Short-Term Disability Insurance

SHORT-TERM DISABILITY - A57600 SERIES

In Arkansas, Policies A57600AR, A57600LBAR. In Delaware, Policies A57600DE & A57600LB. In Idaho, Policy A57600IDR. In New York, Policy NY57600. In Oklahoma, Policies A57600OK, A57600LBOK. In Oregon, Policies A57600OR, A57600LBOR. In Pennsylvania, Policies A57600PA, A57600LBPA. In Texas, Policies A57600TX, A57600LBTX. In Virginia, Policies A57600VA, A57600LBVA. This is a brief product overview only. The plans advertised herein offer supplemental insurance coverage and are not major medical insurance plans. Coverage may not be available in all states including but not limited to DE, ID, NJ, NM, NY or VA. Benefits/premium rates may vary based on plan selected. Optional riders are available at an additional cost. The policy has limitations and exclusions that may affect benefits payable. Refer to the policy for complete details, limitations, and exclusions. For costs and complete details of the coverage, please contact your local Aflac agent.

Limitations and Exclusions for residents of Arizona:

Disability caused by a Pre-existing Condition or reinjuries to a Pre-existing Condition will not be covered unless it begins more than 12 months after the Effective Date of coverage. Aflac will not pay benefits for a Disability that is being treated outside the territorial limits of the United States. Aflac will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void. Aflac will not pay benefits whenever fraud is committed in making a claim under this coverage or any prior claim under any other Aflac coverage for which you received benefits that were not lawfully due and that fraudulently induced payment. Aflac will not pay benefits for a Disability that is caused by or occurs as a result of any bacterial, viral, or micro-organism infection or infestation, or any condition resulting from insect, arachnid, or other arthropod bites or stings as a Disability due to an Injury; such disability will be covered to the same extent as a Disability due to Sickness.

Aflac will not pay benefits for a disability that is caused by or occurs as a result of your:

1. Pregnancy or childbirth within the first ten months of the Effective Date of coverage (Complications of Pregnancy will be covered to the same extent as a Sickness);
2. Using any drug, narcotic, hallucinogen, or chemical substance (unless administered by a Physician and taken according to the Physician’s instructions), or voluntarily taking any kind of poison or inhaling any kind of gas or fumes;
3. Participating in any activity or event, including the operation of a vehicle, while under the influence of a controlled substance (unless administered by a Physician and taken according to the Physician’s instructions) or while intoxicated (“intoxicated” means that condition as defined by the law of the jurisdiction in which the accident occurred);
4. Participating in, or attempting to participate in, an illegal activity that is defined as a felony (“felony” is as defined by the law of the jurisdiction in which the activity takes place); or being incarcerated in any detention facility or penal institution;
5. Intentionally self-inflicting a bodily injury, or committing or attempting suicide, while sane or insane;
6. Having cosmetic surgery or other elective procedures that are not Medically Necessary;
7. Having dental treatment, except as a result of Injury;
8. Being exposed to war or any act of war, declared or undeclared;
9. Actively serving in any of the armed forces, or units auxiliary thereto, including the National Guard or Reserve;
10. Donating an organ within the first 12 months of the Effective Date of the policy;
11. Mental or emotional disorders, including but not limited to the following: bipolar affective disorder (manic-depressive syndrome), delusional (paranoid) disorders, psychotic disorders, somatoform disorders (psychosomatic illness), eating disorders, schizophrenia, anxiety disorders, depression, stress, or post-partum depression. The policy will pay, however, for covered disabilities resulting from Alzheimer’s disease, or similar forms of senility or senile dementia, first manifested while coverage is in force.

Benefits will be paid for only one Disability at a time, even if the Disability is caused by more than one Sickness, more than one Injury, or a Sickness and an Injury.

PRE-EXISTING CONDITION LIMITATIONS: A “Pre-existing Condition” is an illness, disease, infection, disorder, condition or injury for which, within the 12-month period before the Effective Date of coverage, medical advice, consultation, or treatment was recommended or received, or for which symptoms existed that would ordinarily cause a prudent person to seek diagnosis, care, or treatment. Disability caused by a Pre-existing Condition or reinjuries to a Pre-existing Condition, including deliveries for children conceived prior to the Effective Date of coverage, will not be covered unless it begins more than 12 months after the Effective Date of coverage.

Limitations and Exclusions for residents of Idaho:

Disability caused by a Pre-existing Condition will not be covered unless it begins more than 12 months after the Effective Date of coverage. Aflac will not pay benefits for a Disability that is being treated outside the territorial limits of the United States. Aflac will not pay benefits whenever fraud is committed in making a claim under this coverage or any prior claim under any other Aflac coverage for which you received benefits that were not lawfully due and that fraudulently induced payment.

Aflac will not pay benefits for a disability that is caused by or occurs as a result of your:

1. Pregnancy or childbirth if the pregnancy began prior to the Effective Date of the policy. Complications of such pregnancy will be covered to the same extent as a Sickness;
2. Elective abortions (An elective abortion means an abortion for any reason other than to preserve the life of the female upon whom the abortion is performed);
3. Alcoholism or drug addiction;
4. Participating in a felony, whether charged or not (“felony” is as defined by the law of the jurisdiction in which the activity takes place); or being incarcerated in any detention facility or penal institution;
5. Intentionally self-inflicting a bodily injury, or committing or attempting suicide, while sane or insane;
6. Having cosmetic surgery or other elective procedures that are not Medically Necessary, except that “cosmetic surgery” shall not include reconstructive surgery when the service is incidental to or follows surgery resulting from trauma, infection or other diseases of the involved part;
7. Having dental treatment, except as a result of Injury;
8. Being exposed to war or any act of war, declared or undeclared;
9. Actively serving in any of the armed forces, or units auxiliary thereto, including the National Guard or Reserve; or
10. Mental or emotional disorders, including but not limited to the following: bipolar affective disorder (manic-depressive syndrome), delusional (paranoid) disorders, psychotic disorders, somatoform disorders (psychosomatic illness), eating disorders, schizophrenia, anxiety disorders, depression, stress, or post-partum depression. The policy will pay, however, for covered disabilities resulting from Alzheimer’s disease, or similar forms of senility or senile dementia, first manifested while coverage is in force.

Benefits will be paid for only one Disability at a time, even if the Disability is caused by more than one Sickness, more than one Injury, or a Sickness and an Injury.

PRE-EXISTING CONDITION LIMITATIONS: A “Pre-existing Condition” is an illness, disease, infection, disorder, condition, or injury for which, within the six-month period before the Effective Date of coverage, medical advice, consultation, or treatment was recommended or received from a Physician. Disability caused by a Pre-existing Condition, including deliveries for children conceived prior to the Effective Date of coverage, will not be covered unless it begins more than 12 months after the Effective Date of coverage.  

Limitations and Exclusions for residents of New Jersey:

Disability caused by a Pre-existing Condition or reinjuries to a Pre-existing Condition will not be covered unless it begins more than 12 months after the Effective Date of coverage. Aflac will not pay benefits for an illness, disease, infection, or disorder that is diagnosed or treated by a Physician within the first 30 days after the Effective Date of coverage, unless the resulting Disability begins more than 12 months after the Effective Date of coverage. Aflac will not pay benefits for a Disability that is being treated outside the territorial limits of the United States. Aflac will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void. Aflac will not pay benefits whenever fraud is committed in making a claim under this coverage or any prior claim under any other Aflac coverage for which you received benefits that were not lawfully due and that fraudulently induced payment. Aflac will not pay benefits for a Disability that is caused by or occurs as a result of any bacterial, viral, or micro-organism infection or infestation, or any condition resulting from insect, arachnid, or other arthropod bites or stings as a Disability due to an Injury; such disability will be covered to the same extent as a Disability due to Sickness.

Aflac will not pay benefits for a disability that is caused by or occurs as a result of your:

1. Giving birth when conception occurs prior to the Effective Date of coverage (Complications of Pregnancy will be covered to the same extent as a Sickness);
2. Being under the influence of any narcotic (unless administered on the advice of a Physician), or voluntarily taking any kind of poison or inhaling any kind of gas or fumes;
3. Participating in any activity or event, including the operation of a vehicle, while intoxicated or under the influence of any narcotic unless administered by a Physician and taken according to the Physician’s instructions (“intoxicated” means that condition as defined by the law of the jurisdiction in which the Injury or cause of loss occurred);
4. Attempting to commit or committing a felony or being engaged in an illegal occupation;
5. Intentionally self-inflicting a bodily injury, or committing or attempting suicide, while sane or insane;
6. Having cosmetic surgery, except reconstructive surgery when such service is incidental to or follows surgery resulting from trauma;
7. Having dental care or treatment, except as a result of Injury;
8. Being involved in war or any act of war, declared or undeclared;
9. Actively serving in any of the armed forces, or units auxiliary thereto, including the National Guard or Reserve. (We will return the premium paid during such service, and upon termination of military service, you have the right to renew coverage.);
10. Mental or emotional disorders, including but not limited to the following: bipolar affective disorder (manic-depressive syndrome), delusional (paranoid) disorders, psychotic disorders, somatoform disorders (psychosomatic illness), eating disorders, schizophrenia, anxiety disorders, depression, stress, or post-partum depression. The policy will pay, however, for covered disabilities resulting from Alzheimer’s disease, or similar forms of senility or senile dementia.

Benefits will be paid for only one Disability at a time, even if the Disability is caused by more than one Sickness, more than one Injury, or a Sickness and an Injury.

PRE-EXISTING CONDITION LIMITATIONS: A “Pre-existing Condition” is an illness, disease, infection, disorder, pregnancy, or injury for which symptoms existed that would cause an ordinarily prudent person to seek diagnosis, care, or treatment within a one-year period preceding the Effective Date of coverage or a condition for which medical advice or treatment was recommended by a physician or received from a physician within a five-year period preceding the Effective Date of coverage. Disability caused by a Pre-existing Condition or reinjuries to a Pre-existing Condition will not be covered unless it begins more than 12 months after the Effective Date of coverage.

Limitations and Exclusions for residents of Virginia:

Disability caused by a Pre-existing Condition will not be covered unless it begins 12 months after the Effective Date of coverage. Aflac will not pay benefits for an illness, disease, infection, or disorder that is diagnosed or treated by a Physician within the first 30 days after the Effective Date of coverage, unless the resulting Disability begins more than 30 days after the Effective Date of coverage. Aflac will not pay benefits for a Disability that is being treated outside the territorial limits of the United States. Aflac will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void. Aflac will not pay benefits whenever fraud is committed in making a claim under this coverage for which you received benefits that were not lawfully due and that fraudulently induced payment. Aflac will not pay benefits for a Disability that is caused by or occurs as a result of any bacterial, viral, or micro-organism infection or infestation, or any condition resulting from insect, arachnid, or other arthropod bites or stings as a Disability due to an Injury; such disability will be covered to the same extent as a Disability due to Sickness.

Aflac will not pay benefits for a disability that is caused by or occurs as a result of your:

1. Pregnancy or childbirth within the first ten months of the Effective Date of coverage (Complications of Pregnancy will be covered to the same extent as a Sickness);
2. Participating in any activity or event, including the operation of a vehicle, while under the influence of any narcotic unless taken on the advice of a Physician or while intoxicated (“intoxicated” means that condition as defined by the law of the jurisdiction in which the accident occurred);
3. Participating in, or attempting to participate in, an illegal activity that is defined as a felony, whether charged or not (“felony” is as defined by the law of the jurisdiction in which the activity takes place);
4. Intentionally self-inflicting a bodily injury, or committing or attempting suicide, while sane or insane;
5. Having cosmetic surgery or other elective procedures that are not Medically Necessary; (cosmetic surgery shall not include reconstructive surgery when such service is incidental to or follows surgery resulting from trauma, infection or other diseases of the involved part, and reconstructive surgery because of congenital disease or anomaly of a covered dependent child which has resulted in a functional defect);
6. Having dental treatment, except as a result of Injury;
7. Being exposed to war or any act of war, declared or undeclared; or actively serving in any of the armed forces, or units auxiliary thereto, including the National Guard or Reserve (Aflac will upon receipt of written notice of military service, refund all premiums as is applicable to such persons on a pro rata basis.);
8. Donating an organ within the first 12 months of the Effective Date of the policy;
9. Mental or emotional disorders, including but not limited to the following: bipolar affective disorder (manic-depressive syndrome), delusional (paranoid) disorders, psychotic disorders, somatoform disorders (psychosomatic illness), eating disorders, schizophrenia, anxiety disorders, depression, stress, or post-partum depression. The policy will pay, however, for covered disabilities resulting from Alzheimer’s disease, or similar forms of senility or senile dementia, that manifests itself while coverage is in force.
10. Work-related Injuries.

Benefits will be paid for only one Disability at a time, even if the Disability is caused by more than one Sickness, more than one Injury, or a Sickness and an Injury.

PRE-EXISTING CONDITION LIMITATIONS: A “Pre-existing Condition” is an illness, disease, infection, disorder, or injury for which, within the 12-month period before the Effective Date of coverage, medical advice, consultation, or treatment was recommended or received, or for which symptoms existed that would ordinarily cause a prudent person to seek diagnosis, care, or treatment. Disability caused by a Pre-existing Condition will not be covered unless it begins 12 months after the Effective Date of coverage.

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