Application for Individual Accident Insurance

Please review the information and/or questions stated here, answer or initial as applicable, then click "next" to proceed.

Open Enrollment

December 14th - December 28th!

Still have questions?

  • 1.800.992.3522
  • www.aflac.com
  • Aflac Worldwide Headquarters
    1932 Wynnton Road
    Columbus, GA 31999