Sun Life Group Benefits Insurance Reviews

Sun Life has unfortunately been the benefits and insurance provider for both my current and past employer. I have not had worse consistent customer service from any organization in my life, than Sun Life. Congrats - this is quite an honour. In summary... - Their website was designed in 1995 with hidden areas, cross-links, broken links. - Their phone system was developed shortly thereafter...disconnects, connects to the wrong dept., need to enter in your login and password multiple times, only to have to provide it to an agent, when they eventually answer - Escalating calls to a "manager" is a painful experience...don't expect someone to hear you or listen - Their benefits and financial services depts. don't talk to each other, can't help each other, which is a problem given they have a one-window access into both. - Sending a message on their system is like sending snail mail to Santa - expect no response, and if one comes, it's by next holiday season. - Benefits routinely incorrectly assessed. At least once per year for the last several years, I need to bring a manager in to fix the problem. I'm assuming that they are the lowest cost provider, which is why employers select them, however, the dismal experiences over so many years should scream to employers who care about their employers and their associated benefits to look somewhere else. Sun Life feels like a dinosaur who will eventually, at some point, go extinct.

My health insurance plan with Sun Life says 80% coverage for Orthodics which I have to wear in all my shoes and have to re-order every year since my condition worsens.
This year I ordered custom made orthodics that cost 500$. After submitting my first health claim of the year Sun Life rejected it with the classic excuse that somewhere in the contract buried with very small characters there is a limit of one orthodics every 24 months.
However, they never considered to post the same information on the website with my health plan.
Fact that I did not have any claims over the year was not an argument. Also, could not use any of the 100$/month I pay into my plan or to use the very advertised 'flex dollars'.
So now, just before Christmas I have to thank them for the 500$ debt in my account.
I feel like I was miserably robbed with no intend for help from anybody in this institution.
Unfortunately I cannot not choose my health insurance at work but I can witness how low this insurance company can go and how quick is to screw their customers.
I wanted to choose 0 stars value for money since this is what I got but unfortunately that doesn't work.

I provide a brief summary, as the various hoops I have had to jump through are many and mundane.

The company I work for transferred from a very solid and professional drug insurance firm to the godawful Sun Life Financial. Even though their presentations promised a smooth transfer, come first trip to the pharmacy after cut over day, find out that medication needs to be pre-approved prior to being filled. My medication is time dependent, so I had no choice but to pay out of pocket for the drugs. Then I had to chase my doctor for them to fill out forms again justifying the use of the drug and send to SLF. Doctor completed, the forms and faxed through. (What a waste of time for the doctor?!) I called SLF to confirm that everything was good and that I could submit my out of pocket claim and also on my next trip to the pharmacy would be without incident. I was promised everything was fine, a letter was received confirming my drug coverage. I arrived at the pharmacy - same thing. Refused by insurer. A call to the SLF resulted in being transferred 3 times over 45 minutes, about half as many times as I was offered to use their website to check my status - an obvious and painful delaying tactic, do they think people will give up and actually try their website? Its BS - does nothing, not customer interaction can be achieved from the site. I was eventually told the drug ID number they had on record was wrong and I would need my doctor to resend the drug approval - also I was told this was my fault? Turns out the drug has a different number in their system and the doctor and I should have known this and provided it. I am now two months out of pocket with my first paper claim rejected and back to square one. A very unsatisfactory company. Medical insurance companies are vampires to the system anyways, but Sun Life Financial are turning it into an art form.

I worked & paid in to their contracted plan for 21 yrs, using it for dental, prescriptions & glasses without any problems. A life changing disease made the Canadian Gov't deem me to be "totally & permanently disabled" & the Canadian gov't granted me CPP Dissability till age 65. Sun Life however refused to pay me LTD after only 2 yrs. Their contract said I was to be paid until age 65....but that is just a scam. I am very grateful to our gov't who approved my CPP Dissability claim. The gov't makes their medical evaluation & makes their decision & pays you a dependable amount each month until age 65. Sun Life is just one giant fraud. Sun Life really should be forced to close down since they never honour their contracts. Sun Life is an unreliable scam. Sun Life is a failure, who will never pay out. They harrass you constantly & close your file throughout your 2 yrs of LTD (causing emotional disstress). The gov't is way better than Sun Life.

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.

I had no choice but to choose Sun life since my company is tied up with them. I applied for Short Term Disability (STD) in January 2016 due to a mental illness I have (depression and anxiety). Could not work so needed time off, so I applied and submitted to Sun Life. Within 3 days they declined my claim saying it is not a physical injury that prevents me from working and further says I'm claiming money for personal reasons!

Being said, Sun Life thinks mental illness is a joke unless I have a disease or in physical pain. A huge disappointment coming from a large corporation to make this comment. And to think in Canada we raised 25 million dollars to research on the stigma on mental illness and Sun life thinks it's nothing. And to think I'm claiming money for personal reasons??

I spend more than $100 to complete this from only to be denied in 3 days. Worst insurance company ever, and now I have to force myself to return back to work with this illness.

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 made a claim to Sun Life since last August. We are now in April and I problably talked to one of their representants 3 or 4 times at most. The rest of the time, I was talking to answering machines and nothing else. And when they do answer your call, it is to tell you nothing else but lies and excuses for refusing to pay you. From what they told me, they can change their reglementations whenever they feel like it. Even their superintendant won't answer the phone! All they do is changing representant to make you feel they care... but it all comes down to a restart with no end. I truly am hoping my company will change insurance company. I am fedup being forced to give my money to those crooks!