Sun Life Group Benefits Insurance Reviews

My spouse was a employee for Ontario Hydro. Unfortunately, they chose Sun Life for their health benefits. We sent in documents for receipts for our glasses. They just ignore us. They do not contact us to tell us why they are not paying. When we phone them, the lie and say they didn't receive any receipts. They keep saying this no matter how many receipts you sent in.

My family , unfortunately has Sun Life for our secondary Dental insurance. Even though we pay for this insurance through my husband's employer they do not pay on claims . This has caused me to go into collections with a dentist office. Their customer service department is lousy. I have emailed them numerous occasions and they have only responded twice stating that they are not able to find the claim I'm questioning ,yet I received the EOB from them. HORRIBLE! If I could rate this company with zeros stars, I would. The company is no longer using them as of July 1st! Thank goodness!

I had my therapy recently and submitted the claim to my two coverages, one under my employer and the other one under my Husband, both Sun Life. I got reimbursed for a portion only from my plan and denied the balance under my spouse plan. The reason? Because they only paid according to their price limit! Coordination of benefit was never applied on this case plus this is my first claim for two years! There is no consideration. I got pregnant and taking care of my baby, and trust me. I feel all the pain in my back. But when I decided to have a massage from a decent spa, I never thought that I wouldn't be able to use my benefits.

This company are the Kings of no pay. I submitted phsio/massage therapy. There were the secondary provider. I submitted it thru mail!! yes Canada Post. I gave them the Px and the amount paid by Blue Cross on Blue Cross letter head. They denied it because I did not sent the original Px. I got the original from the clinic and sent it to them. Then they denied it because they said they were the seconday provider and they have no proof that the primary provider paid!! I sent them the Blue Cross form which clearly states BLUE CROSS PAYS, and they had the claim filled out online clearly showing the amount Blue Cross paid and they had 20% left to pay. Next they denied it because I reached my max for the year. The max for the year was $500 and I had submitted. It took me 3 months, 6 phone calls, 4 letters/written submissions and they paid me the $28 they owed me. $28!!! And I have since submitted other phsio/massage bills and each time they do the same actions. All the people who work with me get the same run around when they submit expenses. This should be shut down. They like taking my $175 a month in premiums. NO company should have this company as an insurance provider

I found out at the end of January 2016 that I needed surgery. I began the process of starting a claim about a month before I actually stopped working. My case was a bit complicated because I need 2 surgeries, and at the time I submitted the paperwork the second surgery date was unknown. I submitted the paperwork before my surgery on March 23rd, got the forms filled out by my doctors, and thought everything was fine. I called multiple times, was told my claim was approved, and it was fine. When I was supposed to start getting paid, I never got a check. I called them - turns out they were missing a form, that no one had ever told me about. I get the form worked out and submit it, and call them a few days later.... only to find out that there was ANOTHER form missing. They kept telling me that I needed to talk to my claims manager Tanya, but she never seemed to be in the office - we're convinced she doesn't exist. The 6th of 7th time I called, I was informed that I had TWO claims - one for short term disability, which has been approved, and one for state. "State?" I asked them. Turns out they were missing forms for that as well, that no one had decided to tell me about the other SIX OR SEVEN TIMES I HAD CALLED. You would think that if they were missing a form, they would call you to ask about it; nope. Sun Life is deducting $170 from my checks every week for this state disability, and to date I have not received any of that money, even though the state claim has been approved at this point. Back to the short term disability; I have been getting checks the last two weeks, so I was lulled into thinking everything was okay. I still have not gotten my state money... but I thought I was okay on the short term side. My second surgery is tomorrow, so I started the process to extend my leave. After FINALLY getting ahold of Tanya, she assured me that all she needs to do is call my doctors office tomorrow after my surgery to find out how much longer I'll be out. She said that she would just extend my leave to whatever the doctor says - we'll see tomorrow if that happens. I received a check today that showed me 2 things. First, the amount is off by $100. Second, they are showing my leave as suspended. I also was given a claim number for my state disability - I looked up that claim, and it shows a check that I never received, and that I have already returned to work.

Long story short, AVOID THIS COMPANY AT ALL COSTS. They jerk you around and absolutely do not care about your wellbeing. They lie to you and say they have everything they need, just to retract that statement the next time you call. You will never get what you're owed if you go through this company, so save yourself the trouble and STAY AWAY.

I have a group insurance plan through my employer. I have been diagnosed with cancer since 2009. My condition has deteriorated since then requiring me to purchase a hospital bed. I have coverage up to $4000.00 for this item. When I filed a claim, they denied it stating they needed more information. I had given them a doctors note and an estimate. They denied the doctors note. I got another note from my doctor costing $40.00. I sent it in via priority post. Sun life received this the next business day. I was told it takes 7 business days to process. They denied it again because they didn't like the receipt. Maybe it was the colour of the paper or the staple I used; I don't know. I've sent another receipt. This time it was handwritten. Then I'm told it will take 7-9 business days to process. I've yet to see the outcome. They have a neat little requirement that you must complete before honouring (I use that term lightly) their obligation; You must pay for the bed yourself in advance. Anyone knows people on disability insurance don't make much money and can't afford to do this. So, if you can't pay up front they will not pay what they owe. Convenient isn't it? Why couldn't they have told me at first everything they needed; in detail. Nope. They strung me around for one and a half months hoping I would throw my arms up in exasperation and walk away. Not going to happen. If this last receipt is denied I will contact my lawyer and have him settle it. Be vary wary of this insurance company. You have to fight tooth and nail to get them to live up to their obligations. I would not recommend this company for anything. Do not trust them to have your best interests at heart.

This company is the worst to deal with. I pay for coverage through my employer for short-term disability. I had carpal tunnel surgery in September and am still unable to return to work. My surgeon filled out the paperwork stating no use of the right hand. Not sure what more they need. There is a very high chance of another surgery to try to correct the problem. Now more paperwork needs to be filled out by the doctor. What a run around. They say they will return your call within 24 hours. Another crock. It took my member of parliament calling them for the call to be returned. I have not been denied yet but looks like it is going to go that way. I am trying to find out if there is a way to opt out of paying for this as when it is needed, they don't pay. I have never claimed been unable to work until now. I am not asking to be off for the rest of my life. Just until they fix the problem. I would rather donate my payments. Why should I have to pay for something I can never use? This company is a joke. I realize that they make money by not paying out however it is crooked to take money from people if they can never utilize the services that are supposed to be provided that you pay for. Will be talking to my union to see what steps to take to remove this payment from my pay and put it to anywhere but these crooks

I had a health plan through my group. Alberta
Took pre-authorization for orthodontal and endodontic expenses separately submitted by each of these specialists.
The Sun Life team approved both the pre-authorization separately.
These orthodontal and endodontic treatment expenses for the child are very expensive and not easily affordable for parents.
Despite the pre-authorization approval received from Sun Life, the insurance company refused to pay an amount of approx 463$ which is approximately 8% of the payment made by us ($10000) for these specialists.

A complaint was registed with Sun Life and case id was issued.
Their customer care representative Mr. G informed me that the pre-authorization approval was a mistake by their team and hence then cannot compensate the amount of $463

I followed up with Mr. G for several months and the case was open. But Mr. G states that he has put a write-off request to his senior management due to the error from Sun-life in the pre-approvals. But his senior management did not take steps.

Despite several follow-ups, Sun Life did not honor their pre-authorization approval and did not reimburse me for the expenses made

Result
Orthodontic Expenses for the treatment by us : $8000
Endodontic expense for the treatment by us : $2600

Pre-authorization sent out separately for the above to Sun Life
Approved pre-authorization amount for orthodontics : $2000
Approved pre-authorization amount for endodontics : $463

When expenses were submitted after treatment, Sun Life insurance company paid only 2000$ instead of the pre-approved amount of 2463$ with further loss of 463$

Experience
1) Despite taking approvals, the team is not professional enough to understand customer concerns and did not honor their commitment.

2) Why the customer has to always bear the loss due to the any lapses of Sun Life medical insurance team.

3) please be careful when you sign up with Sun Life plans and they will tweak the clauses to their own benefit despite preauthorization

4) they collect hefty premium for these plans

5) Sharing this information to all of you so that no other customer should have to face similar things while dealing with Sun Life health and dental insurance

I have UHIP with Sun Life. Initially they say everything is covered 100% including doctor visits, but when you claim they decide what % you pay out of pocket all of a sudden. First, they never send you the health plan information packet, second, the out of pocket expense % is not mentioned anywhere. So you're basically lost, and they decide how much they pay for each claim. God knows how they calculate these percentages. Their customer reps can't even explain this. Poor service, and misleading info!

I have group benefits through my hospital..In Toronto/ Mississauga area. My goodness what a subpar provider Sun Life Insurance is. My wife and I did co-ordinated benefits for a pair of eyeglasses, and (Manulife) which is my wife's provider paid out their portion with no concerns. Not even one question. Sun Life did not pay out a cent.. they keep sending it around in circles to our Human Resources and then them... for eyeglasses.. no paymnet yet after 4 months.. I pay the benefits and they have not paid out one penny ..not one... when you need them.. for eye glasses... I have had Dejardin, Manulife , Equitable life and even Td Insurance.. and have been around 25 years in social services. Sun Life is the bottom of the barrel. If you are a company like a hospital, non profit agency,private or public company.. this should be the last choice you should make.. Do you want your employees to respect you.? Well then, don't choose Sun Life Insurance as your group provider... saving money does not always pay in the long run for your employee loyalty and or lost time for the HR dept in your agency..

Sincerely

Mike