Buyers beware - Serious Flawed claim process
by Frustrated client on Dec 15, 2023
1 out of 5 stars
Call waits 4 hours and claim processed over 3 months. We need to provide the files repeatedly and repeatedly.
They do not appear to care about customer service (i have been on hold for a long time, every time i need to call, clearly they do not appreciate that I too have things to do with my time, if I email them a question, it can take a month to get a response from them) They also don't seem to care about mental health, their coverage for mental health is extremely limiting only allowing for a psychologist appointment and doesn't allow for certified cognitive behavioural therapy, this is an antiquated way to do things.
Am with the Fed Gov and switched over to Canada Life after years of great service for Med/Dental benefits. Everything worked perfectly.
The entire Canada Life website runs like a scam and it seems those who designed it are either utterly incompetent or the company is trying their hardest to put clients off and save money at their expense.
There were to be no impacts to my family's services but everyone has had to provide new info at the pharmacy and dentist. This after the pharmacy charged full pricing and told my spouse "you have no coverage". Then the scramble for the lousy paper copy of the ID card because they won't provide a real one due to "greening" initiatives.
Need help with anything? Feel like wasting 1/2 hour or longer on the phone? Good luck! Call one number and it tells you to call another after you've entered your group and individual plan numbers twice.
Tried to log in after previously receiving confirmation that my account is active and it wouldn't log us in saying "It's not you, It's us". Then locks your account for too many attempts and you have to call the help line. Once you get through and finish playing 20 questions with the agent...Ta Dah! an 8 to 10 day wait for someone to push a reset button.
Wouldn't voluntarily purchase any coverage from this company. Way to go CL. Not.
Long phone wait times.
Extremely RUDE customer service agents.
Take forever to process your claim or they don't do it at all.
No empathy for customers and their time.
If you have an option, stay away from these people.
Zero stars!
It's very difficult to submit a claim, and when you do it takes forever to receive the money back.
Also, when you need massage therapy, you have to get a prescription, while other providers fine in covering it.
Similarly, they keep changing their plan to make more money on you. For example, i just received a letter in the mail about : " brand name prescription drugs". " The plan changed how claims for brand name prescription drugs are paid. It implemented mandatory generic drug substitution on July 1, 2023. This means that when you submit a claim for a brand name drug that has a generic drug equivalent, the reimbursement amount for the brand name drug is limited to the cost of the generic drug equivalent. This applies even if your prescription indicates "no substitution". Personally, it sounds like a SCAM, where they try to maximize profits for the expense of the client.
Recommendation: Stay AWAY
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They have my insurance saved as secondary and can’t figure out how to update it. I paid out of pocket for an appt.
My secondary won’t pay because (rightfully) Canada Life is supposed to be primary.
Wait times on the phone are ridiculous.
App and webpage are not accessible over one week, terrible service, not acceptable for health insurance, looking into lawsuit.
The long waiting time it takes to process recurrent and regular claims, even when these a recurrent every month or every three months, Ex: if you have a condition like DIABETES TYPE 1 and you are insulin-dependent and will need insulin pump and supplies for the rest of your life, WHY DOES IT TAKE 20 DAYS to get this type of claims processed???
Why if the insurance was covering the remaining balance of the insulin pump for a year, suddenly one day the insurance sent me a letter saying this is no longer covered? they decided it would no longer be covered, without any prior email or notification about the changes.
If you can stay away from this so-called insurance company
Talking a very long time to get a claim, when there is a problem also takes a long time to support. The support is not 24 hours, no weekend and only support to the plan member (no family member) this even make the issue difficult to resolve. Also, the time zone is different making it even more difficult. If there was zero stars, I would give it zero stars.
The system is not consistent. This is the worst ever insurance system and support. Only cheap companies are using this cheap insurance.
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Their claim process is highly flawed, something out of the 1990s that has not been upgraded ever. It is not user friendly at all and sends you in circles with different names for what you are claiming for. The mobile app is even worse with the inability to download forms. This is 2023 it should not have to be downloaded, we should be able to just fill it out add pictures of receipts and submit, done. I swear they make it difficult to just pay the bill yourself. If my work did not have this plan, I would not have this. Buyers beware!! Pharmacy prescriptions is the only part of the plan that works well for me so far.