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Consumer Complaints

BBB Accredited Business since 05/01/1975

American Fidelity Assurance Company

Phone: (405) 523-2000Fax: (405) 416-7879

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Customer Complaints Summary

13 complaints closed with BBB in last 3 years | 6 closed in last 12 months
Complaint TypeTotal Closed Complaints
Advertising / Sales Issues2
Problems with Product / Service11
Billing / Collection Issues0
Delivery Issues0
Guarantee / Warranty Issues0
Total Closed Complaints13

Complaint Breakdown by ResolutionAbout Complaint Details

Complaint Resolution Log (13)BBB Closure Definitions
05/08/2015Problems with Product / Service | Read Complaint Details
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Complaint
Inferior and or improper service.
I was advised multiple times that my check was mailed on 4-9-15 in which it was not until 4-14-15 at a lesser amount than requested. Today 4-15-15 still has yet to arrive therefore complaining due to improper and or inferior service for being advised wrongfully.

Desired Settlement
I would like the net balance originally requested.

Business Response
Our records indicate the American Fidelity's required distribution forms were received on April 1, 2015. These forms were forwarded to the employer's third party administrator for approval. Upon receipt of approval from the third party administrator, the outstanding loan balance had to be withdrawn from the account and paid on the loan. This is a 3-5 business day process. Upon completion of the loan payoff the remaining balance was withdrawn on April 14, 2015. The check was mailed overnight delivery to the customer on April 14, 2015. This transaction was completed within our normal processing times.

08/18/2014Problems with Product / Service | Read Complaint Details
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Complaint
I was in hospital for a few days. I have a policy that pays if there is an accident or hospitalization. I got bit or cut myself shaving. Both are accidents and they are denies me coverage. I sent all hospital and doctors records that they needed. One even said I got bit by bug.

Desired Settlement
I want what my policy pays for. This includes doctor visits and hospital stay. This is over $1500.00

Business Response
Contact Name and Title: ****** ******** -******
Contact Phone: XXX-XXX-XXXX *****
Contact Email: **********************@americanfidelity.com
Ms. ****** submitted an accident claim to us on March 24, 2014. The medical records recieved indicated a diagnosis of cellulitis and that she could have had a bug bite or cut herself shaving but there was no indication of an injury taking place. The claim was denied as not payable because it did not meet the policy definitions of an accidental injury as a single event resulting in an injury could not be identified. The definitions are as follows:

ACCIDENT: A sudden, unexpected and unintended event, which results in bodily injury, which is independent of disease or bodily infirmity or any other cause.

COVERED ACCIDENT: An Injury caused by an Accident, for which benefits are provided, which is independent of any disease or bodily infirmity or any other cause and that takes place while the Covered Person is covered under this policy. A Covered Accident is an Accident that occurs as a result of a Common-Carrier Accident or Other Accident as defined in this policy.

INJURY: A bodily injury which is caused directly by an Accident, independent of Sickness, disease, bodily infirmity or any other cause occurring on or after the Effective Date of coverage while the coverage is in force.

On April 23, 2014 Ms. ****** appealed the claim decision and the Appeals Committee at American Fidelity reviewed the file. On June 9, 2014 the Appeals Committee upheld the denial decision based on the policy definitions and notified Ms. ****** that no benefit would be paid for the hospitalization for the cellulitis.

I hope that I have explained in detail the actions taken with Ms. ******'s claims. If there is anything else we can do to assist, whether it be additional questions surrounding the specific benefit or questions surrounding any other benefit they *** be due, please do not hesitate to contact us directly at X-XXX-XXX-XXXX. We are happy to assist during this process.



Consumer Response
(The consumer indicated he/she DID NOT accept the response from the business.)
I got a spider bite before and had to be hospitalize and it was celluliti and they paid the claim. the accident was the bite or cut which caused the cellulitis. Getting a bug bite or cutting self shaving is a sudden, unexpected and unintended event, which results in bodily injury, which is independent of disease or bodily infirmity or any other cause.

Final Business Response
Ms. ****** has the right to a second level of administrative appeal at American Fidelity. The appeal must be made in writing within 60 days from the date of this response. Written comments, documents, records, and other information relating to the claims should be included with the appeal. The appeal can be faxed to X-XXX-XXX-XXXX, emailed to **********************@americanfidelity.com, or mailed to P.O. Box XXXXX Oklahoma City, Oklahoma XXXXX-XXXX. Please include the customer number XXXXXXX on the appeal.

Thank you,
****** ******** -******
AFES Benefits, Team Leader
XXX-XXX-XXXX *****

04/15/2014Problems with Product / Service | Read Complaint Details
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Complaint
I have submitted claims for reimbursement from my flexible spending account 3 times (for 2 sep. claims). The first was submitted in late December, 2013. The second was submitted in Feb. of 2014. With both claims, nothing has happened. No reimbursement has been issued. I have contacted customer service 2 times, and have been directed to resubmit my claims to specific employees, which I have done, and I have still not received the reimbursement to which I am entitled per the terms of the plan.
Product_Or_Service: Flexible Spending Account
Account_Number: Contract w/ Northwes

Desired Settlement
I wold like my reimbursement deposited to my account immediately!

Business Response
Contact Name and Title: ***** ******** Vice Pres.
Contact Phone: 405/XXX-XXXX
Contact Email: **************@americanfidelity.com
Ms. *********** elected to participate in a Health Flexible spending account through the employer's Section 125 plan. Claims were filed under her spouse's name. The claims were denied because her spouse does not have the account. Ms. *********** submitted a claim under her name and payment was made to her the following business day.

10/02/2012Problems with Product / Service | Read Complaint Details
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Complaint
I got hurt and filed a claim on my disability insurance. I have been given the run around for 3 weeks now and they never return my calls.
Every time I talk to someone they tell my my claim is being processed and that it ****** take another day and another day and another day. I can not get any processor to return my calls to have an idea of when and how much I can expect. I took the policy to protect my income. I have been unable to work for a month, I am out of money, food, and gas. I still have no idea when or how I ****** be able to pay my bills or eat again.

Desired Settlement
I expected my policy to be able to protect my income incase I was unable to work. I expect this large company to be able to process a claim in a timely manner that would continue my income so that I can exist and not loose everything because I got hurt. They are very quick to get money from me every time I get paid and I would expect them to be able to process a claim and pay me in a timely manner. Once again it is a the end of another business day and I am hungry.

Business' Initial Response
Contact Name and Title: Charlotte Johnson
Contact Phone: XXX-XXX-XXXX
Contact Email: *****@af-group.com
We received the mail on July 16 and July 31, 2012. The benefits underthe Disability Rider was processed on August 6, 2012. The benefits under the Accident Only Policy was processed on August 7, 2012. A benefit check has been mailed to the Insured $450.00 for the benefits under the Accident Only Policy and $600.00 for the Disability Rider.

Consumer's Final Response
(The consumer indicated he/she DID NOT accept the response from the business.)
The policy was not explained at the time of purchase to be what I found it to be and the salary was not equivalent to my salary throughout the year at school. further testing has revealed that my right diaphragm is paralyzed, which ****** or ****** not have happened at the time of the accident. My daughter called when I fell and what she was told was totally different than what happened. I am still not back to work at Royal Excursion.

Business' Final Response
We are currently reviewing the rebuttal and are requesting additional information from our account representative and ****** respond upon receipt.

11/24/2014Problems with Product / Service
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06/02/2014Problems with Product / Service | Read Complaint Details
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Complaint
They stripped my Aviation Rider, charged the same premium and would not own up to it for over 10 years
I bought a $100,000 life policy from Mid-Continent Insurance Co. prior to 2001 ~$40/month premium with Aviation Rider (policy pays off if I pilot an airplane & die during).
Dec. 2003 AFA (named above) buys out Mid-Cont and begins drafting the same premium on my checking account ($46.20/mo at that time).
This is when I began asking IF I continued to enjoy an Aviation Rider on this new name policy.
NOTHING was sent me by mail in assurance, except to state ... IF you had it with Mid-Cont, then you have it with us. Well, I had a letter from Mid-Cont saying yes, so was content at times with all that.
... but only for a few years at a time. I would phone and IF I could ever get with the correct party at that merry-go-round, they would simply assure (like their name) that all was A-OK.
Several other attempts were made to get some confirmation in writing over the years but still only the obtuse relies, if any ... mostly no replies.

Finally AFA says - your term life is to expire, big upcharges ahead, better convert to whole life (whopper charges). During this email conversation, I was able to get enough information to pass on to my home/auto/etc. insurance agent for him to conclude ... NO AVIATION RIDER was EVER on my AFA life policy like it was on my Mid-Cont.

I have since terminated AFA policy XXXXXXXX

Desired Settlement
I want a settlement of the amount of premium an Aviation Rider would have cost extra for the period 12/29/2003-01/29/2014 made out to me as a check. If that cannot be calculated, then I want a refund of 1/2 my premiums in that duration:
$46.20 2003
$590.64 2004
$627.96 2005
$668.28 2006
$710.64 2007
$758.04 2008
$811.44 2009
$871.92 2010
$863.06 2011
$1013.57 2012
$1102.29 2013
$100.80 2014

Business Response
Effective January 28, 1988 Mr. ****** was issued a One Year Renewable and Convertible Term Life Insurance policy with Mid-Continent Life Insurance Company. The policy did not include a specific Aviation Rider on the policy, nor was he charged any additional premium for aviation or being a pilot. The policy, also, did not include an Aviation Exclusion Rider. Therefore, had Mr. ****** died as a result of piloting, the benefit would have been paid to his designated beneficiary upon receipt of due proof of the death of the Insured, provided such death occurred prior to the Final Expiry Date while the policy was in force.

On December 31, 2000 American Fidelity Assurance Company assumed the Mid-Continent block of business. American Fidelity made no changes to Mr. ******'s original policy contract. As the policy renewed each year for another one year term period, Mr. ****** was notified what his new monthly premium would be. The premium increase was a result of the term renewal under the terms of the original policy contract, not due to an Aviation Rider or because he was a pilot. American Fidelity continued to draft the premium automatically each month from his bank account as had been done by Mid-Continent.

Since 1989, Mr. ****** has inquired about coverage as a pilot. Mid-Continent and American Fidelity have responded to his requests advising the policy did not have an Aviation Exclusion Rider attached, nor was he charged additional premium for being a pilot.

Per the terms of the original policy contract, the conversion period to age 65 was due to expire on January 28, 2014. American Fidelity notified Mr. ****** of this in case he wanted to convert to a permanent form of coverage. Conversion information had been sent to him with current options available. On March 26, 2014 American Fidelity received a request from Mr. ****** to surrender his life insurance policy. The policy has been terminated and a refund of unearned premium from March 26, 2014 to March 28, 2014, the policy's anniversary date, was refunded. Because this was a Term Life policy, there was no cash value.

If Mr. ****** has any correspondence or documentation from Mid-Continent or American Fidelity showing he paid or was charged additional premium for aviation, please email to me at ************@americanfidelity.com; fax to (XXX)XXX-XXXX; or mail to the following address. I'll be happy to research further.

American Fidelity Assurance Company
Attention: ***** ****** - Life Division
PO Box XXXXXX
Oklahoma City, OK XXXXX-XXXX


Consumer Response
(The consumer indicated he/she DID NOT accept the response from the business.)
The facts (again) are that my Mid-Continent Life Insurance policy included an extra cost aviation rider through the period they were in business and confirmed by a letter now in possession of my insurance agent @ W.E. Gibson Ins. - I will notify him to return it for submittal.

The last premium paid to Mid-Cont was $46.20/month Nov 2003.

The next premium of $46.20 was paid to AmerFidIns who "took over" Mid-Cont & their policies. Ever since that date, AmerFidins has AVOIDED all inquiries (until Dec 2014) concerned over aviation rider in effect.

In fact, since I do not have any documentation, I challenge them to provide proof of correspondance as alleged in their re-writing of history version stated as a response.



Final Business Response
Based on the follow-up inquiry by Mr. ******, it does not appear that any new questions are being asked. Our previous correspondence provided to Mr. ****** stated his life insurance policy did not have an Aviation Exclusion Rider and no additional premium was added for him being a pilot. Had Mr. ****** died as a result of piloting while the policy was in-force, the full death benefit would have been paid to his designated beneficiary.

We have not yet received the letter from Mr. ******'s agent at W. E. Gibson Insurance referenced in his April 16, 2014 response. This can be mailed, emailed, or faxed to me at the following:

American Fidelity Assurance Company
Attention: ***** ****** - Life Division
PO Box XXXXXX
Oklahoma City, OK XXXXX-XXXX
Email: ************@americanfidelity.com
Fax: (XXX) XXX-XXXX

We would be happy to discuss this with Mr. ****** to clarify our position or answer any questions he *** have. He can contact me, ***** ******* directly at (XXX)XXX-XXXX extension 3848, or my direct line is (XXX) XXX-XXXX.

Final Consumer Response
(The consumer indicated he/she DID NOT accept the response from the business.)
USPS will bring this BBB evidence that my Mid-Cont Ins policy had no aviation exclusion rider:

What is an "Aviation Exclusion Rider"?
An Aviation Exclusion Rider is an addendum that basically makes your policy void should you die in an aviation-related accident other than as a fare-paying passenger on a scheduled airline. If you are a pilot you should never consider a policy that contains an Aviation Exclusion Rider.

05/16/2014Problems with Product / Service | Read Complaint Details
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Complaint
I have a policy created in December of 2000. AF changed my policy without my consent since after paying them for over ten years.
I went on disability in January. My policy is to cover me during disability. They changed my policy without my consent which was signed in December of 2000 and now they told me I'm only covered for 60 days.

Desired Settlement
I would just like them to honor what I originally signed off on in December of 2000. They gave me coverage in 2003 but now they are providing almost nothing. I was short about 3000 after paying them approximately 12000 in ten years. They changed my policy in the last year or so without my consent.

Business Response
Contact Name and Title: *************************
Contact Phone: XXXXXXXXXX
Contact Email: **************@americanfidelity.com
Ms. ******* is an Insured under a group disability Policy held by Bank of Oklahoma N.A. trustee, who is the Policyholder. The Policy was changed to GXXX-XXX effective 1/1/2014. Prior to 1/1/2014 there was no offset by sub-differencial pay. For any loss incurred on or after 1/1/2014 sub-differencial pay is a direct offset from the $2100.00 monthly Disability Benefit after 60 calendar days of disability. After 60 days of disability, the Minimum Monthly Disability Benefit of $210.00 became payable due to her receipt differential pay. Ms. *******'s prior disability that began in 2003 was paid under the terms of the Policy at that time, meaning subdifferantial was not an offset so her benefits were greater for that loss. Our records confirm we notified Ms. ******* of the impending change in the Policy that would take effect 1/1/2014 with a letter dated 11/22/2013. The letter was sent to Ms. ******* with a new Certificate of Insurance and explaiend there would be plan changes effective 1/1/2014 including that "Your Disability Benefit **** be reduced by amounts payable to you for SubDifferential pay extending beyond 60 calendar days. Because benefits were paid to Ms. ******* in accordance with the terms of the policy in effect when her loss began, there are no additional benefits payable to her.

Consumer Response
(The consumer indicated he/she DID NOT accept the response from the business.)
I signed this policy in December of 2000. They should honor an old policy. I signed this policy not as a group but as an individual! The year I needed disability AF chose to change my policy and not pay what was owed to me. I've paid on time each month for the last fourteen years and have only used my policy twice for my last two children. How convenient they choose to change the policy this year. I will appeal and consult with other companies and never recommend American Fidelity to other people. In fact I will tell other family members what they've done and have them cancel.

Final Business Response
As indicated in my prior response, Ms. ******* is insured under a group disability income Policy. She is entitled to this coverage as an employee at Fontana Unified School District. Periodically there are changes made to the Policy and as an Insured, Ms. ******* is subject to those changes. Benefits were provided to Ms. ******* in accordance with the terms of the Policy at the time her loss was incurred. We are sorry she is not happy with the available benefits but benefits were paid under the terms of the coverage at the time her loss was incurred. If she chooses to appeal the decision she can do so by contacting American Fidelity in writing on a timely basis, stating the basis for her appeal and submitting any information she feels should be given consideration. ***** ******** Special Risk Analyst

09/10/2013Problems with Product / Service
05/22/2013Problems with Product / Service
05/09/2013Advertising / Sales Issues

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