Aflac Calendar Year Confusion
I recently submitted a claim for a Wellness Benefit with a date of service in February 2025. However, Aflac denied my claim, stating that a Wellness Benefit had already been paid out in this calendar year.
The last benefit I received was for a service date in November 2024, which was last year.
I’m starting to wonder if my policy, which began in May 2015, operates on a May-to-April calendar year instead of the standard January-to-December.
Could they be mistaken in denying my claim?
It sounds like you’re facing a frustrating situation with your Aflac claim. Typically, “calendar year” refers to the January-to-December timeframe, but insurance policies can have specific terms regarding benefit payouts.
Given that your last Wellness Benefit was for a service in November 2024 and your new one is in February 2025, it would seem that there’s a strong argument for the claim to be valid if the previous benefit was indeed processed in the last calendar year (meaning the benefits year aligns with the typical January to December period).
However, if your policy has specific terms indicating that your benefit year runs from May to April (especially if the policy states it), then Aflac might be adhering to that. It’s important to check the exact language of your policy and any documentation related to wellness benefits.
I recommend reaching out to Aflac for clarification on their definition of the calendar year in your policy and citing your understanding based on your benefits timeline. If the denial seems unjustified, ask for a detailed explanation, and don’t hesitate to appeal the decision if necessary. Good luck!