Sun Life Group Benefits Insurance Reviews

I'm covered under group coverage through work, and there have been two times where they have denied dental coverage. First, my son had to go to a dental specialist (although is someone who provides similar dental services), and they said it wasn't covered, so they provided a 'similar' fee guide for services performed - which ended up being about 35% lower. Second, I paid $3400 for a dental surgery /services and the first part was put to my wife's benefit provider (also Sun Life), which ended up getting paid, but then, although my information for coverage was also on the form, they did not pay my portion. They told me I had to re-submit... which I did about 100 days later and they denied it saying it was beyond my plan's time limits. 90 days? Even though on the first submission everything was there. Enough said.... if you're thinking about going with a particular provider, well, you know what you should do...

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

The HR of my husband's company continuously tells SUN to pay her dental. And continually they refuse. If you do a search on Sun Life Financial, ALL they care about are their INVESTORS. So my kid gets to go around with rotten teeth to keep investors getting a return. I even wrote the president and VP and someone else there and they wrote back two pages of BS to me.

Since I got a new employer, I had to switch to Sun Life. I have had nothing but huge problems with them. After months of paying for a family plan, my fiancé had dental work done only to find out we had to pay all money out of pocket because Sun Life was saying that we were not covered. After many many calls with them, they finally saw that we were in fact covered and had been this whole time. Fast forward 5 months later and we still have not been refunded the money. They are now trying to claim that they paid us out. Incredibly rude cutting me off when I tried to explain what had happened. They do not listen, do not refund or properly cover you for multiple claims. I will be cancelling my coverage and will never deal with them again. I will go back to my previous insurance company which is wonderful, respectful and I never have issues with. Sun Life, maybe you should treat you clients with respect as we pay for the seats you sit in.

Okay. Let's get things straight here, I would give a 0/5 for Sun Life in the disability sector. 3/5 to the group benefits. I have been off work due to what I have found out is bad ADHD and a myriad of anxiety disorders that I have been dealing with my whole life, and things have started to go extremely bad aka, almost suicide... I have been doing my due diligence with going to my appointments etc. waiting. Going to more appointments. Until I have finally gotten to see my psychiatrist today. When I first applied and got accepted for my disability claim. It took 3 weeks to get anything done. It took two weeks for my case manager to get a hold of me and confirm. Then after that. It took a week for my claim amount and dates to process. Then somehow a whole week to mail me a check... second time I applied for an extension. It took another 3 weeks to get any money. It is extremely difficult to get a hold of any case manager. As for some reason they aren't actually ever in their office. Why? I do not know. This is a benefits company. You are supposed to be helping people who are disabled or in need of help. These people need quick service. Not a lot of people have a whole months worth of savings to back themselves on to these days. May I mention, we also pay into this. So it is basically our money, to begin with, okay? So I have been diagnosed with bad ADHD and three other anxiety disorders along with a stress disorder. So my fiance and I were not able to pay rent due to 3-week delays, which happened twice now. I have been evaluated and strictly told to take 3 months off work for new medication and a strict plan ordered by the psychiatrist. I have left 4 messages in the last 3 days trying to get a hold of a case manager, to avoid the previous almost month-long delays. It is absolutely ridiculous, unprofessional and stressful. Sun Life financial should be stripped of their licenses and removed from the insurance business. People need money when they are not working. Unbelievably horrible service from this company and I am appalled my company uses them for their insurance and benefits. I could go on all day about the bad experiences I've had with Sun Life. But this will have to do. If someone high up in Sun Life reads this on some off chance. There needs to be some changes

This is by far the worst company I have ever interacted with (in any industry, for anything).

They are currently charging me for vision insurance but do not have me in the system. Because they do not have me in the system, they say they can't be charging me. My paychecks say otherwise.

The customer service is slow, rude, and completely unknowledgeable.

They are inexpensive because in this case, you really do get what you pay for. The hours of time you spend trying to fix their mistakes is worth so much more than the money you "save". If you care about yourself, choose ANY other company.

My company use to use Manulife Financial, then they switched to Sun Life, no doubt to save a buck. Sun Life repeatedly seems to find ways to dissuade me from using my benefits. For example, twice now, they have told me that I needed a doctor's note in order to qualify for coverage of certain health services. Not knowing any better, I paid for a prescription. (not covered) I recently found out that my employer's plan with Sun Life does not require me to get a prescription. Now that I'm trying to get Sun Life to compensate me for the costs that I've incurred due to their misinformation, or should I call it "intentional dissuasion", they give me the run around. It's like they're trying to make it harder for me to use my health benefits. Furthermore, everytime I call them, I'm on hold for at least 15 minutes it seems. I'm not exaggerating. You can't email them without sending a "secure message" through their site. In order to see their reply, you have to log in to the site and view it.