then im cancelling with them if they still deny it because that is horse$hit.
Appeal most definitely. I still can't understand how it matters that your due date is less than 40 weeks after the claim goes in if you were indeed NOT pregnant before 1/1.
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| Posted 12/4/15 9:22 AM |
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Dani
Life is about choices.
Member since 5/05 6532 total posts
Name:
Dani
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Re: im so frustrated, upset, annoyed.. AFLAC
Posted by clotheshorse
Posted by Dani
they stand by the fact that it's calculated by your last menstrual period.. and that you can't have a due date less than 40 weeks after the start of your claim.
so i was due oct 5. oct 7 was the earliest i could be due to receive disabilitity.
but honestly, im going to fight it stating that i was indeed NOT pregnant and that i didn't even file the claim for it until AFTER the 40 weeks as well. i started disability in november.
and then im cancelling with them if they still deny it because that is horse$hit.
Appeal most definitely. I still can't understand how it matters that your due date is less than 40 weeks after the claim goes in if you were indeed NOT pregnant before 1/1.
exactly!
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| Posted 12/4/15 9:26 AM |
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Dani
Life is about choices.
Member since 5/05 6532 total posts
Name:
Dani
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Re: im so frustrated, upset, annoyed.. AFLAC
here's what the disclaimer says though... i dont think i have a shot..
Aflac will not pay benefits for a disability that is caused by or occurs as a result of your:
Pregnancy or childbirth within the first ten months of the Effective Date of coverage (Complications of Pregnancy will be covered to the same extent as a Sickness);
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| Posted 12/4/15 9:32 AM |
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JandJ1224
Member since 6/06 5911 total posts
Name:
Jannette
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Re: im so frustrated, upset, annoyed.. AFLAC
I remember when I had my first daughter I also didn't qualify for the AFLAC that I had been paying for, for that very reason. I don't remember the details but I was annoyed too.
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| Posted 12/4/15 9:53 AM |
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Pomegranate5
LIF Adult
Member since 2/11 4798 total posts
Name:
Pomegranate5
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Re: im so frustrated, upset, annoyed.. AFLAC
Posted by Dani
here's what the disclaimer says though... i dont think i have a shot..
Aflac will not pay benefits for a disability that is caused by or occurs as a result of your:
Pregnancy or childbirth within the first ten months of the Effective Date of coverage (Complications of Pregnancy will be covered to the same extent as a Sickness);
Hate to say this but Aflac is very strict about this clause and there is little to no chance that you would win an appeal. I'm sorry. Especially since you've been paying them for 10 months for nothing. 
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| Posted 12/4/15 9:58 AM |
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Pomegranate5
LIF Adult
Member since 2/11 4798 total posts
Name:
Pomegranate5
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Re: im so frustrated, upset, annoyed.. AFLAC
Posted by clotheshorse
Posted by Dani
they stand by the fact that it's calculated by your last menstrual period.. and that you can't have a due date less than 40 weeks after the start of your claim.
so i was due oct 5. oct 7 was the earliest i could be due to receive disabilitity.
but honestly, im going to fight it stating that i was indeed NOT pregnant and that i didn't even file the claim for it until AFTER the 40 weeks as well. i started disability in november.
and then im cancelling with them if they still deny it because that is horse$hit.
Appeal most definitely. I still can't understand how it matters that your due date is less than 40 weeks after the claim goes in if you were indeed NOT pregnant before 1/1.
Unfortunately, medically speaking she was considered pregnant as of the date of her last period.
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| Posted 12/4/15 10:00 AM |
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FTM427
LIF Adult
Member since 1/12 1261 total posts
Name:
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Re: im so frustrated, upset, annoyed.. AFLAC
Posted by Dani
here's what the disclaimer says though... i dont think i have a shot..
Aflac will not pay benefits for a disability that is caused by or occurs as a result of your:
Pregnancy or childbirth within the first ten months of the Effective Date of coverage (Complications of Pregnancy will be covered to the same extent as a Sickness);
This is ridiculous...what if you delivered 2 weeks early? Then they wouldnt cover you because you were within 10 months? I would definitely fight it, given that the difference between your date and the date they say you are eligible is basically 48 hours!
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| Posted 12/4/15 10:00 AM |
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ave1024
I Took The Wrong Road
Member since 12/07 6153 total posts
Name:
That Led To The Wrong Tendencies
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Re: im so frustrated, upset, annoyed.. AFLAC
Posted by FTM427
Posted by Dani
here's what the disclaimer says though... i dont think i have a shot..
Aflac will not pay benefits for a disability that is caused by or occurs as a result of your:
Pregnancy or childbirth within the first ten months of the Effective Date of coverage (Complications of Pregnancy will be covered to the same extent as a Sickness);
This is ridiculous...what if you delivered 2 weeks early? Then they wouldnt cover you because you were within 10 months? I would definitely fight it, given that the difference between your date and the date they say you are eligible is basically 48 hours!
This basically prevents people from signing up for Aflac when they know or know they are about to be pregnant. I am sure people who do this are probably not very profitable for Aflac so they are going to be super strict.
Honestly I am surprised it's a 10 month rule and not a 1 year rule which would avoid any confusion.
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| Posted 12/4/15 10:05 AM |
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Dani
Life is about choices.
Member since 5/05 6532 total posts
Name:
Dani
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Re: im so frustrated, upset, annoyed.. AFLAC
I actually signed up with them in November but because of their rules, I couldn't go into effect until January. And of course I signed up with them because my husband and I were trying. I'm so annoyed. I'm definitely cancelling them. I'll save the money I pay into it to be prepared for the next time I'm out of work.
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| Posted 12/4/15 10:29 AM |
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