Complaints
This profile includes complaints for American Fidelity Assurance Company's headquarters and its corporate-owned locations. To view all corporate locations, see
Customer Complaints Summary
- 72 total complaints in the last 3 years.
- 29 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.
Initial Complaint
Date:03/06/2024
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Complaint: ********
I am rejecting this response because: I was not *********** would not cover a work related injury. I was told that it would not cover until AFTER my ********* comp ended on more than one occasion. Had I known I would not have paid the premiums for the 2 years that I was off work recuperating or bought the policy for $174.58 a month. If they won't pay until my full retirement age then I want the money back for the premiums that I paid for the policy so i have at least some money to live on!Sincerely,
have paid her!! I feel they need to pay the policy until my full retirement age as the policy states due to their agent falsely stating that the policy covered my injury and the csr's saying that I was covered when worker's comp ended. I filed an appeal and it was denied also.
*********************************
Business Response
Date: 03/11/2024
Dear Ms. ********:
This correspondence is in response to the Better Business Bureau complaint received in
our office on March 6, 2024, filed by the above referenced complainant.
The complaint submitted by our insured states that he purchased a disability policy with
the assurance that any disability would be covered, regardless of occurring at work or otherwise.
Our insured believes his disability policy should provide benefits until retirement age due to the
information provided by the account manager who sold him the policy in 2020.
Our records indicate that our insured initially applied for a disability policy in August 2020,
which excludes benefits for work related disabilities. The following year, our insured applied for
an accident policy with an accident disability income rider. The rider covers accident-related
disabilities regardless of whether the accident was work related. We consulted the account
manager with whom our insured worked during both enrollment sessions. While he did not recall
meeting with our insured specifically, he advised that it is his standard practice to explain to
customers that the disability policy covers disabilities due to accidents outside of the job and
workers’ compensation covers accidents on the job. Additionally, at time of enrollment for the
disability policy, our insured was provided a brochure that included information regarding the
work-related disability exclusion. Furthermore, we have reviewed the phone records between
our insured and/or his spouse and there is no record that customer service indicated his disability
policy would provide benefits once his workers’ compensation claim ended. To the contrary, our
insured and his spouse were advised multiple times, and as early as January 2022, that the
disability policy included an exclusion for work-related disabilities and that benefits would not be
payable under the disability policy for any work-related disability. In fact, during a phone
conversation in October 2022, the insured’s spouse confirmed that she was aware of the
exclusion in the disability policy and was only inquiring about the accident disability income rider
under her spouse’s accident policy.
BBB complaint – BBB ID NO. ********
Office of Appeals
AMERICAN FIDELITY ASSURANCE COMPANY • 9000 Cameron Parkway Oklahoma City, OK 73114 • americanfidelity.com
Based on the information available to us, our insured and his spouse have been accurately
advised that disability benefits under our insured’s disability policy would not be payable as his
policy includes an and exclusion for work-related disabilities. Our insured had a work-related
accident for which benefits under his accident disability income rider attached to his accident
policy provided benefits and for which workers’ compensation accepted liability. As such,
disability benefits have accurately been denied under his disability policy.
Our goal is for our insureds to have positive experiences with American Fidelity and we
invite the insured to contact us if he would like to further discuss the situation.
Sincerely,
Lorianne *******
Appeals Counsel
American Fidelity Assurance CompanyBusiness Response
Date: 03/15/2024
Dear Ms. ********:
This correspondence is in response to the Better Business Bureau follow-up complaint
received in our office on March 12, 2024, filed by the above referenced complainant in response
to our March 6, 2024 response to his initial complaint.
The follow-up complaint submitted by our insured states that he was told his disability
policy would not cover his work-related injury until after his workers’ compensation case ended.
He stated that because he was told that numerous times, he continued to pay policy premiums
while out on disability. He states that should his disability policy not pay until retirement age, he
is requesting a refund of premiums.
As mentioned in our March 6, 2024 letter, we have reviewed the phone records between
our insured and/or his spouse and there is no record that customer service indicated his disability
policy would provide benefits once his workers’ compensation claim ended. To the contrary, our
insured and his spouse were advised multiple times, and as early as January 2022, that the
disability policy included an exclusion for work-related disabilities and that benefits would not be
payable under the disability policy for any work-related disability. Based on the information
available to us, our insured was made aware of the disability policy’s work-related exclusion
through multiple sources. Our insured had a work-related accident for which benefits under his
accident disability income rider attached to his accident policy provided benefits and for which
workers’ compensation accepted liability. As such, disability benefits have accurately been
denied under his disability policy.
Although there are no benefits available to our insured’s work-related disability claim,
benefits under the disability policy would have been provided for an incurred covered loss while
the coverage remains in force. Therefore, we are not able to refund the premiums.
BBB complaint – BBB ID NO. ********
Office of Appeals
AMERICAN FIDELITY ASSURANCE COMPANY • 9000 Cameron Parkway Oklahoma City, OK 73114 • americanfidelity.com
Our goal is for our insureds to have positive experiences with American Fidelity and we
invite the insured to contact us if he would like to further discuss the situation.
Sincerely,
Lorianne *******
Appeals Counsel
American Fidelity Assurance CompanyCustomer Answer
Date: 03/15/2024
Complaint: ********
I am rejecting this response because: I would like a written transcript of every call that was made. That way I can go over them myself with our attorney.
Sincerely,
*********************************Initial Complaint
Date:03/06/2024
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I applied for paid leave ****** in December 2023. I was approved fir my weekly benefits from Jan 2nd - Feb 1st. I still have not received my benefits and every week I call and they tell me they will send them to my bank account and will be deposited in 2 to 3 business days.Business Response
Date: 03/11/2024
Dear Ms. ********:
This correspondence is in response to the Better Business Bureau complaint received in
our office on March 6, 2024, filed by the above referenced complainant.
The complaint submitted by our insured states that her claim was approved for benefits
covering the period of January 2nd – February 1st. She states that although she has called weekly,
she still has not received policy benefits.
At American Fidelity, we value our customers and are committed to providing quality
insurance products and customer care to our valued insureds. We are also very careful to protect
our customer’s private personal and health information. As our response could be shared on a
public site, we are unable to provide detailed responses in this forum.
Our records provide that our insured’s claim and payment approval was processed on
February 18, 2024. Benefits were submitted for direct deposit based on the bank account
information provided by our insured. However, the funds were returned due to no account
and/or unable to locate account. On February 26, 2024, our records indicate that we received
updated bank account information and a request was made to reissue the funds to the updated
bank account. Instead, a paper check was mailed to our insured’s address. After receipt of this
correspondence, we voided the paper check as it had not yet been tendered and reissued the
benefits for direct deposit to our insured’s updated bank account. We have received confirmation
that the funds have been transferred. Therefore, we believe this matter to be resolved.
We apologize for any frustration this may have caused our insured as it is our goal is for
our insureds to have positive experiences with American Fidelity. We invite the insured to contact
us if she would like to further discuss the situation.
BBB complaint – BBB ID NO. ********
Office of Appeals
AMERICAN FIDELITY ASSURANCE COMPANY • 9000 Cameron Parkway Oklahoma City, OK 73114 • americanfidelity.com
Sincerely,
Lorianne *******
Appeals Counsel
American Fidelity Assurance CompanyInitial Complaint
Date:02/26/2024
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I have had an open claim since November and have had this insurance for 19 months. This company seems to be incompetent and none of the employees, representatives, adjusters, or supervisor have any information about the jobs that they hold. I wait a month at a time to receive feedback from adjusters, regarding the progress of my claims. I am constantly told that my claim is being expedited but there is never any progress made on my claims. The adjusters hang up in my face and dont return calls or emails. The supervisors have no information either. I pay for a service that seems to be unavailable. The adjusters claim to request medical records from listed physicians offices but none of the offices have any records from American fidelity. I had to call and request that they send in my information. I am fed up with the company. I am already suffering from a disability, and now Im having the most trouble trying to process a service I pay for.Business Response
Date: 03/04/2024
Dear Ms. ********:
This correspondence is in response to the Better Business Bureau complaint received in
our office on February 26, 2024, filed by the above referenced complainant.
The complaint submitted by our insured states that since November 2023, she has had an
open claim on a policy that she has carried for 19 months. Our insured expressed frustration with
our customer service department regarding the ongoing claim review process. She would like
American Fidelity to finish the job.
At American Fidelity, we value our customers and are committed to providing quality
insurance products and customer care to our valued insureds. We are also very careful to protect
our customer’s private personal and health information. As our response could be shared on a
public site, we are unable to provide detailed responses in this forum.
In order to determine policy benefits, we must receive a complete claim for benefits and
any necessary records. By December 4, 2023, we received all three required sections of our
insured’s claim forms requesting policy benefits. Based on information provided on her claim
forms and due to the recent September 1, 2023, Effective Date of coverage for increased benefits
(decreased Elimination Period from 30-days to 7-days), a review of her medical records was
necessary to rule out Pre-Existing Conditions. However, in an Explanation of Benefits mailed to
our insured on December 28, 2023, we commenced her disability claim and paid benefits under
her existing policy with the 30-day Elimination Period. Although our insured returned to work on
January 7, 2024 and is no longer claiming disability benefits, we are continuing our efforts of
requesting her medical records on her behalf to determine if additional benefits are owed. A
third and final request was made on February 22, 2024, to the VA Memphis Health Care for her
medical records. We welcome our insured to submit her medical records as our efforts have gone
unsuccessful. Based on the information available to us, it appears that the necessary steps are
being taken in processing our insured’s claim as quickly and efficiently as possible while adhering
to applicable Policy provisions.
BBB complaint – BBB ID NO. ********
Office of Appeals
AMERICAN FIDELITY ASSURANCE COMPANY • 9000 Cameron Parkway Oklahoma City, OK 73114 • americanfidelity.com
Our goal is for our insureds to have positive experiences with American Fidelity and we
invite the insured to contact us if she would like to further discuss the situation.
Sincerely,
Lorianne *******
Appeals Counsel
American Fidelity Assurance CompanyInitial Complaint
Date:02/26/2024
Type:Status:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Complaint: ********
I am rejecting this response because: I spoke to close to 10 or more customer service representatives one of which was a supervisor. All of these people put me on hold to review my policy, my claim, etc and every single one of them kept telling me American Fidelity had all the documentation needed to process my claim and kept giving me approximate dates when I should be receiving a payment. Each time after my calls American Fidelity continued to come up with an additional form they claimed was the only form needed to process my claim. They were not in fact the only forms because each time after 7-10 business days elapsed I was told of yet another form needed. I should've been given a complete list of forms from my 1st or even 3rd phone call not having just shy of a month of back and forth. During this time I was experiencing additional undue stress caused by nobody I spoke to having correct information and having no source of income to pay my bills yet I kept being given approximate dates of expected payment. The utter lack of correct information is being dismissed by this company along with the unnecessary high level of stress caused by them. American Fidelity has a complete lack of regard for their clients and obviously needs to overhaul their training of both regular customer service reps as well as supervisors. Their response is unacceptable.
Sincerely,
*******************any doesn't want to pay out on their policy. The entire advertised purpose this company exists is to make sure people who are off of work can pay their bills. I have yet to pay my February bills and in a week it will be a new month with no payment date in sight. American Fidelity took my premium payments in exchange for a promise of easing my financial, mental, and emotional stress should I ever be not able to work. In reality all they have done is to cause more stress. I did my due diligence several times specifically asking if anything more was needed of me and my answer repeatedly was, no. Each week that goes by I found out more documents were needed. This is highly deceptive marketing on the company's part. This company needs to make good on their level of service promised in a timely fashion. If anything all they've accomplished by adding to my mental and emotional stress is to prolong my healing process after my surgery which is unacceptable.Business Response
Date: 03/04/2024
Dear Ms. ********:
This correspondence is in response to the Better Business Bureau complaint received in
our office on February 26, 2024, filed by the above referenced complainant.
The complaint submitted by our insured states that she submitted a claim on January 30,
2024. She states that she spoke to customer service and confirmed that all documents had been
received, but was advised on February 15, 2024 that additional information was needed. She
argues that it has now been five weeks and we need to make good on promised timely service.
At American Fidelity, we value our customers and are committed to providing quality
insurance products and customer care to our valued insureds. We are also very careful to protect
our customer’s private personal and health information. As our response could be shared on a
public site, we are unable to provide detailed responses in this forum.
In order to determine policy benefits, we must receive a complete claim for benefits and
any necessary records. On January 30, 2024, we received one of the three required sections of
our insured’s claim form. We mailed her an Explanation of Benefits on January 30, 2024
requesting she provide the remaining two portions of the claim form for our review. On February
7, 2024, we received the employer’s portion of claim form. We mailed our insured an Explanation
of Benefits on February 7, 2024 requesting she provide the physician’s portion of the claim form.
On February 9, 2024 we received the physician's portion of the claim form. On February 15, 2024,
we spoke to our insured regarding her claim status, and she advised that the return-to-work date
provided on the physician’s claim form was incorrect. On February 23, 2024, we received a
revised physician’s portion of the claim form. On February 26, 2024, we spoke to our insured and
advised that based on information provided on her claim form and the recent January 1, 2024,
Effective Date of coverage, a review of her medical records would be necessary to rule out PreExisting Conditions. We are currently in the process of requesting and collecting our insured’s
medical records on her behalf. Based on the information available to us it appears that the
BBB complaint – BBB ID NO. ********
Office of Appeals
AMERICAN FIDELITY ASSURANCE COMPANY • 9000 Cameron Parkway Oklahoma City, OK 73114 • americanfidelity.com
necessary steps are being taken in processing our insured’s claim as quickly and efficiently as
possible while adhering to applicable Policy provisions.
Our goal is for our insureds to have positive experiences with American Fidelity and we
invite the insured to contact us if she would like to further discuss the situation.
Sincerely,
Lorianne *******
Appeals Counsel
American Fidelity Assurance CompanyBusiness Response
Date: 03/11/2024
Dear Ms. ********:
This correspondence is in response to the Better Business Bureau complaint rejection
received in our office on March 4, 2024, filed by the above referenced complainant regarding our
March 4, 2024 response to her initial complaint.
The complaint rejection submitted by our insured states that she spoke to ten or more
customer service representatives including a supervisor and was advised that they had all the
information necessary to review her claim. She argues that she was given approximate payment
dates. She argues that she should have been given a complete list of the forms needed the first
time she called and not had the back and forth. She argues that she was not provided with correct
information causing high levels of stress. For these reasons she feels our response is
unacceptable.
As previously advised in our initial response dated March 4, 2024, we received a
completed claim form requesting Policy benefits on February 23, 2024 and advised our insured
on February 26, 2024 that additional information was necessary to consider policy benefits. We
are currently in the process of requesting and collecting our insured’s medical records on her
behalf to complete the claim review process. It appears that the necessary steps are being taken
in processing our insured’s claim as quickly and efficiently as possible while adhering to applicable
Policy provisions.
After receipt of the complaint rejection, we reviewed the phone records for our insured.
We found that we spoke to our insured on multiple occasions between January 26, 2024 and
February 26, 2024 regarding her claim. On January 26, 2024 she contacted us asking what was
necessary to file a claim and we informed her that she would need to provide all three portions
of the claim form for us to review. During subsequent calls we discussed claim status, details of
the documents submitted, missing required documents, and time frames for reviewing the
documents submitted. There is no indication in any of these calls that we advised our insured we
BBB complaint – BBB ID NO. ********
Office of Appeals
AMERICAN FIDELITY ASSURANCE COMPANY • 9000 Cameron Parkway Oklahoma City, OK 73114 • americanfidelity.com
had received everything necessary to process her claim or that we provided dates by which she
would receive benefits.
Our goal is for our insureds to have positive experiences with American Fidelity and we
invite the insured to contact us if she would like to further discuss the situation.
Sincerely,
Lorianne *******
Appeals Counsel
American Fidelity Assurance CompanyInitial Complaint
Date:02/02/2024
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
have a flex spending reimbursement account with *********************************************, through Tuscaloosa County Schools. I retired from Tuscaloosa County effective August 1, 2023. Qualified expenses that occurred after July 31, 2023, have been denied due to my retirement. My retirement resulted in the termination of ***************; however I have excess of over $800 of funds I contributed into the account. All claims that I submitted for reimbursement with service dates after July 31, 2023 have been denied. According to a phone representative for AF, my policy states that reimbursements would only be approved for services that occurred during my employment with ********** (Jan 1 through July 31, 2023). AF refused access to my policy when asked about the guidelines, and only offered to share information from a blog regarding benefits after termination. Also, my specific policy/benefit is not listed in my personal online account. Furthermore I received personal counseling for the policy prior to signing the agreement; however, I did not receive counseling prior to/or following my retirement.Desired Outcome/SettlementBusiness Response
Date: 02/13/2024
Dear Ms. ********:
This correspondence is in response to the Better Business Bureau complaint received in
our office on February 5, 2024, filed by the above referenced complainant.
The complaint submitted by our insured states that she had a Healthcare Flexible
Spending account (“FSA”) with American Fidelity and that expenses incurred after she retired on
August 1, 2023 have been denied. She would like all the claims for 2023 approved and paid or
all monies in her FSA returned.
At American Fidelity, we value our customers and are committed to providing quality
insurance products and customer care to our valued insureds. After receipt of our insured’s
complaint, we reviewed her FSA activity for the 2023 plan year. We determined that her claims
have been properly adjudicated.
By law, the FSA only provides reimbursement for eligible medical expenses incurred while
a participant is covered by the plan. When our insured signed her Benefit Verification form for
the 2023 plan year, she acknowledged that, “If I have elected the FSA benefit, I have received a
copy of the Rules of Participation and understand and agree to the terms and conditions of
participation in the Section 125 Plan, Flexible Spending Account(s) and/or Benefits Debit Card.”
The Rules of Participation were attached to the Benefit Verification and include the following, “If
employment is terminated and you do not elect to continue HCFSA coverage through COBRA,
only eligible expenses incurred before termination of coverage may be reimbursed.” As our
insured did not elect to continue her FSA through COBRA, only eligible medical expenses incurred
before her retirement are reimbursable under the FSA.
BBB complaint – BBB ID NO. 21237939
Office of Appeals
P.O. Box 25523 Oklahoma City, OK 73125-0523 • americanfidelity.com
Our insured’s FSA election for 2023 was $900 and she had a carryover amount of $223.59
from the 2022 plan year. She tried to use her Benefits Debit Card in September, but it was
properly denied as the expense was incurred after her retirement. All her other claims were
submitted in December 2023. Those incurred prior to her termination date were approved and
reimbursed and those incurred after her termination date were denied in accordance with the
FSA rules. She has $888.17 remaining in her FSA since most of her claims paid in 2023 were
covered by her 2022 carryover.
Her plan has a run-off period that ends March 31, 2024. So, she still has until March 31,
2024 to make claims for eligible medical expenses incurred prior to her July 31, 2023 termination
date. By law, FSAs are “use or lose” accounts. This means that at the end of the plan year, the
funds not used to reimburse eligible medical expenses must be forfeited and returned to the
employer's plan. Accordingly, we may not distribute the remaining FSA balance to our insured.
If our insured has additional questions,she can contact our Customer Service Department
at 800-662-1113.
Sincerely,
Lorianne *******
Office of Appeals
American Fidelity Assurance CompanyInitial Complaint
Date:01/10/2024
Type:Status:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Complaint: ********
I am rejecting this response because:On December 21, 2023 I inquired with my account rep *************************** about the beneficiary on my account. The screen shot attached shows an email sent from the beneficiary department verifying that my ex husband *********************** was still listed as a beneficiary on account *********.
Sincerely,
***************************Business Response
Date: 01/16/2024
Dear Ms. ********:
This correspondence is in response to the Better Business Bureau complaint received in
our office on January 10, 2024, filed by the above referenced complainant.
The complaint submitted by Ms. ***** states that she divorced in 2019 and requested
American Fidelity update her name and beneficiary. She states her name was updated but argues
that despite submitting the forms three times the beneficiary has not been updated as of January
8, 2024. She is requesting her information be updated correctly and wants an official apology.
Based on our review, Ms. *****’ Request For Change of Beneficiary was processed as
quickly and efficiently as possible after receipt of the fully executed form.
We regret our insured’s frustrations as our goal is for customers like our insured to have
positive customer service experiences. Based on our review, our insured initially submitted a
Request For Change of Beneficiary on April 11, 2020. The form was not fully executed, and on
April 11, 2020 we mailed Ms. ***** a letter advising the change could not be processed and
requesting she submit a fully executed form. On September 3, 2020 we received the fully
executed Request for Change of Beneficiary form and the beneficiary for Ms. ***** disability and
life policy was updated from her ex-spouse to her father as requested. On September 10, 2020
and September 28, 2020 we mailed Ms. ***** letters advising her the her requested beneficiary
change had been processed for her policies. On January 17, 2022 we received a duplicate Request
for Change of Beneficiary form, however, as the change had been processed in September 2020
no change was facilitated. On January 2, 2024 we received an email from Ms. ***** requesting
the immediate processing of her Request for Change of Beneficiary form updating her beneficiary
BBB complaint – BBB ID NO. ********
Office of Appeals
P.O. Box 25523 Oklahoma City, OK 73125-0523 • americanfidelity.com
from her ex-spouse to her father. On January 3, 2024 we mailed Ms. ***** a letter advising that
her Request for Change of Beneficiary form had been processed.
Based on our review, Ms. *****’ fully executed Request For Change of Beneficiary was
received on September 3, 2020 and processed September 10, 2020. We mailed Ms. *****’ two
letters confirming the beneficiary change on September 10 and 28, 2020 respectively. After Ms.
***** January 2, 2024 inquiry regarding her Request For Change of Beneficiary, we mailed her a
letter on January 3, 2024 advising the change had been processed. We apologize for any
confusion this may have caused as our letter did not specify the change had been processed in
September 2020. It appears that Ms. *****’ Request For Change of Beneficiary from her exspouse to her father was processed as quickly and efficiently as possible in September 2020. If
our insured has additional questions, she can contact our Customer Service Department at 800-
662-1113.
Sincerely,
Lorianne *******
Office of Appeals
American Fidelity Assurance CompanyBusiness Response
Date: 01/22/2024
Dear Ms. ********:
The follow up complaint submitted by Ms. ***** in response to our January 16, 2024
response to the original complaint states that she rejects our response.
The complaint rejection submitted by Ms. ***** states that she was emailed by her
account manager in December 2023 who forwarded her an email from our beneficiary
department advised her that her ex-spouse was still the beneficiary.
After receipt of her rejection, we conducted additional research and found that on
December 21, 2023, our beneficiary department emailed Ms. *****’ account manager and
provided incorrect information regarding the beneficiaries of Ms. *****’ policies. As this
communication was not directly between our beneficiary department and Ms. ***** it was not
found during our initial review, and therefore we did not address this in our initial response.
We apologize that Ms. ***** was provided incorrect information in December 2023. As
advised in our initial response, Ms. *****’ fully executed Request For Change of Beneficiary was
received on September 3, 2020 and processed September 10, 2020. We apologize for any
confusion the December email may have caused. Ms. *****’ Request For Change of Beneficiary
from her ex-spouse to her father was processed as quickly and efficiently as possible in
September 2020. As requested, our special services department is mailing Ms. ***** a letter
providing confirmation that her father is the beneficiary of her policies.
If our insured has additional questions,she can contact our Customer Service Department
at 800-662-1113.
BBB complaint – BBB ID NO. ********
Office of Appeals
P.O. Box 25523 Oklahoma City, OK 73125-0523 • americanfidelity.com
Sincerely,
Lorianne *******
Office of Appeals
American Fidelity Assurance CompanyInitial Complaint
Date:12/28/2023
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
On 06/01/23 I experienced fraud using my American Fidelity Flex Benefits Account Card. The thieves wiped out my account, taking $400 of the $435. I had in ***************. I filed an online fraud claim immediately online with American Fidelity. I called American Fidelity the next day to make sure the claim was processing. I was told to wait 90 days ** Mastercard needed to review the claim and within 90 days I would have an answer/resolution. Fast forward to 12/27/23 (7 months later) and I have heard NOTHING from American Fidelity or Mastercard about this claim. I have called every month and asked for updates, been promised that someone will call with an update, and heard NOTHING. I have every call, date, time, and who I spoke to written down and attached below. The American Fidelity staff I reach on the phone reach out to their supervisors and still no resolution has occurred. My son is awaiting medically necessary surgery and I need the $400 in this account to pay for that, so we have had to postpone his surgery until we can get this resolved and that is not right.Business Response
Date: 01/04/2024
Dear Ms. ********:
This correspondence is in response to the Better Business Bureau complaint received in
our office on December 28, 2023, filed by the above referenced complainant.
The complaint submitted by our insured states that she experienced fraud on her
American Fidelity Flex Benefits Account Card and that $400 was taken from her account. She
immediately filed an online fraud claim with American Fidelity. When she called the next day to
follow up she was told to wait 90 days because Mastercard needed to review the claim and within
90 days she would have an answer/resolution. As of December 27, 2023 she has heard nothing
from American Fidelity or Mastercard on this claim.
At American Fidelity, we value our customers and are committed to providing quality
insurance products and customer care to our valued insureds. After receipt of our insured’s
complaint we did contact our Master Card partner to expedite a response in our insured’s fraud
claim. We apologize that it took six months for us to get this information. Based on the
information provided by Master Card there was no fraud on the Benefits Debit Card. One of the
insured’s cards was presented at a provider for payment of an expense on June 1, 2023. We have
contacted our insured directly about this topic and we believe the issue has been resolved.
We apologize for any inconvenience this may have caused our insured and appreciate her
communication as it is only through feedback that we can continually work to improve our
customer service experience. If our insured has additional questions she can contact our
Customer Service Department at 800-662-1113.
BBB complaint – BBB ID NO. ********
Office of Appeals
**** *** ***** ******** ***** ** ********** * ********************
Sincerely,
Lorianne *******
Office of Appeals
American Fidelity Assurance CompanyInitial Complaint
Date:12/07/2023
Type:Status:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.I accept this resolution but I ask the appeal manager to please inform *************************, billing department manager, of such decision because two days ago she offered me a different resolution that was not as satisfactory. She proposed I cover the missing premium out of pocket and that I have until January 13 to do so. I replied back to ask if the option of using the benefits I will claim ( as stated in the letter and as I had previously accepted) was a valid option but as of today she has not responded back. Thank you for your help.
e been dealing with this issue since I about 6 months pregnant and I am now 2 weeks out from giving birth and yet I dont have an answer. I would like a resolution to this problem with enrollment so that I can claim benefits I have been paying for for years. Several agents who said they were going to take care of the problem simply disappeared and it has been so far an huge waste of time. AF not only have been unprofessional but has also caused me additional stress a pregnant woman does not need. I also feel AF agents cannot be trusted and I do not recommend this insurance company to anyone.
Sincerely,
*************************Business Response
Date: 12/15/2023
Dear Ms. ********:
This correspondence is in response to the Better Business Bureau complaint received in
our office on December 7, 2023, filed by the above referenced complainant.
The complaint submitted by our insured states that she enrolled into new coverage
effective July 2023 because she had found out that her previous 2020 coverage was discontinued.
However, her new coverage became effective after her pregnancy was diagnosed. She states that
if it wasn’t for the gap in coverage, she would have a covered claim. She states that she later
found out that the gap in coverage was due to an error not of her own. She states that she has
been advised of the possibility to reinstate her 2020 policy with no gap in coverage and to deduct
the missing premiums from her disability claim she intends to file after delivery. She states that
she has dealt with this matter for months and is now two weeks from giving birth and she still
hasn’t received a resolution regarding this matter.
At American Fidelity, we value our customers and are committed to providing quality
insurance products and customer care to our valued insureds. After receipt of insured’s
complaint, we found that the insured’s employer stopped premium payment for our insured’s
policy, which resulted in her coverage terminating effective January 1, 2022. It has been decided
to reinstate our insured’s previous policy with no gap in coverage and to allow for missing
premiums to be deducted from our insured’s future claim payment. This decision has been
agreed upon from our insured. At this time, we have not received a claim for policy benefits.
When a claim is submitted, it will be considered under our insured’s policy effective in September
2020. We believe this matter to be resolved.
BBB complaint – BBB ID NO. 20975229
Office of Appeals
P.O. Box 25523 Oklahoma City, OK 73125-0523 • americanfidelity.com
We apologize for any inconvenience this may have caused our insured and appreciate her
communication as it is only through feedback that we can continually work to improve our
customer service experience. We look forward to speaking with our insured and discussing their
specific situation in more detail. They can contact our Customer Service Department at 800-662-
1113.
Sincerely,
Lorianne *******
Office of Appeals
American Fidelity Assurance CompanyInitial Complaint
Date:11/27/2023
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Complaint: ********
I am rejecting this response because: American Fidelity in writing from Nordstrom that the plan effective date is June 1st. The car accident documented on the police report and doctors report indicate March 11 2023 is date of accident and the reason why client needed to be taken out of work for valid medical reasons was as reports that AF recieved American Fidelity contract states from the time of accident would cover if rider is in an accident and provides proof. Proof has been provided multiple times to AF. Employer has provided what AF request. American Fidelity continues to overlook that client was not on employer plan at the time of accident on March 11 2023, therefore the entire claim is valid. Therefore contracted payments of **** per month are long overdue from the time of accident to Nov 2 Yet even after recieving the plan start date "effective date" American Fidelity insisted upon and after receiving proof under American Disability laws for *** leave which means that employer approved leave for medical as a unpaid leave as not eligible for coverage through employer. AF still overlook the proof that has been provided as a means to avoid fulfilling the valid claim on a contracted agreement that was in force and eligible at the time of accident and does not disqualify claimant for being on a plan at the time of accident because claimant wasn't on a plan at the time of accident and the documentation sent to BBB and American Fidelity demonstrate the effective date is June 1st. In addition to *************** information that has been sent by client even though it says effective date June 1st for employer plan, they should finally realize that they were wrong in their assumptions and just finally pay the claim. The proof is there now and requesting full payment as this has caused undue hardship. If we had been contracted with any other company, this would have been handled promptly and correctly.
even refused to call with claimant to verify this information when they knew they were already making up an excuse not to pay. They insisted on bullying a disabled customer out of their contracted agreement after a complaint was filed against them. They owe **** dollars in back pay and even though the paperwork they requested had been recieved, they say they didn't get it so resent it and then they say it doesn't say the effective date but it clearly does say **** 1st. Therefore even though we and the BBB has it in writing that they would correct the retaliatory rescind if a start date was provided. **** 1st is clearly after Feb March April and May, they continue to make up things to avoid payment. They got the start date of **** 1st and an explanation that the party's default employers plan would not cover a car accident on March 11 2023 because they were NOT covered Therefore were covered under American Fidelity until they wrongfully rescinded to avoid payment. Please pay the claim.
Sincerely,
************************* ****Business Response
Date: 12/01/2023
Dear Ms. ********:
The second follow up complaint submitted by Ms. ************* in response to our
December 1, 2023 and December 11, 2023 responses to the original and follow up complaints
received, state that she rejects our follow up response.
The complaint rejection submitted by Ms. ************* states that she has submitted the
required proof needed on multiple occasions for us to pay benefits.
Ms. *************’s complaint involves her Eligibility under a Spousal Accident Only
Disability Income Rider (the “Rider”) attached to her spouse’s Group Disability Income Benefits
policy. This Rider coverage was offered as an option through Ms. *************’s spouse’s
employer’s group disability plan.
As previously advised, based on the information provided to us Ms. ************* is not
eligible for Rider coverage as she was covered under other group disability coverage. As such, her
Rider coverage was rescinded and all Rider premium paid was refunded. To verify the coverage
dates of her other group disability coverage, we have requested a statement confirming the
coverage effective dates from Sedgwick, the other group disability provider. Ms. *************
has not provided the requested documentation and continues to provide pages from a
Confirmation of Benefits from her employer, Nordstrom that does not provide the necessary
information. At this time, we have not received the requested statement from Sedgwick verifying
Ms. *************’s eligibility for Rider coverage. Upon receipt of confirmation that she was not
covered by other group disability coverage and, therefore, eligible for Rider coverage, we will
reverse our recission and provide any applicable Rider benefits due.
BBB complaint – BBB ID NO. ********
Office of Appeals
**** *** ***** ******** ***** ** ********** • americanfidelity.com
Sincerely,
Lorianne *******
Office of Appeals
American Fidelity Assurance CompanyBusiness Response
Date: 12/11/2023
Dear Ms. ********:
The follow up complaint submitted by Ms. ************* in response to our December 1,
2023 response to the original complaint states that she rejects our response.
The complaint rejection submitted by Ms. ************* states that we have been
provided with proof multiple times by her and her employer. She argues this situation has caused
undue hardship and wants her $1,500 monthly payment beginning from November 2022 through
the present.
Ms. *************’s complaint involves her Eligibility under a Spousal Accident Only
Disability Income Rider (the “Rider”) attached to her spouse’s Group Disability Income Benefits
policy.
As previously advised in our initial response dated December 1, 2023, we received
information indicating Ms. ************* had other group disability coverage and was not eligible
for coverage based on the Rider provisions. We requested information from her employer or
primary benefits provider which would verify her eligibility. We communicated with and spoke
to Ms. *************, her employer, and her benefits provider on multiple occasions over several
months. However, we were unable to obtain any documentation or confirmation of her eligibility
for Rider coverage. Based on the information provided to us initially, she is not eligible for Rider
coverage and, therefore, on August 10, 2023, we mailed her a letter rescinding Rider coverage
and refunding all Rider premium paid. At this time, we have not received documentation from
her employer or primary benefits provider verifying her eligibility for Rider coverage. As
previously advised, upon receipt of confirmation that she was not covered by other group
BBB complaint – BBB ID NO. ********
Office of Appeals
**** *** ***** ******** ***** ** ********** • americanfidelity.com
coverage and, therefore, eligible for Rider coverage, we will reverse our recission and provide
any applicable Rider benefits due.
Sincerely,
Lorianne *******
Office of Appeals
American Fidelity Assurance CompanyCustomer Answer
Date: 12/11/2023
Complaint: ********
I am rejecting this response because: American Fidelity has recieved proof that claimant was not on a plan. They indicated that they were waiting for a start date of employer plan and even tried to call without client to help them and were unsuccessful because of privacy policy that is similar to their own in regards to third party information. Claimant provided the necessary information Oct 24 Nov 7 and Nov 29 and sent it again today via email to the disability claims department. Effective date of June 1 2023 translates to start date of June 1 2023. Therefore the valid claim under contract with American Fidelity should not be breached as AF is attempting. The claimant was indeed not under a plan at the time of accident. Therefore payments of **** per month from May 2 to Nov 2 and the tactics and delays are causing undue hardship to a 10 year client.
Sincerely,
************************* ****Business Response
Date: 12/18/2023
Dear Ms. ********:
The second follow up complaint submitted by Ms. ********-Cruz in response to our
December 1, 2023 and December 11, 2023 responses to the original and follow up complaints
received, state that she rejects our follow up response.
The complaint rejection submitted by Ms. ********-Cruz states that she has submitted the
required proof needed on multiple occasions for us to pay benefits.
Ms. ********-****** complaint involves her Eligibility under a Spousal Accident Only
Disability Income Rider (the “Rider”) attached to her spouse’s Group Disability Income Benefits
policy. This Rider coverage was offered as an option through Ms. ********-****** spouse’s
employer’s group disability plan.
As previously advised, based on the information provided to us Ms. ********-Cruz is not
eligible for Rider coverage as she was covered under other group disability coverage. As such, her
Rider coverage was rescinded and all Rider premium paid was refunded. To verify the coverage
dates of her other group disability coverage, we have requested a statement confirming the
coverage effective dates from Sedgwick, the other group disability provider. Ms. ********-Cruz
has not provided the requested documentation and continues to provide pages from a
Confirmation of Benefits from her employer, Nordstrom that does not provide the necessary
information. At this time, we have not received the requested statement from Sedgwick verifying
Ms. ********-****** eligibility for Rider coverage. Upon receipt of confirmation that she was not
covered by other group disability coverage and, therefore, eligible for Rider coverage, we will
reverse our recission and provide any applicable Rider benefits due.
BBB complaint – BBB ID NO. ********
Office of Appeals
**** *** ***** ******** ***** ** ********** • americanfidelity.com
Sincerely,
Lorianne *******
Office of Appeals
American Fidelity Assurance CompanyCustomer Answer
Date: 12/19/2023
Complaint: ********
I am rejecting this response because: American Fidelity created an excuse not to fulfill their contracted and paid for agreement. They seemed to have recieved a letter confirming hours for the unpaid ADA *** accommodation leave from leave administrator which is different than an elected coverage plan to avoid payment on a valid claim. American Fidelity has also been sent a statement from employer dated Oct 13 2023 FIVE times now which provides the information they insisted upon the employer plan effective date is June 1 2023 to remove the block and incorrect rescission. Interesting that they haven't recieved that which has been sent 5 times now with a clear explanation. But have recieved everything else. Unless they have recieved and still do not want to fulfill thier contract. American Fidelity has also recieved employee handbook that also explains that employees are not eligible for coverage until 6 months of employment. Which coincides to June 1. All of this proof has been provided several months ago. Please pay the delayed claim from American Fidelity unethical tactics in the amount of **** per month from time of accident 3/11/23 to the time of return to work 11/2/23 as stated in contract that should not have been delayed denied or rescind in the first place and has caused undue stress and hardship to a long time client of American Fidelity.
Sincerely,
************************* ****Initial Complaint
Date:09/16/2023
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Complaint: ********
I am rejecting this response because:Although I do appreciate the response, I am aware that after March of this year I was told that another physician form and additional documents were requested and would need to be provided. In AF response what was mentioned is,
"September 6, 2023, our insured submitted her award letter providing that she had been receiving a Deductible Source of Income for the entire length of her claim. We are currently in the process of recalculating our insureds claim and an updated Explanation of Benefits will be mailed to her this week."
My medical provider and myself have provided these documents along with additional documents requested to process my claim but again AF always pushes me from receiving my benefits for the plan I pay into with them.
Is it whenever we feel like paying our clients? To what they pay into? That's like playing God when they already have the information already provided to them sometimes a redundant of times of submitting them just because they can't seem to understand that the client has told them many times the documents that were sent were already sent and received confirmimg also through their website and through chat. The cause of delay is them and they don't see it.
Sincerely,
I've supplied all the documents needed to the company I've read in a other person's complaint in here that they lost one or several of documents the person provided. I would have to agree that this has also happened to me when I've provided documentation on several occasions.
** *****************Business Response
Date: 09/21/2023
Dear Ms. ********:
This correspondence is in response to the Better Business Bureau complaint received in
our office on September 16, 2023, filed by the above referenced complainant.
The complaint submitted by our insured states that she and her doctor’s office have
submitted documentation for her continued claim, but we keep requesting more documentation.
She states despite providing verification of her continued disability we have only provided two
payments. She argues that she supplied all documents needed and we are avoiding paying. She
is requesting a refund of the premium paid.
We regret our insured’s frustrations as our goal is for customers like our insured to have
positive experiences when filing a claim. Based on our review, our insured submitted a claim
requesting Disability Benefits on March 2, 2022. We received claim forms providing that her
Disability began March 1, 2022 and received additional claim forms verifying her Disability
through March 31, 2023. We provided benefits to her from March 1, 2022 through March 31,
2023 in accordance with her policy provisions.
On March 24, 2023 we contacted our insured advising that if her disability was extending
beyond March 31, 2023 we needed a claim form completed by her Physician verifying her
continued dates of Disability. During this call our insured provided that she had begun receiving
a Deductible Source of Income per the terms of her Policy. Accordingly, we requested she provide
a copy of the award letter she had received to determine how this income would impact her
claim. On August 4, 2023, we received a new claim form from her physician verifying her
continued Disability through December 31, 2023. We contacted our insured and again requested
her award letter so we could complete our review for additional benefits consideration. On
BBB complaint – BBB ID NO. 20614306
Office of Appeals
P.O. Box 25523 Oklahoma City, OK 73125-0523 • americanfidelity.com
September 6, 2023, our insured submitted her award letter providing that she had been receiving
a Deductible Source of Income for the entire length of her claim. We are currently in the process
of recalculating our insured’s claim and an updated Explanation of Benefits will be mailed to her
this week.
In response to our insured’s request for a refund of premium, we are unable to refund
premiums paid. Benefits have been provided under her Policy for a covered loss while her
coverage is in force. Therefore, we are not able to refund premiums paid.
Our goal is for our insureds to have positive experiences with American Fidelity and if our
insured would like to call and discuss their specific situation in more detail, they can contact our
Customer Service Department at 800-662-1113.
Sincerely,
Lorianne *******
Office of Appeals
American Fidelity Assurance CompanyBusiness Response
Date: 09/27/2023
Dear Ms. ********:
The follow-up complaint submitted by our Insured in response to our September 21, 2023
response to the original complaint states that she rejects our response.
The complaint rejection submitted by our insured states that while she appreciates our
response, she and her medical provider have submitted all documentation requested. She argues
we have avoided paying her benefits for a policy she pays into.
We regret our insured’s frustrations as our goal is for customers like our insured to have
positive experiences when filing a claim. Throughout her claim, our insured provided additional
claim forms verifying her continued Disability through December 31, 2023. On several occasions
the claim forms submitted were incomplete or contained information which required us to
contact the insured, her treating physician, or her employer. Based on our review, it appears
that additional information was needed in order to determine applicable benefits under our
insured’s disability policy.
There were occasions when multiple attempts were necessary before receiving a
response to our requests. The reasons for any delays were communicated to our insured to
keep her apprised of her claim status. Based on our review we processed our insured’s initial
claim and continuing claim documents as quickly and efficiently as possible while adhering to
the Policy provisions.Customer Answer
Date: 09/27/2023
Complaint: ********
I am rejecting this response because: I received the following information mentioned from AF that was paid to me. Also, mentioning that if anything I owe them. It isn't right that I have been paying into my benefits and that they want to withhold what I pay into. That isn't even what I had received from them, it is less. I truly believe after reading the reviews under clients who pay into their benefits that they truly do not or are given a difficult time receiving what they pay into when it comes to filing a claim for their private disability insurance through their employer. With this employer being ***********************************. This is terrible.
Sincerely,
** *****************
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