Page 15 - Aflac Flipbook 2023

American Family Life Assurance Company of Columbus Periods of disability meeting either of these separation Provider will not be required if it is determined that such
(herein referred to as Aflac) requirements will begin a new Benefit Period, subject to a regular care would be of no benefit to the insured.
Worldwide Headquarters  1932 Wynnton Road  Columbus, Georgia 31999 new Elimination Period. Benefits will cease on the date of your death.


1.800.99.AFLAC (1.800.992.3522) TOTAL DISABILITY BENEFITS:
WAIVER OF PREMIUM BENEFIT: If your covered
SHORT-TERM DISABILITY COVERAGE Sickness or covered Off-the-Job Injury causes your Total We will insure you as follows while coverage is in force:
Policy Series A57600 Disability for more than 90 consecutive days (or after the
Elimination Period shown in the Policy Schedule, If your covered On-the-Job Injury causes your Total
Disability and you are not working at any job for pay or
Read Your Policy Carefully. This document provides a very TOTAL DISABILITY BENEFITS: whichever is greater) while the policy is in force, Aflac will
brief description of the important features of the coverage. We will insure you as follows while coverage is in force: waive, from month to month, the premium for the policy benefits, we will pay you the Daily Disability Benefit for
each day of your Total Disability. This benefit is payable
This is not the insurance contract, and only the actual policy and any applicable rider(s) for as long as you remain
provisions will control. The policy itself sets forth in detail the If your covered Sickness or covered Off-the-Job Injury disabled, up to the applicable Benefit Period shown in the up to the Total Disability Benefit Period you selected and
is subject to the Elimination Period shown in the Policy
rights and obligations of both you and Aflac. It is, therefore, causes your Total Disability and you are not working at Policy Schedule.
important that you READ YOUR POLICY CAREFULLY! any job for pay or benefits, we will pay you the Daily For premiums to be waived, Aflac will require an Schedule. Also see the Uniform Provision titled “Term,”
and the definition of “Benefit Period.”
Short-term disability coverage is designed to provide, to Disability Benefit for each day of your Total Disability. employer’s statement and a Physician’s or Mental Health
This benefit is payable up to the Total Disability Benefit
persons insured, coverage for disabilities resulting from a Period you selected and is subject to the Elimination Provider’s statement certifying your inability to perform During the first 12 months or the first 52 weeks of your
covered accident or Sickness, subject to any limitations set Period shown in the Policy Schedule. Also see the said duties or activities, and may each month thereafter Total Disability, if you are working at your job for pay or
forth in the policy. Coverage is not provided for basic hospital, Uniform Provision titled “Term,” and the definition of require a Physician’s or Mental Health Provider’s benefits, we will pay you one-half of the Daily Disability
basic medical-surgical, or major medical expenses. “Benefit Period.” statement that your inability to perform said duties or Benefit for each day of your Total Disability. After benefits
have been payable for 12 months or the first 52 weeks, if
Benefits. The following benefits are a part of the policy. During the first 12 months or the first 52 weeks of your activities continues. Aflac may ask for and use an you are working at any job for pay or benefits, no benefits
independent consultant to determine your disability when
Aflac will pay the following benefits, as applicable, if your Total Disability, if you are working at your job for pay or this benefit is in force. will be payable.
disability is caused by a covered Sickness or covered benefits, we will pay you one-half of the Daily Disability You will no longer be qualified to receive this benefit
Off-the-Job Injury and occurs while coverage is in force. Benefit for each day of your Total Disability. After You must pay all premiums to keep the policy and any upon the earlier of your: (1) being released by your
All benefits are subject to the Limitations and Exclusions, benefits have been payable for 12 months or the first 52 applicable rider(s) in force until Aflac approves your claim Physician to perform the material and substantial duties
Pre-existing Condition Limitations, and other policy weeks, if you are working at any job for pay or benefits, for this Waiver of Premium Benefit. You must also of your Full-Time Job, or (2) working at any job after
terms. no benefits will be payable. resume premium payment to keep the policy and any benefits have been payable for 12 months or the first 52
applicable rider(s) in force, beginning with the first
Disability due to pregnancy and childbirth is payable to the You will no longer be qualified to receive this benefit premium due after you no longer qualify for disability weeks.
same extent as a covered Sickness. Disability as a result of upon the earlier of your: (1) being released by your benefits. Separate periods of disability, resulting from the same or
pregnancy that began on or before the Effective Date of Physician or Mental Health Provider to perform the a related condition and not separated by 180 days or
coverage is not covered except for disability due to material and substantial duties of your Full-Time Job, or The Waiver of Premium Benefit is not available with a more, are considered a continuation of the prior disability.
Complications of Pregnancy, which will be covered to the (2) working at any job after benefits have been payable three-month Total Disability Benefit Period. Once the maximum Benefit Period has been paid, you
same extent as a covered Sickness. The maximum period of for 12 months or the first 52 weeks. IF YOU HAVE ANY OTHER DISABILITY BENEFIT IN will not be eligible for a new Benefit Period or any
disability allowed for disability due to childbirth is six weeks FORCE WITH US, ONLY ONE DISABILITY BENEFIT IS disability benefits due to the same or a related condition
for noncesarean delivery and eight weeks for cesarean Separate periods of disability, resulting from the same or PAYABLE. unless you have been released by a Physician from the
a related condition and not separated by 180 days or
delivery, less the Elimination Period, unless you furnish proof prior disability, are no longer disabled and are no longer
that your disability continues beyond these time frames. more, are considered a continuation of the prior disability. 4. OPTIONAL BENEFITS: qualified to receive disability benefits for a period of 180
Once the maximum Benefit Period has been paid, you
Disability due to Mental Illness is payable up to the Benefit will not be eligible for a new Benefit Period or any Disability Benefit for On-the-Job Injury Rider: days.
Period and is limited to the Maximum Lifetime Disability disability benefits due to the same or a related condition (Series A57650) Applied For:   Yes  No Separate periods of disability, resulting from unrelated
Period For Mental Illness. unless you have been released by a Physician or Mental Aflac will pay the following benefits, as applicable, if your causes are considered a continuation of the prior
Benefits will be paid for only one disability at a time, even if Health Provider from the prior disability, are no longer disability is caused by a covered On-the-Job Injury and disability unless they are separated by your returning to
the disability is caused by more than one Sickness, more than disabled and are no longer qualified to receive disability occurs while coverage is in force. All benefits are subject work at a Full-Time Job for 14 working days during which
one Injury, or a Sickness and an Injury. We reserve the right benefits for a period of 180 days.. to the Limitations and Exclusions, Pre-existing Condition you are performing the material and substantial duties of
to meet with you while a claim is pending, or to use an Separate periods of disability, resulting from unrelated Limitations, and other policy terms. such job, you have been released by a Physician from
independent consultant and Physician’s or Mental Health causes are considered a continuation of the prior the prior disability, and are no longer qualified to receive
Provider’s statement to determine whether you are disability unless they are separated by your returning to Benefits will be paid for only one disability at a time, even if any disability benefits under the policy.
qualified to receive disability benefits. You must be under work at a Full-Time Job for 14 working days, during the disability is caused by more than one Injury. We reserve Periods of Disability meeting either of these separation
the care and attendance of a Physician or Mental Health which you are performing the material and substantial the right to meet with you while a claim is pending, or to requirements will begin a new Total Disability Benefit
Provider for these benefits to be payable. The care and duties of such job you have been released by a use an independent consultant and Physician’s or Mental Period, subject to a new Elimination Period.
attendance of a Physician or Mental Health Provider will Physician or Mental Health Provider from the prior Health Provider’s statement to determine whether you
are qualified to receive disability benefits. You must be
not be required if it is determined that such regular care disability, and are no longer qualified to receive any WAIVER OF PREMIUM BENEFIT: If your covered On-
would be of no benefit to the insured. Benefits will cease disability benefits under the policy. under the care and attendance of a Physician or Mental the-Job Injury causes your Total Disability for more than
on the date of your death. Health Provider for these benefits to be payable. The 90 consecutive days (or after the Elimination Period
care and attendance of a Physician or Mental Health
shown in the Policy Schedule, whichever is greater) while
A57625R1NMD 1 6/22 A57625R1NMD 2 6/22