Critical Illness Insurance Support

We're here to help! Get the support you need for critical illness insurance, from filing claims to understanding coverage, all in one place.

 

Jump to FAQs

Examples of What May Be Covered

 

Surviving a critical illness may come at a high price. Limited Benefit Critical Illness Insurance can help you prepare for expenses that may not be covered by traditional major medical insurance.

For a covered illness, you may receive a lump sum benefit for the following:

  • Heart attack
  • Coronary artery bypass surgery
  • Permanent paralysis resulting from a covered accident
  • Major organ failure
  • End stage renal failure
  • Permanent damage due to stroke

The health screening benefit pays a lump sum when a covered person receives a health screening test. Test include but are not limited to:

  • Blood test for triglycerides
  • Doppler ultrasound
  • Echocardiogram
  • Electrocardiogram
  • Serum cholesterol
  • Exercise or pharmacologic stress test
  • Neuroimaging studies

File a Critical Illness
Insurance Claim

The fastest way to file a critical illness insurance claim is through your online account or our mobile app, AFmobile®

Access your account 24/7 with AFmobile®

Manage your insurance benefits and reimbursement accounts on our mobile app, AFmobile!

TIP: To file a claim, you will need to provide medical records or office notes from the date you were first treated for symptoms associated with the illness to the present.

Learn what is required 

Frequently Asked Questions

  • Limited Benefit Critical Illness Insurance is designed to pay a benefit directly to you if you’re diagnosed with a covered life-altering illness. You may use this benefit to help pay for deductibles, copayments, everyday living expenses, or even lost income while you’re recovering.

    Covered illnesses/conditions may include:

    • Heart attack
    • Coronary artery bypass surgery
    • Permanent damage due to stroke
    • Permanent paralysis resulting from a covered accident
    • Major organ failure
    • End stage renal failure

     

    Learn more about critical illness insurance 

  • Benefits are paid directly to you, so you may use the money toward medical costs or daily living expenses as needed. 

  • A disease, accident, sickness, physical condition or mental illness for which a covered person has experienced any of the following: (a) treatment; (b) incurred expense; (c) took medication; (d) received care or services including diagnostic testing or related measures; or (e) received a diagnosis or advice from a physician, within the timeframe listed in the Schedule of Benefits.

    Log in to View Your Policy Details 

  • The fastest way to file a critical illness insurance claim is through your online account or our mobile app, AFmobile®.

  • When filing a critical illness insurance claim, you will need to provide the following documentation:

    • Statement of Insured, completed via online claim filing or paper claim form.
    • Attending Physician Statement: Complete the Statement of Insured on the first page, then have the physician in charge of your care complete the remaining pages. Upload the form via your online account, or mail or fax it.
    • Medical records or office notes from the date you were first treated for symptoms associated with the condition until the present date.

     

    We may also need:

  • The fastest way to file an infectious disease claim is through your online account or our mobile app, AFmobile®

    When filing an infectious disease claim you, will need to provide the following documentation:

    • Statement of Insured, completed via online claim filing or paper claim form.
    • Attending Physician Statement: Complete the Statement of Insured on the first page, then have the physician in charge of your care complete the remaining pages. Upload the form via your online account, or mail or fax it.
    • Medical records or office notes from the date you were first treated for symptoms associated with the condition until the present date.
    • If filing for occupational HIV/Hepatitis B, C, or D, you will also need to provide an incident report or notice of exposure.

    We may also need:

  • You can download and print a paper claim form herePlease note, paper claim filing is not the fastest option. File a claim online or through AFmobile to get your money faster.

  • Claims are generally processed within seven business days after all required documentation is submitted.

    However, your critical illness policy’s annual screening benefit may qualify for quick processing. When you submit your screening benefit claim online or through AFmobile, you can receive payment in as little as one day when enrolled in direct deposit, no extra documentation required.

    Learn more about AFQuickClaims® 

  • Yes. Benefits will not be paid for critical illnesses resulting from or caused by:

    • Self-inflicted injury or sickness
    • Suicide or attempted suicide
    • Intoxication or being under the influence of narcotics outside of physician care
    • Committing a felony
    • Being incarcerated in any type of penal institution
    • Diagnosis outside the United States
    • Participating in a riot, insurrection, rebellion, civil commotion, civil disobedience, or unlawful assembly

     

    These exclusions may vary.

    Log in to View Your Policy Details 

  • The fastest way to check the status of a claim is through your online account or our mobile app, AFmobile®.

    • Online
      1. Log in to your online account
      2. Click on the Claims tab
    • AFmobile
      1. From the AFmobile dashboard, scroll down to Insurance Claims
      2. Once a claim has been processed, find the status of the claim under the insurance policy name

  • Employee benefit amounts range from $10,000 to $30,000 and are payable in $10,000 increments. Children are covered at 25% of the employee benefit amount at no additional cost. Spousal coverage is available at 50% of the employee benefit amount at an additional cost. 

  • A document that details information about specific plan benefits. You can view your Schedule of Benefits in your policy document through your online account.

  • This benefit is payable for the Insured and spouse, if applicable, once per calendar year for annual health screening tests. Maximum of one covered test per calendar year. Qualified tests include:

    • Blood test for triglycerides
    • Doppler ultrasound
    • Echocardiogram
    • Electrocardiogram (EKG)
    • Serum cholesterol test to determine HDL and LDL levels
    • Exercise or Pharmacologic stress test
    • Neuroimaging studies
  • If a covered person receives a recurrent diagnosis or second occurrence date for a covered critical illness, for which the Critical Illness Benefit has been paid, we will pay an additional benefit equal to 50% of the benefit amount purchased. 

    The first occurrence date and the recurrent diagnosis must:

    • Occur while the policy is in force and
    • Be separated by at least 180 days

    Recurrent Diagnosis Benefit will be payable only for the following:

    • Heart attack
    • Permanent damage due to a stroke 
    • Major organ failure
  • A benefit will be paid following a Heart Attack (Acute Myocardial Infarction) due to Coronary Artery disease resulting in death of a portion of the heart muscle.

    A heart attack is not congestive heart failure, atherosclerotic heart disease, angina, cardiac arrest, or any other dysfunction of the cardiovascular system.

  • A benefit will be paid for open heart surgery performed by a Physician to correct Coronary Artery Disease with bypass grafts. Coronary Artery Bypass Surgery does not include balloon angioplasty, laser angioplasty, stenting, valve replacement surgery, or procedures other than Coronary Artery Bypass Surgery. Payment for Coronary Artery Bypass will reduce the Heart Attack Benefit. No benefit will be payable if the Heart Attack Benefit has been paid.

  • A benefit will be paid for permanent damage due to a stroke. A stroke is defined as permanent neurological damage to the brain which results from an acute or sub-acute interruption of blood flow to brain tissue, including infarction of brain tissue due to blood flow to the brain tissue, including infarction of brain tissue due to embolism, thrombus, or bleeding. Permanent damage due to a stroke does not include Transient Ischemic Attacks (TIA).

  • A benefit will be paid for failure of major organ function diagnosed by a physician that results in placement on the United Network for Organ Sharing (UNOS) list for transplant of the heart, liver, lungs or entire pancreas. Kidney failure is included under the End Stage Renal Failure Benefit.

  • A benefit will be paid for irreversible failure of both kidneys to function and requires regular dialysis or renal transplantation. Failure of one kidney is not included unless the covered person only has one kidney. 

  • A benefit will be paid for a spinal cord injury due to a covered accident resulting in the loss of use of two or more limbs. Paralysis must be diagnosed by a physician as permanent, total and irreversible. 

  • As long as you were continuously covered for 12 consecutive months prior to the date your coverage under the policy ends, you can submit a request to American Fidelity within 30 days of losing eligibility, for continuation of coverage.

    Learn more about keeping your coverage, or if you have any questions, please contact the Policy Continuation team online or call 800-943-2231.

Get Your Money Faster

With AFQuickClaims®, get the most out of your critical illness policy's annual health screening benefit! Submit your claim online or through AFmobile and you could get paid in as little as one day with direct deposit, no need for extra paperwork hassle.

 

Learn More About AFQuickClaims 


Explore Our Critical Illness Insurance Blogs

Need more help?

Our customer service team is available Monday – Friday 7:00 a.m. to 7:00 p.m. CST.

 

Contact Us