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Hospital Confinement Indemnity Claims

To file a hospital confinement indemnity claim, please complete the appropriate claim form and follow the guidelines below:

  • Include an authorization signed and dated by the patient with every claim.
  • Send a copy of your hospital bill giving the number of days confined.
  • Your claim cannot be processed without the hospital bill.
  • Send a copy of the Physician's Statement (Form S-2029) with diagnosis, completed and signed by the physician.
  • Send a copy of a police accident report if your claim is a result of a motor vehicle accident.

Additional information may be required.

Insurance Claims for Hospital Confinement Indemnity | Aflac New York Insurance