Sun Life Group Benefits Insurance Reviews
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If your employer offers you this insurance either refuse it or see if they are willing to look into other insurance companies. I have 100% on prescriptions, but today I have spent over an hour in my pharmacy trying to find out if an IUD is covered by my benefits. It got to the point that my pharmacist had to sit on the phone and firstly explain what an IUD was and that there were non-hormonal and hormonal ones. .. He had to explain multiple times that because it was not hormonal it did not have a drug identification number. They attempted multiple times to tell me to just pay for the item and submit a claim to see if it was covered but luckily my pharmacist stood his ground and made Sun Life search their systems until they found the item (which they had previously told us either didn't exist or was too new and so wasn't in their system). In the end I was told that the item was not covered (which is frustrating) but I was told still to attempt to submit a claim, so it it covered or not?!
My pharmacist told me that he has made claims with Alberta Blue Cross and other companies for this IUD without any trouble. I don't know why I was surprised since every other medical claim I've made in the last year has been 'randomly' selected for auditing. AVOID AVOID AVOID
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...
Don't choose Sun Life. Very bad company. Sun Life collects money and tries to save on their expenses. I am working in health practitioner association and our association has many complaints from Sun Life members and their customers.
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 had extended healthcare coverage through my professional association which I paid thousands of dollars for over the years. Having had skin cancer 3 times, I decided to have a skin treatment advised by my skin specialist. The treatment was approved by Sun Life ahead of time but my claim was denied when submitted. They requested bogus information and talking with their customer rep didn't help. Having been ripped off by Sun Life I have cancelled my health plan. I would advise not doing business with this company as their conduct is dishonest.
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.
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
LTD benefits were offered through my employer. I almost DIED and Sun Life DENIED the benefits that were part of my benefit package through my employer. They used ONE sentence in ONE medical record that indicated my condition was "improving" (ie, no longer DYING) and they denied me based on that.
My "customer service representative" was a poor excuse for a human being and should be ashamed of herself for treating other human beings like that!
Ended up having to get an attorney to get what I was owed, and they still SUCK! If there is a holiday, they don't prepare in advance and get the checks cut early! Oh no, they wait until AFTER the holidays and just send your check LATE!
They should be shut down!